Sleep, accounting for roughly one-third of a person’s life, plays an important role in human health. Despite the close association between sleep patterns and medical diseases proven by several studies, it has been neglected in recent years. Presently, all societies are facing the most challenging health-threatening disease, cancer. Among all cancer types, gastrointestinal (GI) cancers, especially colorectal type, seem to be one of the most relevant to an individual’s lifestyle; thus, they can be prevented by modifying behaviors most of the time. Previous studies have shown that disruption of the 24-h sleep–wake cycle increases the chance of colorectal cancer, which can be due to exposure to artificial light at night and some complex genetic and hormone-mediated mechanisms. There has also been some evidence showing the possible associations between other aspects of sleep such as sleep duration or some sleep disorders and GI cancer risk. This review brings some information together and presents a detailed discussion of the possible role of sleep patterns in GI malignancy initiation.
VineisPWildCP.Global cancer patterns: causes and prevention. Lancet2014; 383: 549–557.
2.
ZhangSSunKZhengR, et al. Cancer incidence and mortality in China, 2015. J Natl Cancer Center2021; 1: 2–11.
3.
BrayFFerlayJSoerjomataramI, et al. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin2018; 68: 394–424.
4.
BrustugunOMøllerBHellandÅ.Years of life lost as a measure of cancer burden on a national level. Br J Cancer2014; 111: 1014–1020.
5.
SungHFerlayJSiegelRL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin2021; 71: 209–249.
6.
ScherüblH.Alcohol use and gastrointestinal cancer risk. Visceral Med2020; 36: 175–181.
7.
Mysuru ShivannaLUroojA. A review on dietary and non-dietary risk factors associated with gastrointestinal cancer. J Gastrointestinal Cancer2016; 47: 247–254.
8.
DonohoeCPidgeonGLysaghtJ, et al. Obesity and gastrointestinal cancer. J Br Surg2010; 97: 628–642.
9.
AmihăeseiICMungiuO.Main neuroendocrine features and therapy in primary sleep troubles. Rev Med Chir Soc Med Nat Iasi2012; 116: 862–866.
10.
TufikSAndersenMLBittencourtLR, et al. Paradoxical sleep deprivation: neurochemical, hormonal and behavioral alterations. Evidence from 30 years of research. An Acad Bras Cienc2009; 81: 521–538.
11.
WangFBíróÉ.Determinants of sleep quality in college students: a literature review. Explore2021; 17: 170–177.
12.
Martínez-de-QuelÓSuárez-IglesiasDLópez-FloresM, et al. Physical activity, dietary habits and sleep quality before and during COVID-19 lockdown: a longitudinal study. Appetite2021; 158:105019.
13.
ZhaoXZhangTLiB, et al. Job-related factors associated with changes in sleep quality among healthcare workers screening for 2019 novel coronavirus infection: a longitudinal study. Sleep Medicine2020; 75: 21–26.
14.
MiyamotoM.Pharmacology of ramelteon, a selective MT1/MT2 receptor agonist: a novel therapeutic drug for sleep disorders. CNS Neurosci Ther2009; 15: 32–51.
MorganLHamptonSGibbsM, et al. Circadian aspects of postprandial metabolism. Chronobiol Int2003; 20: 795–808.
22.
KarlssonBKnutssonALindahlB.Is there an association between shift work and having a metabolic syndrome? Results from a population based study of 27 485 people. Occup Environ Med2001; 58: 747–752.
23.
LuojusMKLehtoSMTolmunenT, et al. Sleep duration and incidence of lung cancer in ageing men. BMC Public Health2014; 14: 1–7.
24.
ZhangXGiovannucciELWuK, et al. Associations of self-reported sleep duration and snoring with colorectal cancer risk in men and women. Sleep. 2013; 36: 681–688.
25.
JiaoLDuanZSangi-HaghpeykarH, et al. Sleep duration and incidence of colorectal cancer in postmenopausal women. Br J Cancer2013; 108: 213–221.
26.
WardEMGermolecDKogevinasM, et al. Carcinogenicity of night shift work. Lancet Oncol2019; 20:1058–1059.
27.
IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. Painting, firefighting, and shiftwork. IARC Monogr Eval Carcinog Risks Hum2010; 98:9–764.
28.
StraifKBaanRGrosseY, et al. Carcinogenicity of shift-work, painting, and fire-fighting. Lancet Oncol8(12): 1065–1066.
29.
HeckmanCJKlossJDFeskanichD, et al. Associations among rotating night shift work, sleep and skin cancer in Nurses’ Health Study II participants. Occup Environ Med2017; 74: 169–175.
30.
AlbrechtU.Timing to perfection: the biology of central and peripheral circadian clocks. Neuron2012; 74: 246–260.
31.
SchiblerU.Circadian time keeping: the daily ups and downs of genes, cells, and organisms. Progr Brain Res2006; 153: 271–282.
32.
ReppertSMWeaverDR.Coordination of circadian timing in mammals. Nature2002; 418: 935–941.
33.
StorchK-FLipanOLeykinI, et al. Extensive and divergent circadian gene expression in liver and heart. Nature2002; 417: 78–83.
34.
ReppertSMWeaverDR.Molecular analysis of mammalian circadian rhythms. Ann Rev Physiol2001; 63:647–676.
35.
LucasRJPeirsonSNBersonDM, et al. Measuring and using light in the melanopsin age. Trends Neurosci2014; 37: 1–9.
36.
TonsfeldtKJChappellPE.Clocks on top: the role of the circadian clock in the hypothalamic and pituitary regulation of endocrine physiology. Mol Cell Endocrinol2012; 349: 3–12.
37.
DamiolaFLe MinhNPreitnerN, et al. Restricted feeding uncouples circadian oscillators in peripheral tissues from the central pacemaker in the suprachiasmatic nucleus. Genes Dev2000; 14: 2950–2961.
38.
YagitaKTamaniniFVan der HorstGT, et al. Molecular mechanisms of the biological clock in cultured fibroblasts. Science2001; 292: 278–281.
39.
PandoMPMorseDCermakianN, et al. Phenotypic rescue of a peripheral clock genetic defect via SCN hierarchical dominance. Cell2002; 110: 107–117.
40.
SchiblerU.The daily up and down of genes, cells and organisms. Proc Indian Natl Sci Acad Part B2005; 71: 257.
41.
KingDPZhaoYSangoramAM, et al. Positional cloning of the mouse circadian clock gene. Cell1997; 89: 641–653.
42.
GekakisNStaknisDNguyenHB, et al. Role of the CLOCK protein in the mammalian circadian mechanism. Science1998; 280: 1564–1569.
43.
HogeneschJBGuY-ZJainS, et al. The basic-helix–loop–helix-PAS orphan MOP3 forms transcriptionally active complexes with circadian and hypoxia factors. Proc Natl Acad Sci USA1998; 95: 5474–5479.
44.
BungerMKWilsbacherLDMoranSM, et al. Mop3 is an essential component of the master circadian pacemaker in mammals. Cell2000; 103: 1009–1017.
45.
KumeKZylkaMJSriramS, et al. mCRY1 and mCRY2 are essential components of the negative limb of the circadian clock feedback loop. Cell1999; 98: 193–205.
46.
VitaternaMHSelbyCPTodoT, et al. Differential regulation of mammalian period genes and circadian rhythmicity by cryptochromes 1 and 2. Proc Natl Acad Sci USA1999; 96: 12114–12119.
47.
OkamuraHMiyakeSSumiY, et al. Photic induction of mPer1 and mPer2 in cry-deficient mice lacking a biological clock. Science1999; 286: 2531–2534.
48.
ShearmanLPSriramSWeaverDR, et al. Interacting molecular loops in the mammalian circadian clock. Science2000; 288: 1013–1019.
49.
PreitnerNDamiolaFZakanyJ, et al. The orphan nuclear receptor REV-ERBα controls circadian transcription within the positive limb of the mammalian circadian oscillator. Cell2002; 110: 251–260.
50.
UedaHRChenWAdachiA, et al. A transcription factor response element for gene expression during circadian night. Nature2002; 418: 534–539.
51.
YuWNomuraMIkedaM.Interactivating feedback loops within the mammalian clock: BMAL1 is negatively autoregulated and upregulated by CRY1, CRY2, and PER2. Biochem Biophys Res Commun2002; 290: 933–941.
