Health Scan: When donor gets a good sleep, stem-cell transplant goes better

The study was supported by the US National Institutes of Health and carried out in cooperation with Stanford University Medical Center.

By JUDY SIEGEL-ITZKOVICH
Updated: NOVEMBER 29, 2015 01:43
Sleep disorder (photo credit: INGIMAGE)
Sleep disorder
(photo credit: INGIMAGE)
When a donor gets an adequate amount of sleep, the success rate of the bone marrow donated for transplants to treat cancer dramatically increases, according to neuroimmunologist Assistant Prof. Asya Rolls of the Technion-Israel Institute of Technology.
Writing in a recent issue of the prestigious journal Nature Communication, she said that the “navigational ability” of stem cells to renew themselves and the patient’s immune system after they are injected in the body is much better if the cell donor gets a good night’s sleep. If the donor is not adequately rested, the success rate of the transplant drops by 50 percent, said Rolls, who did her work together with research student Ben Korin.
“Our study was conducted in mice, thus it is still too early to reach conclusions about humans.
Nevertheless, the study points to the importance of sleep in medical processes.” It is clear that for critical and especially complex processes like bone-marrow transplants, we must ensure that the donor sleeps well, even though this is not easy in a hospital environment, she added.
“The discovery offers optimism, as it’s not an impossible problem, and if we help the donor to sleep well, we can increase the chances for a successful transplant of hematopoietic stem cells from the bone marrow,” said Rolls. In an experiment that we did, it turned out that it was possible to enhance the relevant abilities needed by the donor by giving him or her only two hours of extra sleep.
The study was supported by the US National Institutes of Health and carried out in cooperation with Stanford University Medical Center.
CALMING THE SURGICAL PATIENT
Anxious patients heading into surgery often receive medication to ease their fears, but a few calming words from their physicians might actually be more effective medicine. “Conversational hypnosis,” as the approach is known, may do a better job than pills for relaxing patients before anesthesia and surgery, according to research presented at the recent Anesthesiology 2015 meeting in Chicago.
“The anesthesiologist uses calm, positive words to divert the patient’s attention and help him or her feel more comfortable,” said Dr. Emmanuel Boselli, lead author of the study and an anesthesiologist at Édouard Herriot Hospital in Lyons, France. “It reflects a change in the way the physician interacts with the patient, and takes just a few minutes.”
Researchers used conversational hypnosis, which consists of talking quietly and positively to the patient (“Keep calm and quiet” vs. “Please don’t move”) and focusing the patient’s attention on something other than the preparations for surgery and anesthesia procedure. They compared the results of hypnosis to the use of a standard medication called hydroxyzine, which is taken orally to relax patients before their procedure.
To measure the effects of both, they asked patients to provide a subjective measurement of their comfort on a scale ranging from 0 (no comfort) to 10 (maximal comfort). They also used an objective test called the Analgesia/Nociception Index (ANI), a 100-point index that is based on heart-rate variability.
When patients are extremely anxious and stressed, the ANI is zero and when they are completely relaxed, the ANI is 100.
In the study of 100 patients undergoing hand surgery, 50 had conversational hypnosis while being given regional anesthesia, and 50 were given 25 mg of oral hydroxyzine 30 minutes to an hour before the induction of anesthesia. Their levels of relaxation were assessed using the ANI as well as the comfort scale, both prior to and after receiving hypnosis or medication and anesthesia.
Patients measured an average ANI of 51 before and 78 after hypnosis, whereas those who had medication averaged 63 before and 70 after. The average comfort scale of those who had received hypnosis was 6.7 before and 9.3 after, while patients who had medication averaged 7.8 before and 8.3 after.
According to Boselli, the study suggests that conversational hypnosis might increase patient self-reported comfort during regional anesthesia without medication, and that this effect might be objectively monitored using the ANI. “Conversational hypnosis can be used prior to surgery in conscious patients having local or regional anesthesia,” Boselli concluded. “It also could be beneficial before general anesthesia to decrease patient anxiety.”