Help for sleep problems during cancer treatment

December 2, 2015 Providence Health Team

When you or a loved one is undergoing cancer treatment, sleep is very important. But it also can be elusive. If sleep wasn’t a problem before starting treatment, struggling with insomnia can increase the anxiety, stress and depression brought on by a cancer diagnosis.

There are a myriad of reasons why normal sleep patterns are interrupted during cancer treatment. The symptoms of cancer may include pain or discomfort, making it difficult to get comfortable. Chemotherapy drugs can make you feel tired and drowsy throughout the day, which can make it difficult to fall asleep at night. Sometimes other medications prescribed to combat the side effects of chemotherapy can derail sleep. For example, steroids often are prescribed to control nausea and vomiting from chemotherapy, but they also can make you feel energized.

What keeps you up?

Try to identify the cause of your sleep problems. Is it primarily stress and anxiety? Are you drinking caffeine to stay awake during the day? Taking certain medications before bed? Consider keeping a sleeping journal that charts your sleep habits, time of day you take medications and diet. A prescribed sleep medication may help you sleep through the night. However, there are also a number of things you can do to prepare your body and mind for a good night’s sleep.

Natural relaxation techniques

To help you achieve a deeper state of rest or divert thoughts that inhibit sleep, consider exploring relaxation techniques; most of these can be done at home. Don’t discount the classic folk remedy “counting sheep.” Research shows that it is, in fact, an effective technique to entice sleep.

Also consider trying these other techniques.

  • Meditation produces a deep state of relaxation and a tranquil mind. There are different types of meditation – some require deep breathing, while others call for visualization, chanting or silently repeating words or phrases.
  • Guided imagery, also known as guided meditation or visualization, helps you form mental images of places or situations you find relaxing. You can do this on your own or you can choose to be guided by an instructional CD or trained professional.
  • Cognitive refocusing involves replacing thoughts that cause your sleep problems with distractions. For example, try focusing your attention on a lit candle or other object to divert thoughts that interfere with sleep.
  • Progressive muscle relaxation works by slowly tensing and then relaxing each muscle group. Start at your toes, tensing your muscles for at least five seconds and then relaxing them for 30 seconds. Work your way up your body, applying the technique to each muscle group, including your head and neck.
  • Passive muscle relaxation requires that you identify tension in specific muscle groups and use statements such as "let the muscle become limp, loose or heavy." You can do this in place of progressive muscle relaxation if it’s painful to tense and release muscle groups.
  • Hypnosis is similar to guided imagery. However, a physician or licensed hypnotherapist would be needed to induce deep relaxation.

Here are a number of other things that can help you fall asleep and stay that way through the night.

  • Don’t eat or exercise within two hours of bedtime.
  • Ask your health care provider if you are taking your medications at the right times of the day. 
  • Keep a consistent sleep schedule. Make sure you go to bed each night and wake up each morning at the same time.
  • Minimize daytime naps. If you must take a nap, do not sleep for more than an hour at a time.
  • If you’re drinking a lot of caffeine, try to slowly cut down and avoid drinking caffeine in the evening. 
  • Don’t read or watch TV in bed and turn illuminated faces of clocks or handheld devices away from the bed to ensure the room is dark.

Daytime exercise is important

Exercise can help relieve stress, improve your mood and keep you awake during the day. If it's OK with your doctor, try mild to moderate exercise. For example, take a 20-minute walk most days of the week. You might also try yoga or stretching. A 2014 study by the American Society of Clinical Oncology found that breast cancer patients undergoing radiation experienced less fatigue and other side effects after adding yoga to their routine.

Talk to your provider

This information is meant to be helpful and educational, but it’s not a substitute for medical advice. Let your health care provider know if you have unrelieved pain, anxiety or depression that is causing difficulty sleeping, or if you continue to have sleep problems despite trying different sleep management techniques and strategies.

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