Sleeping Well with Cancer: What Adult Survivors Should Know

Getting refreshing, uninterrupted sleep that leaves you with enough energy for the day is critical for many of your body’s processes. These include maintaining your metabolic health, immune response, learning, memory, emotion regulation, and heart health.

For some cancer survivors, getting this kind of quality sleep may feel impossible. While sleep-related challenges are common in general, they are even more common among people who have been diagnosed with cancer. According to the National Cancer Institute approximately half of cancer survivors report difficulty sleeping.

What Causes Sleep Problems for Cancer Patients and Survivors?

Sleep can be negatively impacted by many things, some of which may be related to cancer and some of which may not.

For example, sleep can be impacted by stress related to a cancer diagnosis, treatment-related side effects (and medications used to manage these side effects), a noisy or bright sleep environment (like a hospital room), and many other factors. Although tumors can sometimes negatively impact sleep, particularly in the case of brain tumors, cancer itself usually does not cause sleep disturbances. Rather, it is the consequences of cancer and its treatment that impact sleep.

Common Sleep Difficulties During and After Cancer Treatment

During cancer treatment, some people find they sleep more than they did before. Others find they have increased trouble sleeping, while others don’t have any sleep difficulties, at all.

Overall, about 60% of survivors undergoing cancer treatment report sleep problems. This is true across many different types of cancer treatment, such as radiation therapy, chemotherapy, hormonal therapy, and immunotherapy.

After finishing cancer treatment, many people who have difficulty sleeping during treatment find that their sleep improves. For others, sleep problems persist for a long time, sometimes even years.

One study asked more than 1,900 cancer survivors about their sleep nine years after they were diagnosed with cancer, and found that 20% had poor sleep quality, 51% were experiencing high levels of sleep disturbance, and 28% were taking medications for sleep. The survivors with worse sleep were also more likely to experience emotional distress, fear of cancer recurrence, physical challenges, and economic stress.

Not every survivor will have long-term difficulties with sleep, but it is a relatively common experience and is central to overall wellbeing.

What Can Survivors Do to Help Their Sleep?

If you have difficulty sleeping, the first thing to do is to talk to your medical team about it. You can ask to be referred to a sleep specialist or behavioral health services, if available. This can help you figure out if your sleep problems represent a diagnosable sleep disorder, like chronic insomnia.

Many of the leading non-medication treatments for sleep problems have specifically been shown to work in people who have been diagnosed with cancer. This includes things like Cognitive-Behavioral Therapy for Insomnia (which is recommended by the National Comprehensive Cancer Network as the first treatment to seek for insomnia), exercise therapies, mind-body therapies, and mindfulness-based therapies.

It is also important to practice good sleep hygiene, especially if your sleep problems are milder and do not represent a diagnosable sleep disorder. A few specific things to keep in mind that can be important for people who have been diagnosed with cancer:

Rest Your Body Out of Your Bed

In addition to difficulties with sleep, cancer also often leads to high levels of fatigue, which can cause some people to want or need to rest during the day. If you feel like you want or need to lie down while awake during the day, try doing it on a couch or a chair instead of in your bed. This can help your body sleep better in your bed at night.

Nap if You Need to but Keep Naps Short and Early

If you need to nap, aim to keep your naps to 20-to-30 minutes or less and try to take them earlier in the day, ideally before mid-to-late afternoon. This can help you to still feel sleepy enough to fall asleep at bedtime.

Discuss Sleep Issues with Your Medical Provider

Sleep problems often go undiscussed in survivorship. There are a lot of good reasons why this happens. It can be hard to have enough time to talk about everything that needs to be addressed in a medical appointment, and it can feel like sleep isn’t the most important thing at any given time.

When undergoing cancer treatment and living in survivorship, it may feel like there are bigger mountains to climb and that sleep problems just aren’t worth addressing. Difficulty sleeping can be like a pebble in your shoe: It is still possible to climb the mountain, but things will go much better if you remove the pebble than if you continue climbing with it in your shoe. So, if you have sleep problems, be sure to share this with your medical team so you can get the support you need.

---

More Articles