Cancer treatments – including chemotherapy, radiation and surgery – can affect how well you sleep. Sandy Pyle, RN, an oncology nurse navigator at the Loran Smith Center for Cancer Support at Piedmont Athens Regional, explains how treatment can disrupt your sleep and shares advice for getting a better night’s rest.
“We all have nights where we have trouble sleeping, but sleep disorders don’t affect a large portion of the population,” says Pyle. “However, about 50% of people with cancer experience insomnia during treatment. That’s pretty significant.”
How cancer treatments affect sleep
“Medications given during chemotherapy can have a big impact on sleep,” she says. “Patients are often given medication before they get chemotherapy to help reduce the side effects of the chemo. Some of the drugs make you sleepy; others, like steroids, can cause insomnia. Radiation can cause severe fatigue and surgery can cause many different side effects that affect sleep, particularly pain.”
The treatments can also cause nausea, constipation and diarrhea, making it hard to sleep, Pyle adds.
There’s also a mental health component.
“The worry and stress of cancer can cause insomnia,” she says. “Even after treatment is done, people may be concerned about recurrence, and that stress can impact their sleep as well.”
How long-term cancer treatment side effects impact sleep
“It takes a while for the body to recover from treatment,” says Pyle. “Radiation and chemotherapy all have lasting effects. Depending on what your treatment is, it can affect your sleep down the road.”
She also notes that most breast and prostate cancers are driven by hormones, and these patients are put on hormone-blocking therapies that can cause insomnia.
Sleep is essential for cancer recovery
“We cannot live if we don’t get an adequate amount of sleep,” she says. “During the sleep cycle, all of our hormones are at work. We need good sleep for healthy bone marrow, blood cells and immune system function.”
Lack of sleep can also affect your weight.
“We know that being at a healthy weight is a big part of cancer prevention and recovery,” says Pyle. “There are hormones that increase and suppress hunger. If we don’t get enough sleep, both of those hormones can be impacted, and that will make us hungry and overeat.”
How to sleep better during cancer treatment
If you’re having trouble sleeping during or after cancer treatment, Pyle recommends talking to your physician. They can recommend treatment options or lifestyle modifications to improve sleep. They can also help you determine what medications and supplements for sleep are safe for you to take since some can interfere with cancer treatment.
There are also lifestyle changes you can make that are not drug-related, she says. These include:
Getting up and going to bed at the same time each day.
Limiting screen time before bed.
Sticking to a nightly routine, which signals to the brain that it’s time to go to sleep.
Avoiding caffeine in the afternoon or late in the day.
Limiting alcohol consumption. “People think it helps you relax, but it can disrupt your REM sleep, which is crucial whether you’re going through cancer treatment or not,” says Pyle.
Taking short naps (30 minutes or less) as needed. When you’re going through treatment, you may need to carve out extra time for rest. Try to nap earlier in the day so it doesn’t disrupt your nighttime sleep.
Being active during the day. “Activity is really critical during cancer treatment,” she says. “Being active during the day will help you sleep at night. Do any activity you enjoy, whether that’s walking outside, dancing, swimming or gardening. Housecleaning counts too. But avoid exercising within three hours of bedtime because studies show that can have an impact on your ability to sleep.”
Try a mindfulness practice, from simple breathing exercises to a more detailed guided imagery. There are many phone apps available now that offer helpful programs.
If you’ve tried these adjustments and still have trouble sleeping, talk to your physician. They want to know how treatment is affecting you and can offer additional recommendations, such as medication or cognitive behavioral therapy.
Learn more about cancer prevention, wellness and treatment.