Sleep and Cancer: How Patients Can Cope With Insomnia

Written by Karen Selby, RN | Edited By Walter Pacheco

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How Cancer Affects Sleep

For mesothelioma patients, there are various factors that can impact rest and cause sleep problems. Here are a few ways cancer can affect sleep. 

Chronic Pain 

About 75% of cancer patients experience chronic pain, which is persistent pain that lasts longer than three months. Chronic pain in cancer patients can be brought on by tumors pressing against organs and nerves, or nerve changes caused by cancer treatment or surgery. Many mesothelioma and lung cancer patients experience chest pain due to tumors pressing against their lungs and abdomen. Unfortunately, this kind of pain can interrupt a normal sleep schedule, causing cancer patients to have trouble sleeping. 

Side Effects

Cancer symptoms and side effects brought on by treatment can make it hard for patients to get adequate sleep. Cancer itself can lead to a lot of pain, and the medications and treatments used to manage pain can often have their own side effects. Since some cancer treatments such as chemotherapy kill off healthy blood cells, this can result in extreme fatigue and other sleep-related side effects.

For example, restless legs syndrome — the urge to constantly move your legs — is a common side effect of chemotherapy. Other side effects such as nausea, diarrhea, hot flashes or shortness of breath can become uncomfortable and make it difficult to fall or stay asleep. Ultimately, these symptoms and daily fatigue can disrupt your normal sleep schedule and increase the likelihood of sleep problems. 

Emotions and Mental Health

Stress, anxiety and depression are common among those who have been diagnosed with cancer. According to the National Cancer Institute, approximately 15% to 25% of cancer patients experience depression. A person with cancer likely experiences many intrusive thoughts — fear of dying, anxiety around life plans, worries about money or issues with body image — all of which can take a toll on their mental health. 

It can be difficult to shut off these thoughts after such a life-altering diagnosis, especially when trying to fall asleep. These emotions can lead to a change in normal sleeping patterns, which is why many cancer patients develop insomnia. 

Does Amount of Sleep Increase Cancer Risk? 

While the effects of a cancer diagnosis can certainly impact the body’s natural sleep patterns, there is much speculation about the correlation between poor sleep and increased cancer risk. Can too much or too little sleep increase the likelihood of developing cancer? Though there isn’t definitive research proving this to be true, there have been many studies on how changes to sleep habits impact the likelihood of developing cancer. Here are some ways sleep could affect cancer risk. 

Existing Medical Conditions 

Existing medical conditions, such as sleep apnea or COPD, have been linked to increases in the risk of cancer. Obstructive sleep apnea, or OSA, occurs when the muscles in your throat relax during sleep, causing a temporary pause in your breathing. A recent study found that patients with severe OSA were 15% more likely to develop cancer. 

The same study found that those with severe nocturnal hypoxemia, a temporary drop in oxygen saturation during sleep and a common condition found in COPD patients, were at a 30% greater risk of developing cancer. If left untreated, these conditions can lead to serious health problems. 

Shift Work

The body has a biological clock, which controls how we function while we’re awake and when we’re asleep. Jobs that involve shift work can disrupt the normal rest-wake schedule, causing these workers to develop irregular sleeping habits. Our biological clocks respond to light and darkness, and when nighttime approaches, they release hormones such as melatonin to promote sleep.

Studies have shown that night shift workers have an elevated risk of certain cancers due to the disruption of the body’s natural 24-hour rhythm, which can cause changes to cancer-related genes.

5 Tips for Cancer Patients Wanting Better Sleep 

Sleep problems are often inevitable in cancer patients, and if not treated, these problems can continue long into survivorship. Healthy sleep hygiene is an important part of your overall health and can minimize those restless nights. From getting ready for bed to sleep itself, these tips can help you get the rest you deserve. 

1. Create a Pre-Sleep Routine 

Routines are great for improving overall health and reducing stress and anxiety levels. Repeating the same process over and over again can help establish structure that can lead to healthier and improved habits, especially when it comes to sleep. One study found that participants who engaged in a pre-sleep routine saw significant improvements in sleep quality and a decrease in insomnia. 

Cancer patients under a lot of stress can use their pre-sleep routine to work through their stressors and prepare for a more relaxed rest. Taking a hot bath before bed causes a drop in body temperature, making you feel sleepy and relaxed. Other things, such as drinking warm chamomile tea, journaling or meditating before bed, are all great to add to your nighttime routine to promote relaxation. 

2. Limit Daily Naps 

Many mesothelioma patients experience fatigue throughout the day, so sometimes naps are necessary. If you need to rest, listen to your body. Try to limit your naps to under one hour and don’t take a nap after 3 p.m. so you don’t throw off your sleep schedule. 

Though having a regular bedtime may seem like a silly concept, going to bed and waking up around the same time every day allows your body to function more efficiently, which can help you sleep better at night. Sleep problems can throw off your body clock and affect your circadian rhythm — your body’s sleep and wake cycle. By going to bed at the same time each night, you can help regulate it. 

3. Invest in a Weighted Blanket 

Your bedding can play an important role in the overall quality of your sleep. Studies have shown that weighted blankets help reduce anxiety in chemotherapy patients, which helps promote relaxation. Weighted blankets are typically made with a lightweight, breathable fabric that allows for airflow. This helps regulate body temperature during sleep, which is great for patients who are prone to night sweats.  

Experts recommend your room’s temperature stay between 60 and 67 degrees Fahrenheit for optimal comfort. Having a comfortable sleeping environment and limiting distractions before bedtime can do wonders to promote better sleep.

4. Avoid Caffeine and Alcohol 

Before you go to sleep, avoid foods and beverages that are full of sugar, caffeine or contain unhealthy fats, as these can keep you awake at night. Drinking caffeinated sugary drinks such as soda can be harmful to those with lung cancer because the carbon dioxide can cause gas and bloating, making it even harder to breathe at night. Alcohol can also be harmful as it can increase inflammation. If possible, limit liquid intake before bed to avoid having to make too many trips to the bathroom. 

Maintaining a healthy diet is important, especially for those with mesothelioma. Protein-rich foods and calorie-rich fruits and vegetables are staples in a diet for mesothelioma patients — with many helping to promote healthy sleep. For example, fish and nuts are great sources of protein for cancer patients and also help increase melatonin levels before bedtime.  

5. Try Cognitive Behavioral Therapy 

Insomnia can often lead to anxiety about sleep. If you’ve tried all of the tips for healthy sleep and still feel your sleep isn’t improving, consider looking into cognitive behavioral therapy, or CBT. 

Aside from sleep anxiety, cancer patients experience many other mental struggles. CBT can help reduce anxiety and teach you how to manage stressful thoughts. It can also help you get to the root of your sleeping patterns so you can properly address them. Using CBT techniques can help you manage the negative thoughts you may be feeling after your cancer diagnosis, leading to healthier sleep. 

Practicing healthy sleep hygiene can help minimize the risk of cancer development and limit the symptoms of sleep disorders in cancer patients. Consult your doctor and health care team about possible treatment options if your sleep patterns see little improvement. Discussing your sleeping patterns can help you better address your sleep issues. Everyone’s symptoms are different, but sleep is key to maintaining strong physical and mental health long after your cancer diagnosis.