An observational study of insomnia and nightmare treated with trazodone in patients with advanced cancer

Am J Hosp Palliat Care. 2013 Jun;30(4):359-62. doi: 10.1177/1049909112452334. Epub 2012 Jul 9.


Patients with cancer often experience insomnia. Nightmares are also a strong factor that interferes with the maintenance of comfortable and satisfying sleep. However, the prevalence and standard treatment of nightmares in patients with cancer have not been established yet. We aimed to treat insomnia and nightmares with trazodone. From 2008 to 2011, trazodone was prescribed to 30 patients with cancer who reported experiencing insomnia with or without nightmares to the palliative care team in Osaka University Hospital. Effective treatment was seen in 15 patients (50%). Four patients with cancer reported having severe nightmares and 2 patients had beneficial effects, with frightening dreams transformed into acceptable ones. Trazodone may be an effective drug for the treatment of insomnia and nightmares in patients with advanced cancer.

Keywords: antidepressant; cancer patients; hypnotics; insomnia; nightmare; sleep avoidance; trazodone.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antidepressive Agents, Second-Generation / administration & dosage
  • Antidepressive Agents, Second-Generation / therapeutic use
  • Dreams / drug effects*
  • Female
  • Humans
  • Hypnotics and Sedatives / administration & dosage
  • Hypnotics and Sedatives / therapeutic use
  • Japan
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Neoplasms / drug therapy
  • Observation
  • Palliative Care / methods*
  • Sleep / drug effects*
  • Sleep Initiation and Maintenance Disorders / drug therapy*
  • Sleep Initiation and Maintenance Disorders / etiology
  • Trazodone / administration & dosage
  • Trazodone / therapeutic use*
  • Treatment Outcome


  • Antidepressive Agents, Second-Generation
  • Hypnotics and Sedatives
  • Trazodone