52.
HausESmolenskyMH.Biologic rhythms in the immune system. Chronobiol Internat1999; 16: 581–622.
53.
DuffyJFCainSWChangA-M, et al. Sex difference in the near-24-hour intrinsic period of the human circadian timing system. Proceed Natl Acad Sci USA2011; 108: 15602–15608.
54.
BurgessHJEastmanCI.Human tau in an ultradian light–dark cycle. J Biol Rhythms2008; 23: 374–376.
55.
CzeislerCADuffyJFShanahanTL, et al. Stability, precision, and near-24-hour period of the human circadian pacemaker. Science1999; 284: 2177–2181.
56.
TouitouYCosteODispersynG, et al. Disruption of the circadian system by environmental factors: effects of hypoxia, magnetic fields and general anesthetics agents. Adv Drug Delivery Rev2010; 62: 928–945.
57.
StevensRGHansenJCostaG, et al. Considerations of circadian impact for defining ‘shift work’in cancer studies: IARC Working Group Report. Occup Environ Med2011; 68: 154–162.
58.
SchernhammerESLadenFSpeizerFE, et al. Night-shift work and risk of colorectal cancer in the nurses’ health study. J Natl Cancer Inst2003; 95: 825–828.
59.
TouitouYReinbergATouitouD.Association between light at night, melatonin secretion, sleep deprivation, and the internal clock: health impacts and mechanisms of circadian disruption. Life Sci2017; 173: 94–106.
60.
TosiniGBertolucciCFoàA.The circadian system of reptiles: a multioscillatory and multiphotoreceptive system. Physiol Behav2001; 72: 461–471.
61.
HrusheskyWJ.The Temporal Organization of Life: the Impact of Multi-frequency non-linear biologic time structure upon the host–cancer balance. Jpn J Clin Oncol2000; 30: 529–533.
62.
SulliGLamMTYPandaS.Interplay between circadian clock and cancer: new frontiers for cancer treatment. Trends Cancer2019; 5: 475–494.
63.
ShafiAAKnudsenKE.Cancer and the circadian clock. Cancer Res2019; 79: 3806–3814.
64.
WangYQianRSunN, et al. Circadian gene hClock enhances proliferation and inhibits apoptosis of human colorectal carcinoma cells in vitro and in vivo. Mol Med Rep2015; 11: 4204–4210.
65.
KarantanosTTheodoropoulosGPektasidesD, et al. Clock genes: their role in colorectal cancer. World J Gastroenterol2014; 20: 1986.
66.
WoodPAYangXTaberA, et al. Period 2 mutation accelerates ApcMin/+tumorigenesis. Mol Cancer Res2008; 6: 1786–1793.
67.
WangYHuaLLuC, et al. Expression of circadian clock gene human Period2 (hPer2) in human colorectal carcinoma. World J Surg Oncol2011; 9: 1–8.
68.
HuM-LYehK-TLinP-M, et al. Deregulated expression of circadian clock genes in gastric cancer. BMC Gastroenterol. 2014; 14: 1–8.
69.
ZhaoHZengZ-LYangJ, et al. Prognostic relevance of Period1 (Per1) and Period2 (Per2) expression in human gastric cancer. Int J Clin Exp Pathol2014; 7: 619.
70.
OshimaTTakenoshitaSAkaikeM, et al. Expression of circadian genes correlates with liver metastasis and outcomes in colorectal cancer. Oncol Rep2011; 25: 1439–1446.
71.
YuHMengXWuJ, et al. Cryptochrome 1 overexpression correlates with tumor progression and poor prognosis in patients with colorectal cancer. PLoS One2013; 8: e61679.
72.
SuHHuNYangHH, et al. Global gene expression profiling and validation in esophageal squamous cell carcinoma and its association with clinical phenotypes. Clin Cancer Res2011; 17: 2955–2966.
73.
HuNCliffordRJYangHH, et al. Genome wide analysis of DNA copy number neutral loss of heterozygosity (CNNLOH) and its relation to gene expression in esophageal squamous cell carcinoma. BMC Genomics2010; 11: 1–11.
