Sleep Disorders in People with Cancer

Typical sleep issues include:

• Feeling excessively lethargic and exhausted or having a strong desire to rest and sleep more (fatigue)
• Having issues falling or staying asleep (insomnia)
• Oversleeping may have an impact on your daytime activities
• Sleeping excessively during the day may interfere with your ability to sleep at night
• A person's ability to have a restful night's sleep could be hindered by:
  • Extreme heat or cold
  • The urge to use the restroom
  • Sleepwalking
  • Nightmares
  • Sleep terrors

People frequently report sleeplessness both during and after treatment. Insomnia can exacerbate preexisting conditions (including pain, exhaustion, and anxiety) if it is not managed. 

Insomnia has several root causes, such as:

• Stress, worry, or sadness
• Physical discomfort, including pain, headache, hot flashes, nausea, and vomiting
• Medications, chemotherapy, or radiation-related side effects
• Illnesses, such as acid reflux, thyroid problems, or bladder troubles
• Unfamiliar surroundings or shifts in habit, such as an overnight hospital stay

For the proper diagnosis and management of sleep issues, consult your doctor or a sleep specialist who may perform an evaluation. This may involve a polysomnogram (recordings made while you sleep that indicate your breathing and heart rate, brain waves, and other activities).

Because sleeping difficulties can evolve, assessments might occasionally need to be redone.

Supportive care for side effects of cancer or cancer treatment could be part of the treatment for sleep disturbances. There could be a connection between sleep difficulties and the weariness brought on by cancer. Discuss your sleep issues with your family and the medical staff so that they can help and provide information. Supportive care may improve your quality of life and ability to sleep.

Cognitive behavioral therapy (CBT)

Anxiety associated with getting inadequate sleep can be addressed. With the aid of CBT, the anxious thought “I need to sleep” is replaced with the thought “simply relax.” You discover ways to alter sleep patterns that keep you from getting enough rest. In the absence of in-person CBT sessions, virtual CBT sessions have been demonstrated to be beneficial.

CBT might consist of the following:

• Relaxation therapy: Helps lower blood pressure, manage pain, and relieve stress. It might entail tensing and relaxing muscles all over the body. It frequently goes with guided imagery (using the mind to focus on happy pictures) and meditation (focusing on thoughts). You can feel calm and sleepy by practicing self-hypnosis before bed. Exercises from relaxation treatment can make it simpler to use stimuli control and sleep limitation.
• Sleep restriction: Limiting your sleep reduces the amount of time you spend in bed. As a result, you are more likely to feel sleepy the next night. As your sleep quality rises, your ability to sleep is increased. 
• Stimulus control: When you have chronic sleep issues, even getting ready for or into bed can make you anxious, anticipating another sleepless night. Falling asleep becomes extremely challenging because of this anxiety. By using stimulus control you can learn to associate getting ready for bed and staying in bed with sleeping. Stimulus control includes the following changes:
  • Only go to bed when you are truly tired and get out of bed if you are still wide awake after some time. Whenever you feel sleepy, go back to bed.
  • Do not perform any other activity in the bed or the bedroom; use it just to sleep.

Medication

If non-pharmacological treatment is unsuccessful, short-term usage of sleep aids could be necessary.

Certain sleep disturbances are brought on by medical conditions that require medication, such as hot flashes, pain, anxiety, depressive disorders, or mood disorders. The medication prescribed will depend on the nature of your sleep issue (such as difficulty falling or staying asleep) and other medications you are currently taking.

Which sleeping pills are secure and effective for you will depend on your other medications and medical issues. Do not quit taking some sleep aids suddenly because it might result in anxiety, seizures, and a shift in the rapid eye movement (REM) sleep period, which increases dreams and nightmares.

For people with cardiac issues or peptic ulcers, this alteration in REM sleep could be harmful.