Trying to Sleep Well after Cancer

How has your sleep changed since cancer?

The Centers for Disease Control and Prevention have called sleep deprivation a public health crisis, saying that one-third of adults don’t get enough sleep. Almost 80% of Americans report a difficult night at least once a week, and I am pretty sure that those numbers are higher for people living with cancer.

Although I am blessed to be a world-class sleeper, as an oncology social worker, I work with many people who have ongoing troubles getting to sleep and staying asleep at night. Whether the reasons are hot flashes, ruminating about health, family, work or other worries, aches and pains, or normal need for less sleep with aging, the bottom line is that sleep is often a problem. We all know that if you don't sleep, your judgment is less sharp, your reactions are less crisp and you generally feel rotten.

If you have frequent problems with sleep and feeling rested, do speak with your primary care physician. There is a range of medications that can help, and a referral to a sleep specialist may help a lot. At BIDMC, there is an excellent Sleep Disorders Center where specialists are available to work with you on this issue.

Several studies have shown that poor sleep is a problem in the lives of many breast cancer survivors. The findings indicated that sleep disturbances were problematic in long-term survivors, with physiological and psychological predictors of poor sleep. These predictors include hot flashes, depression, anxiety, medications and worries about life problems in addition to the baseline concern about cancer health. Fortunately, as far as I know, there have not been studies that link poor sleep with poorer cancer prognosis—that finding would certainly set off even more anxiety and less sleep.

There is no magic to solve this problem, but here is a list of practices that might help:

• Follow a consistent bedtime routine.
• Establish a relaxing setting at bedtime.
• Stay away from screens (tablets, phones, even television) for at least half an hour before turning off the light. Consider reading an old-fashioned book. (Note: I used to include the day’s newspaper in this suggestion, but I fear that the news today is rarely calming and conducive to sleep!)
• Avoid foods or drinks that contain caffeine, as well as any medicine that has a stimulant, prior to bedtime.
• If hot flashes are a problem, keep a fresh pillowcase and a thermos of cold water next to the bed. Some women like leaving wet washcloths in the freezer during the day and keeping them in a bedside cooler at night.
• A white noise machine may be soothing.