74.
Strambio-De-CastilliaCNiepelMRoutMP.The nuclear pore complex: bridging nuclear transport and gene regulation. Nat Rev Mol Cell Biol2010; 11: 490–501.
75.
SiddiquiNBordenKL.mRNA export and cancer. Wiley Interdiscip Rev2012; 3: 13–25.
76.
OdoMKohKTakadaT, et al. Changes in circadian rhythm for mRNA expression of melatonin 1A and 1B receptors in the hypothalamus under a neuropathic pain-like state. Synapse2014; 68: 153–158.
77.
MarcheseFPRaimondiIHuarteM.The multidimensional mechanisms of long noncoding RNA function. Genome Biol2017; 18: 1–13.
78.
RayIGoswamiS.Circadian rhythm genes in cancer: insight into their functions and regulation involving noncoding RNAs. Chronobiol Int2021; 38: 1231–1243.
79.
MosallayiMMirzaeiHSimonianM, et al. Next-generation sequencing and its applications. J Isfahan Med School2016; 33(368): 2469–2480.
80.
MoridikiaAMirzaeiHSahebkarA, et al. MicroRNAs: potential candidates for diagnosis and treatment of colorectal cancer. J Cell Physiol2018; 233: 901–913.
81.
FathullahzadehSMirzaeiHHonardoostM, et al. Circulating microRNA-192 as a diagnostic biomarker in human chronic lymphocytic leukemia. Cancer Gene Ther2016; 23: 327–332.
82.
SaadatpourLFadaeeEFadaeiS, et al. Glioblastoma: exosome and microRNA as novel diagnosis biomarkers. Cancer Gene Ther2016; 23: 415–418.
83.
Martín-SuberoJIEstellerM.Epigenetic mechanisms in cancer development. In: ColemanWBTsongalisGJ (eds) The molecular basis of human cancer. New York, NY: Humana Press, 2017, pp. 263–275.
84.
TrangPWeidhaasJBSlackFJ.MicroRNAs and cancer. In: ColemanWBTsongalisGJ (eds) The molecular basis of human cancer. New York, NY: Humana Press, 2017, pp. 277–286.
85.
YangQZhangCHuangB, et al. Downregulation of microRNA-206 is a potent prognostic marker for patients with gastric cancer. Eur J Gastroenterol Hepatol2013; 25: 953–957.
86.
NagelRClijstersLAgamiR.The miRNA-192/194 cluster regulates the Period gene family and the circadian clock. FEBS J. 2009; 276: 5447–5455.
87.
HasakovaKReisRVicianM, et al. Expression of miR-34a-5p is up-regulated in human colorectal cancer and correlates with survival and clock gene PER2 expression. PLoS One. 2019; 14: e0224396.
88.
WuSFeslerAJuJ.Implications of circadian rhythm regulation by microRNAs in colorectal cancer. Cancer Transl Med2016; 2: 1.
89.
GarufiCGiacominiETorselloA, et al. Gender effects of single nucleotide polymorphisms and miRNAs targeting clock-genes in metastatic colorectal cancer patients (mCRC). Sci Rep2016; 6: 1–8.
90.
MazzoccoliGColangeloTPanzaA, et al. Analysis of clock gene–miRNA correlation networks reveals candidate drivers in colorectal cancer. Oncotarget2016; 7: 45444.
91.
KochanDZKovalchukO.Circadian disruption and breast cancer: an epigenetic link?Oncotarget2015; 6: 16866.
92.
RoscoeJAKaufmanMEMatteson-RusbySE, et al. Cancer-related fatigue and sleep disorders. Oncologist2007; 12: 35–42.
93.
ThompsonCLLarkinEKPatelS, et al. Short duration of sleep increases risk of colorectal adenoma. Cancer2011; 117: 841–847.
94.
ChenYTanFWeiL, et al. Sleep duration and the risk of cancer: a systematic review and meta-analysis including dose–response relationship. BMC Cancer2018; 18: 1–13.
95.
PapantoniouKCastaño-VinyalsGEspinosaA, et al. Sleep duration and napping in relation to colorectal and gastric cancer in the MCC-Spain study. Sci Rep2021; 11: 1–14.
