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Sleeping Problems

You may be wondering about not getting enough sleep.  Here is some information to help you understand the important part that sleep plays in cancer care. 

Strategies to help with sleep - Patient Handout

‎Sleeping problems are also called insomnia and refers to people having trouble falling asleep, staying asleep or waking up unrefreshed. Insomnia may be new to you or you may have had problems prior to your cancer diagnosis.  Insomnia may be causing stress and affecting your day to day functioning. Getting enough sleep during and after cancer treatment is important to help maintain your energy, focus and can aid in cancer recovery.

Emotional:

Emotions and thoughts can trigger problems sleeping. Stress, anxiety, sadness, depression can keep you from getting the sleep you need.  Most times when the emotional trigger (i.e.: situation, hormone imbalance) goes away, you can sleep better. Sometimes the trigger does not go away and interferes with your quality of life and daily activities.


Long-term:

Insomnia can happen despite adequate opportunity and absence of stressful situations and it can cause distress and affect day-to-day functioning. Chronic insomnia happens when someone has sleep problems three or more times per week for more than one month. 


Other medical conditions:

Other medical conditions such as chronic pain, sleep apnea or restless leg syndrome can also affect your sleep. Your physician can assess if you have these symptoms.


Nutrition:

The quantity of food or type of drink (caffeine or alcohol) if taken at the end of the day can affect the amount and quality of your sleep. 


Cancer-related risk factors

Some cancer patients are at high risk for sleeping problems/insomnia because:

  • the cancer itself may cause problems like nausea, shortness of breath or pain

  • your body chemistry may be altered - such as with hormone fluctuations

  • cancer-related medications like corticosteroids, pain medications or side effects of chemotherapy can affect your ability to sleep

  • fears and worries  about coping and support

Signs of insomnia

  • trouble falling asleep at bed-time, 

  • night-time waking, 

  • waking too early, 

  • not feeling refreshed upon waking

  • daytime problems with memory, attention and fatigue

Possible consequences

  • Emotional: distress, anxiety, irritability, depression, decreased pleasure and social activities

  • Physical: fatigue, increased day-time sleepiness, pain intolerance 

  • Cognitive: problems with concentration, memory and judgment 

  • Compromised role: difficulty doing your normal social or occupational functions

 
Your cancer care team will want to know about any new sleep problems you are having. Your healthcare team may want to:

  • adjust your treatment plan
  • assess and treat any other underlying medical disorders
  • prescribe a medication
  • refer you to another healthcare professional such as a counsellor or sleep specialist
  • recommend ways to cope with stress

What you can do

Ask yourself these questions:

  • Do my sleep problems occur on average of three or more times per week (over the last month)?
  • Do my sleep problems negatively affect my daytime functioning or quality of life?

Before bed, do:

  • engage in winding-down relaxing activities (i.e.: music, warm bath, journal)
  • find a way to let go of worries and fears (seeEmotional Support Resources)

Before bed, do not:

  • take stimulants (e.g.: caffeine, alcohol, nicotine or red ginseng)
  • eat heavy, sugary or spicy foods
  • drink too much fluid (no more than 1 cup/4hrs before bed)
  • go to bed hungry
  • participate in vigorous exercise 
  • watch TV or use computer (stop one hour before bed)

Talk your doctor about your options and ...

  • talk to a counsellor about non-drug strategies and emotional support and/or;
  • join a support group for social interaction, relaxation and/or sleep training and/or;
  • talk to a pharmacist about over-the-counter sleep aids and medications to help with sleep

Recommended websites: Sleeping Problems Websites


BC Cancer Library pathfinder: Fatigue and Sleep Pathfinder


BC Cancer pamphlets: see "Strategies to Help with Sleep" under Emotional Support webpage


Symptom management guidelines: Sleep-Wake Disturbances 

Revised Aug 2015

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