Cancer or its treatments may affect a person's sleep-wake cycle and cause changes in their usual sleeping patterns. Sleep problems, such as lack of sleep or feeling tired, can make coping with cancer more difficult and can make other symptoms seem worse.
Causes
Causes of sleep problems in people with cancer include:
- emotions
- feeling anxious or worrying about their situation
- depression
- grieving
- symptoms related to cancer
- fatigue
- night sweats
- pain
- nausea and vomiting
- shortness of breath
- having to urinate often (urinary frequency)
- side effects of treatments
- medications (pain-relievers, corticosteroids)
- environmental distractions
- light
- noise
- unfamiliar surroundings
Symptoms
People who are receiving cancer treatment may tire more easily and may need to sleep more than usual. Sometimes people can have a range of problems such as trouble falling asleep, not staying asleep, waking up early, feeling that sleep is not refreshing or even not being able to stay awake (called hypersomnia). Insomnia is the inability to fall asleep, to sleep well or get enough sleep and is the most common sleep problem reported by people with cancer.
Diagnosis
The healthcare team will ask questions about sleep to help assess sleep problems. Some of these include:
- How long does it take to fall asleep?
- Do you wake up after falling asleep?
- What is the total time spent asleep?
- Do you take daytime naps? When and for how long?
- Do you wake up feeling refreshed or tired?
- What is your energy level like?
- Are you using anything that may affect sleep, such as corticosteroids, pain-relievers (opioids), caffeine or alcohol?
- Are you taking any medications to help you sleep?
Prevention and management
Finding out the causes of sleep problems is the first step in treating them. For example, if pain is interfering with sleep, then it needs to be treated before sleep can be improved.
Measures can be taken to help with sleep:
- Try to keep a normal bedtime routine, but avoid sleeping all day. It is okay to take a nap, especially when having cancer treatment. Sometimes it is better to avoid daytime naps to help sleep at night.
- Go to bed only when sleepy.
- If possible, increase activity during the day and try to stay active or exercise a little each day.
- Drink warm, non-caffeinated drinks before sleep (such as warm milk) and avoid caffeinated drinks late in the day.
- Avoid drinking alcohol close to bedtime.
- Go to sleep in a quiet setting.
- Try relaxation exercises, listening to soothing music, darkening the room or massage before bed.
- Keep sheets clean, neatly tucked in and as free from wrinkles as possible.
- Have extra covers handy in case it gets cold.
- Talk about fears and concerns during the day to help decrease fear and free the mind at night, which can help with more peaceful sleep.
- Report symptoms, such as pain, that may be causing problems with sleep.
- Talk to the healthcare team about medications to help with sleep.
- Take medications for sleep, pain or other symptoms as prescribed before trying to sleep.