What Can Help Cancer Patients Sleep?

Treatments for sleep disorders in people with cancer include physical therapy, nutritional support, pain management, relaxation therapy, good sleep habits, sleep medications, and other medications (drugs for depression, anxiety, hot flashes).

Sleep disorders interfere with a good night's sleep and can make it difficult for a person to stay alert and involved in activities during the day. 

Sleep disorders can affect as many as half of all cancer patients. 

There are five major types of sleep disorders that affect normal sleep:

• Insomnia
  • Inability to fall asleep and/or stay asleep
• Sleep apnea
  • Abnormal breathing during sleep in which breathing stops for 10 seconds or more
• Hypersomnia
  • Inability to stay awake during the day
• Circadian rhythm disorders
  • Problems with the sleep-wake cycle (circadian rhythm)
• Parasomnia
  • Undesirable physical events (movements or behaviors) or experiences (emotions, perceptions, dreams) that occur during sleep

Four categories of treatments to help cancer patients sleep may include:

• Supportive care for side effects of cancer or cancer treatment
  • Oncology rehabilitation
    • Physical therapy
    • Occupational therapy 
    • Speech therapy 
  • Nutritional support/dietician
  • Pain management
    • Pain medications
    • Nerve block for peripheral neuropathy
    • Botox or nerve stimulation for severe headaches
    • Mindfulness and relaxation techniques 
• Cognitive behavioral therapy (CBT) to help reduce anxiety and help cancer patients relax
  • Stimulus control
    • Use the bed and bedroom only for sleep, so the bed and sleep are linked 
  • Sleep restriction
    • Decreasing the time spent in bed sleeping so patients are more likely to feel sleepy the next night
  • Relaxation therapy
    • Helps to relieve muscle tension and stress and control pain
    • Can make it easier for stimulus control and sleep restriction to work 
• Good sleep habits to help patients fall asleep more easily and stay asleep
  • A consistent sleep routine
    • Go to bed and wake up at the same time each day, even on weekends
  • A comfortable bed and bedroom
    • Use blackout curtains or sleep masks to reduce light
    • Keep the room cool
      • 65°F/18.3°C is considered ideal
  • Wear ear plugs or use white noise to block outside noises
  • Sleep in comfortable loose-fitting pajamas or sleep naked to help regulate body temperature
  • Stimulus control 
    • Avoid daytime napping 
    • Don’t go to bed until you feel sleepy
    • Only use the bed for sleep and sex
    • Don’t watch TV or read in bed 
    • If you are awake more than 20 minutes after getting into bed, get out of bed and sit in a chair and do something boring such as puzzles or knitting (something that does not involve a screen) until you are sleepy
  • Healthy diet 
    • Avoid caffeine and alcohol, which may keep you awake
    • Night time snacks that increase serotonin may help you sleep, such as:
      • Warm milk
      • Whole grain cereal with milk (avoid sugary cereals)
      • Nut butter on toast
      • Oatmeal
      • Fruit smoothie
      • Cottage cheese
  • Regular exercise
    • Avoid exercise before bed
  • Remove the alarm clock
  • Use a weighted blanket
  • Wear socks to warm your feet 
  • Write down stressful thoughts before going to bed so you don’t think about them
  • Relax before bedtime
    • Take a hot bath or shower
    • Listen to relaxing music 
    • Breathing exercises
    • Guided imagery
    • Meditation
    • Practice relaxing yoga
    • Listen to Autonomous Sensory Meridian Response (ASMR)
  • Don’t stress if you can’t fall asleep right away
• Medications
  • Sleep medications may be helpful for short periods
  • Medications also be used to treat conditions that disrupt sleep that need to be treated with drugs, such as pain, depression, anxiety, mood disorders, or hot flashes