How to Improve Sleep During Cancer Treatment

Up all night? You’re not alone. Many people undergoing cancer treatment report difficulty falling and staying asleep. Though your cancer treatment team will likely emphasize the need for rest and quality sleep during treatment, it can sometimes feel easier said than done. Pain, discomfort, side effects, medications, stress, and disruption to your regular routine can sometimes make a good night’s sleep hard to come by.

The definition of a “good night’s sleep” changes from person to person—some may only require six hours of shut-eye per night, while others need eight or more—and even from day to day. During cancer treatment, the body may require more sleep than pre-diagnosis, as sleep is when the body repairs and recovers from surgery, chemotherapy, radiation, and medication. Though there is no standard number of recommended sleeping hours during cancer treatment, the general rule is that you should wake up feeling rested and refreshed after a full night’s sleep or an afternoon nap.

Often, people write off their lack of sleep as an inevitable part of cancer treatment. Most don’t even tell their doctors when it happens. But ignoring your insomnia minimizes the important role sleep plays in physical and mental health. While sleeping, the body and brain perform critical functions that can’t be performed while awake, including repairing cells and tissues, fortifying the immune system, regulating hormones, and boosting brain function. 

Sleep also prepares the body for the waking hours ahead. Research shows that discomfort and fatigue often go hand-in-hand: when we’re well-rested, we’re better equipped to deal with pain and side effects, while fatigue heightens sensitivity. A lack of sleep can also amplify feelings of anxiety or depression and make it difficult to remember important information about your treatment plan, like key information from your last doctor’s appointment or medication instructions from your pharmacist.

If you’re having difficulty with falling asleep, staying asleep, or feeling well-rested when you wake up, keep notes of your sleep patterns and use this information to talk with your cancer care team. Here is some information they might ask for:

• What time are you going to bed and waking up?
• How often do you wake up in the middle of the night?
• Is a specific symptom keeping you from falling asleep, or causing you to wake up? For example, are you gasping for breath, nauseous, or in pain?
• What do you eat, drink, and do in the hours before going to bed?
• How often are you napping during the day?
• Are you getting exercise, and if so, is it comparable to your normal activity levels?
• Are you consuming more caffeine than you would have in the past?

Identifying the root cause of your insomnia can help you develop strategies to adapt (and finally grab some solid ZZZs).

Check your medications

Some medications used in cancer treatment, like steroids, can impair your ability to fall asleep. Ask your doctor or pharmacist if insomnia is an expected side effect of your medication, and if so, how to reduce its impact on your sleep. (Don’t forget to mention any supplements you are taking!) Sometimes, the solution is as simple as switching the timing of your dose from evening to morning, though you should never change your medication routine or take new drugs or supplements without checking with your healthcare team first.

Eat and drink your way to better sleep

Small changes to your diet can make a huge impact on your ability to get a good night’s sleep. Avoid large meals within two hours of bedtime, especially those containing fatty or spicy foods. Both can cause heartburn, which can keep you awake (or wake you up in the middle of the night).

Consider what you’re drinking, too. That afternoon cup of coffee may help you get a second wind at 3 PM, but that energy surge could also last well into the night. Caffeine is a stimulant that can hold off sleep for six hours or more. For best results, avoid coffee, soda, chocolate, and other caffeinated food and beverages after lunch. Ditto for alcohol, which has been found to interrupt sleep patterns.

Get moving

A workout might be the last thing you feel like doing when you’re tired, but it might just be the very thing you need. Physical activity can help promote healthy sleep – studies show even 20 minutes of walking during the day can improve nighttime sleep quality for people undergoing cancer treatment. Bonus points if you head outside—sunshine during the day helps your body to stay awake and alert when you need to, which will boost your ability to drift off when it’s time.

Set a sleep schedule

When you go to bed and get up at the same time each day, every day (even on weekends), your body falls into a consistent routine. According to some studies, maintaining a regular sleep schedule can cut down on the amount of time you spend tossing and turning.