96.
TitovaOEMichaëlssonKVithayathilM, et al. Sleep duration and risk of overall and 22 site-specific cancers: a Mendelian randomization study. Int J Cancer2021; 148: 914–920.
97.
ChenPWangCSongQ, et al. Impacts of sleep duration and snoring on the risk of esophageal squamous cell carcinoma. J Cancer2019; 10: 1968.
98.
FritschiLGlassDHeyworthJ, et al. Hypotheses for mechanisms linking shiftwork and cancer. Med Hypotheses2011; 77: 430–436.
99.
BlaskDE.Melatonin, sleep disturbance and cancer risk. Sleep Med Rev2009; 13: 257–264.
100.
BollingerTBollingerAOsterH, et al. Sleep, immunity, and circadian clocks: a mechanistic model. Gerontology2010; 56: 574–580.
101.
PatelSRZhuXStorfer-IsserA, et al. Sleep duration and biomarkers of inflammation. Sleep2009; 32: 200–204.
102.
AntonovaLAronsonKMuellerCR.Stress and breast cancer: from epidemiology to molecular biology. Breast Cancer Res2011; 13: 1–15.
103.
LochanRDalyAReevesH, et al. Family history of cancer and tobacco exposure in index cases of pancreatic ductal adenocarcinoma. J Oncol2011; 2011: 215985.
104.
BassettiCLAAdamantidisABurdakovD, et al. Narcolepsy – clinical spectrum, aetiopathophysiology, diagnosis and treatment. Nat Rev Neurol2019; 15: 519–539.
DauvilliersYArnulfIMignotE.Narcolepsy with cataplexy. Lancet2007; 369: 499–511.
107.
MohammadiSMayeliMSaghazadehA, et al. Cytokines in narcolepsy: a systematic review and meta-analysis. Cytokine2020; 131: 155103.
108.
JennumPPickeringLThorstensenEW, et al. Morbidity of childhood onset narcolepsy: a controlled national study. Sleep Med2017; 29: 13–17.
109.
TsengC-MChenY-TTaoC-W, et al. Adult narcoleptic patients have increased risk of cancer: a nationwide population-based study. Cancer Epidemiol2015; 39: 793–797.
110.
RogersAMeehanJGuilleminaultC, et al. HLA DR15 (DR2) and DQB1*0602 typing studies in 188 narcoleptic patients with cataplexy. Neurology1997; 48: 1550–1556.
111.
QuinteroEPizarroMARodrigoL, et al. Association of Helicobacter pylori-related Distal Gastric Cancer with the HLA Class II Gene DQB1*0602 and cagA+ Strains in a Southern European population. Helicobacter2005; 10: 12–21.
112.
Cvetkovic-LopesVBayerLDorsazS, et al. Elevated tribbles homolog 2-specific antibody levels in narcolepsy patients. J Clin Invest2010; 120: 713–719.
113.
FranksALSlanskyJE.Multiple associations between a broad spectrum of autoimmune diseases, chronic inflammatory diseases and cancer. Anticancer Res2012; 32: 1119–1136.
114.
van der Horst-BruinsmaIEVisserHHazesJMW, et al. HLA-DQ-associated predisposition to and dominant HLA-DR-associated protection against rheumatoid arthritis. Human Immunol1999; 60: 152–158.
115.
MignotEHaydukRBlackJ, et al. HLA DQB1*0602 is associated with cataplexy in 509 narcoleptic patients. Sleep1997; 20: 1012–1020.
116.
SingalDBlajchmanM.Histocompatibility (HL-A) antigens, lymphocytotoxic antibodies and tissue antibodies in patients with diabetes mellitus. Diabetes1973; 22: 429–432.
117.
FranklinKASahlinCStenlundH, et al. Sleep apnoea is a common occurrence in females. Eur Respir J2013; 41: 610–615.
118.
BenjafieldAVAyasNTEastwoodPR, et al. Estimation of the global prevalence and burden of obstructive sleep apnoea: a literature-based analysis. Lancet Respir Med2019; 7: 687–698.
119.
DurganDJBryanRMJr. Cerebrovascular consequences of obstructive sleep apnea. J Am Heart Assoc2012; 1: e000091.
