Sleeplessness and cancer

Thursday 17 May 2018

'Insomnia - being up to see the sunrise, and realise you haven鈥檛 been asleep yet'.

If you, or someone you care about, has cancer - you may be having trouble sleeping. Insomnia can be bad enough when life is cancer free. It can feel even worse if your days are filled with work, family, appointments, treatments, etc. For those of you living daily with cancer, at whatever stage, a good night's sleep can feel restorative, and help you face another day.

I googled 鈥榠nsomnia鈥, and found over 84,900,000 results. It seems like it is a big and universal problem. 鈥業nsomnia鈥 is a clinical term for people who have trouble falling asleep, difficulty staying asleep, waking too early in the morning, or waking up feeling unrefreshed. More than 30% of the population suffers from insomnia.

Symptoms you may recognise:

(from NHS website)

  • find it hard to go to sleep
  • wake up several times during the night
  • lie awake at night
  • wake up early and cannot go back to sleep
  • still feel tired after waking up
  • find it hard to nap during the day even though you're tired
  • feel tired and irritable during the day
  • find it difficult to concentrate during the day because you're tired聽

Causes of sleeplessness

Cancer and its treatments can cause disturbed sleep - sometimes because of symptoms. These may include having to get up to the toilet frequently, hot flushes and night sweats, steroid medications, and/or pain.

It's also at night time that anxiety and worries play on the mind more. 聽It could be the big things, the 'what if ' questions, and emotional turmoil about an uncertain future. Financial concerns, practical issues, work and family problems - often loom larger in the middle of the night.

Tips to help get a good night's sleep

There is a plethora of advice about how to get a good night鈥檚 rest鈥nd seasoned insomniacs among you may well have other tips to offer. Here is a list I have adapted from various websites (drawing together the main suggestions)

  • It helps to establish a regular, relaxing bedtime routine. Avoid stimulants like coffee, chocolate, and nicotine before going to sleep, and never watch TV, use the computer, smartphone, or pay bills before going to bed. Read a book, listen to soft music, or meditate instead.
  • Avoid alcohol - It鈥檚 tempting to think alcohol will help you sleep, but as it鈥檚 a stimulant, it tends to help keep you awake.
  • Don't eat a big meal or spicy foods just before bedtime. A small snack containing tryptophan (a natural sleep-promoting amino acid) may help, such as turkey, banana or fish. (NHS Choices webpage on Insomnia)
  • Only go to bed when you鈥檙e tired. It鈥檚 tempting to just doze on the settee, but if you鈥檙e feeling that level of relaxation, it鈥檚 worth stirring, and going to bed.
  • Try to make your bedroom is cool, dark, and quiet. I know it sounds common sense, but have comfortable bedding and pillows, and if you wear nightwear, ensure they're loose fitting.
  • 聽Avoid looking at the clock (easier said than done) - turn it away from you, if you can.
  • 聽Worrying can be the big issue. Keep a notepad by the bed. Write the worries down, and close the pad. They can be revisited in the morning if necessary.
  • Don鈥檛 lay there getting more anxious and cross about it. If you can鈥檛 get to sleep, or are awake in the middle of the night, get up, go into another room, maybe read, or do a crossword, or listen to some music. Tell yourself it doesn鈥檛 matter, and stay there for at least half an hour, before returning to bed.
  • An eye mask and ear plugs can be helpful, if outside light and noise is an issue.
  • Don't use the bedroom for anything other than sleeping or sex. Tempting as it is, don't watch television, fiddle about with your laptop, eat, or text. Switch off the electronics.
  • Try not to 鈥榓ngst鈥 about the night鈥檚 loss of sleep. Sometimes it鈥檚 a case of accept it鈥檚 a 鈥榥o sleep鈥 night, and tomorrow night will be better, as you鈥檒l be more tired. Getting stressed about it, just adds to the frustration (and sleeplessness).

When to see further help

If you鈥檙e not sleeping, and it鈥檚 becoming an issue, it is worth going to see your GP to talk things through. Short term sleep medication is sometimes helpful, but isn鈥檛 a good long term solution. Doctors are often understandably reluctant to prescribe sleeping tablets. They may suggest a low dose sleeping tablet, for a minimal length of time, as it doesn鈥檛 fix the long term issues.

Talk through your difficulties in sleeping with your specialist hospital team - it may be that your medications can be part of the cause. Steroids, for example, can cause some difficulty getting to sleep at night. If it鈥檚 cancer symptoms, pain, discomfort, indigestion etc, then mention these to your GP, consultant, or specialist nurse. Symptoms can be checked out, and efforts made to help you be more comfortable so you can sleep.

You can buy 'over the counter' remedies to help with sleep, but it always wisest to check with your GP or pharmacist if you're on any other medications which they might interfere with. Many of the herbal tablets are based around Valerian - it is frequently combined with hops, lemon balm, or other herbs that also cause drowsiness. I've read that it's better if you take them for 2 -3 weeks continuously, rather than occasionally. (Royal College of Psychiatrist's webpage on 'Sleeping Well')

Some 鈥榦ver the counter鈥櫬爉edications contain anti-histamines. The side effect of anti-histamines is drowsiness. It therefore follows that if you take them, 聽you need to be careful about the effects lasting into the following morning. They can also leave you with a dry mouth and throat, and can clash with some of your other medications, so do check.

Meanwhile, If you live near one of our Maggie鈥檚 Centres, you鈥檇 be welcome to drop in and talk about your difficulties sleeping.聽Some of our 澳门彩开奖 Centres hold sleep workshops. Talking about the underlying issues, learning some relaxation skills and stress management, can ease the emotional burden which may be contributing to the restless nights.

Finally, I鈥檝e added some links at the end of my blog, here which you may find useful. Let us know what works for you,

Warm wishes


Blog updated -聽 April 2020


Sleep and cancer聽 聽 聽澳门彩开奖

- 聽Macmillan Cancer Support

鈥 Anxiety and Depression association of America

- 聽Cancer.Net


聽 - 聽 Breast Cancer Now

聽聽聽聽- Royal College of Psychiatrists

聽 聽 - 聽National Cancer Institute

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