That’s not to say that you absolutely must stay awake between certain hours. Naps can be a great addition to your daily routine, especially when your body is feeling particularly fatigued. But don’t overdo it—too much rest can not only make you feel sluggish, but delay your body’s ability to fall asleep at night. For best results, set your alarm to wake you up 30 minutes after you start your siesta.

Create a low-key (and low-tech) bedtime routine

A routine that shifts your mindset from the hustle and bustle of the day can prime your mind and body for deep slumber at night. In the two-to-three hours leading up to bedtime, shut off your computer, television, and mobile devices. Do something relaxing instead, like taking a warm bath, reading a book, or listening to a soothing playlist or podcast until your scheduled lights-out.

Make your bedroom a sleep haven

To set the stage for a great night of sleep, experts recommend creating a comfortable space free from light and noise (if you need extra fortification, consider wearing earplugs and/or a sleep mask). Set your bedroom thermostat to a temperature that feels slightly cool (60 to 67 degrees Fahrenheit is recommended), which encourages your body to fall asleep.

If you are staying in a hospital or care facility, bring items that feel comfortable and familiar to your bedroom, like a favorite pillow, your go-to weighted blanket, a sound machine, or cozy socks (though always check with a nurse first, as each hospital has its own rules about what you can bring in). If your doctor requires blood draws or other check-ins from the nursing staff overnight, ask if it’s possible to minimize disturbances (for example, by agreeing to only turn on one small light in the room when staff is present) during the hours you have scheduled sleep.

Treat any side effects keeping you from getting shut-eye

Pain can interfere with sleep, as can other common side effects of cancer treatments like itchy skin, sleep apnea, nausea, or a persistent cough. Talk with your cancer care team about ways you can reduce your discomfort while trying to sleep. They may be able to recommend a prescription pain medication, over-the-counter lotion, or even an adjustment to your sleep position that could make things more comfortable for you. If you are part of a cancer support group, you might also find your fellow members to have tips, tricks, or product recommendations to help with your specific concern. It’s also worth mentioning that some sleep problems (like sleep apnea) aren’t connected to cancer and may have other causes. If you’re wondering about this, bring it up to your cancer doctor and they can help connect you with the right experts or even an at-home sleep study.

Don’t multitask in bed

If possible, only use your bedroom for sleeping and intimacy. Even if you are spending most of your days laying or sitting while recovering from treatment, changing your physical location can help you set your body’s clock to align with your environment. Spending your days outdoors or in a sunny room makes it easier to sleep when you return to your dark bedroom at night.

Keep a pen and paper on the nightstand

If anxiety or worry are keeping you up at night, consider keeping a journal by your bed. Studies show that writing down your thoughts can help bring closure to one day and keep you from dwelling on a concern or to-do list for the next. Avoid typing these notes into your phone – the blue light emitted from the screen can trick the body into thinking it’s daytime, making sleep harder to come by.

Be mindful

Meditation and mindfulness techniques have been found to improve the duration and quality of sleep in people with cancer. Try a meditation app for sleep. Health Journeys is incredibly popular among cancer patients. And Calm offers guided meditations, breathing exercises, and music. It also has a “Sleep Stories” feature, with more than 100 bedtime stories for adults looking to unwind and fall asleep. 

Still can’t sleep? Try not to stress over it

Worrying over your lack of sleep can keep you up even longer, and trying to force yourself to sleep could actually make things worse. Instead of constantly checking the clock and counting the hours of sleep you’re not getting, try a reset: Get out of bed and repeat your bedtime routine, whether it’s reading a physical book or magazine, drinking a cup of warm milk, journaling, or listening to relaxing music. Keep it bland and boring – in other words, resist the urge to check your e-mail or scroll through social media, which can be too stimulating for the goal of falling asleep. When you start to get tired, head to bed.

The content on this website is intended to provide the best possible information for you, but should not be considered—or used as a substitute for—medical advice. If you have questions about your diagnosis or treatment, please contact your health care provider(s). For questions or comments about this content, please email us at [email protected].