120.
HungJWhitfordEHillmanD, et al. Association of sleep apnoea with myocardial infarction in men. Lancet1990; 336: 261–264.
121.
SillahAWatsonNFSchwartzSM, et al. Sleep apnea and subsequent cancer incidence. Cancer Causes & Control. 2018; 29: 987–994.
122.
FangH-FMiaoN-FChenC-D, et al. Risk of cancer in patients with insomnia, parasomnia, and obstructive sleep apnea: a nationwide nested case-control study. J Cancer2015; 6: 1140.
123.
MarshallNSWongKKCullenSR, et al. Sleep apnea and 20-year follow-up for all-cause mortality, stroke, and cancer incidence and mortality in the Busselton Health Study cohort. J Clin Sleep Med2014; 10: 355–362.
124.
ChristensenASClarkASaloP, et al. Symptoms of sleep disordered breathing and risk of cancer: a prospective cohort study. Sleep2013; 36: 1429–1435.
125.
Campos-RodriguezFMartinez-GarciaMAMartinezM, et al. Association between obstructive sleep apnea and cancer incidence in a large multicenter Spanish cohort. Am J Respir Crit Care Med2013; 187: 99–105.
126.
GozalDHamSAMokhlesiB.Sleep apnea and cancer: analysis of a nationwide population sample. Sleep2016; 39: 1493–1500.
127.
KendzerskaTLeungRSHawkerG, et al. Obstructive sleep apnea and the prevalence and incidence of cancer. CMAJ2014; 186: 985–992.
128.
ChenC-YHuJ-MShenC-J, et al. Increased incidence of colorectal cancer with obstructive sleep apnea: a nationwide population-based cohort study. Sleep Med2020; 66: 15–20.
129.
BrennerRKivitySPekerM, et al. Increased risk for cancer in young patients with severe obstructive sleep apnea. Respiration2019; 97: 15–23.
130.
LeeSKimBGKimJW, et al. Obstructive sleep apnea is associated with an increased risk of colorectal neoplasia. Gastrointest Endosc2017; 85: 568–573.e561.
131.
AlmendrosIMontserratJMRamírezJ, et al. Intermittent hypoxia enhances cancer progression in a mouse model of sleep apnoea. Eur Respir J2012; 39: 215–217.
132.
MartinezCAKerrBJinC, et al. Obstructive sleep apnea activates HIF-1 in a hypoxia dose-dependent manner in HCT116 colorectal carcinoma cells. Int J Mol Sci2019; 20: 445.
133.
CookKMFiggWD.Angiogenesis inhibitors: current strategies and future prospects. CA Cancer J Clin2010; 60: 222–243.
134.
YuenVWWongCC.Hypoxia-inducible factors and innate immunity in liver cancer. J Clin Invest2020; 130: 5052–5062.
135.
BhaskarSHemavathyDPrasadS.Prevalence of chronic insomnia in adult patients and its correlation with medical comorbidities. J Family Med Primary Care2016; 5: 780.
136.
Van SomerenEJ. Brain mechanisms of insomnia: new perspectives on causes and consequences. Physiol Rev2021; 101: 995–1046.
137.
SulsJGreenPADavidsonKW.A biobehavioral framework to address the emerging challenge of multi-morbidity. Psychosomatic Med2016; 78: 281.
138.
BuysseDJ. Insomnia. JAMA2013; 309: 706–716.
139.
ShiTMinMSunC, et al. Does insomnia predict a high risk of cancer? A systematic review and meta-analysis of cohort studies. J Sleep Res2020; 29: e12876.
140.
LinC-LLiuT-CWangY-N, et al. The association between sleep disorders and the risk of colorectal cancer in patients: a population-based nested case–control study. In Vivo2019; 33: 573–579.
141.
HausELSmolenskyMH.Shift work and cancer risk: potential mechanistic roles of circadian disruption, light at night, and sleep deprivation. Sleep Med Rev2013; 17: 273–284.
142.
MazzoccoliGTarquiniRDurfortT, et al. Chronodisruption in lung cancer and possible therapeutic approaches. Biomed Pharmacother2011; 65: 500–508.
