Sleeping Well During Treatment

When you think of cancer side effects, you may think of more well-known problems, like fatigue, pain, or depression. One common cancer side effect — sleep disturbance, or insomnia — affects as many as 30%-60% of people living with cancer or undergoing cancer treatment.1  

If you have cancer or are undergoing cancer treatment, there are many factors to consider when exploring possible causes of insomnia. Stress, anxiety, and even certain treatments like chemotherapy can all impact the length and quality of your sleep.1

Unfortunately, these issues can have a negative effect on your mental and physical health and can impact your quality of life.1If you’re experiencing issues with your sleep, the best first step is a conversation with your doctor. He or she can help pinpoint the causes of your insomnia and develop a plan for helping you sleep better.  

Cancer and insomnia go hand in hand1

Insomnia is characterized by trouble falling asleep, staying asleep, or waking up much earlier than you intended. Cancer-related insomnia is likely driven by a variety of factors.  

The stress and anxiety caused by your cancer diagnosis and treatment plan may cause insomnia. Receiving a diagnosis or planning treatment causes tension, worry, and fear, which can make restful sleep impossible. You may also struggle with depression after your diagnosis, making it difficult to fall and stay asleep as you normally would.  

In addition, you may have significant pain due to your cancer or because of certain treatments, like surgery. Frequent or intense pain makes it difficult to find comfortable positions to sleep in and may prevent you from falling asleep easily.

Further, chemotherapy is known to cause sleep disturbances in almost 40% of people.1 Most people receiving chemotherapy have difficulty staying asleep, and some of the medications given to manage certain chemotherapy side effects, like steroids, may cause you to feel restless or alert.  

What can you do?

If you’re experiencing insomnia while dealing with cancer, you can take action to help restore a restful night’s sleep. Here are a few helpful tips2:

  • Try to limit daytime napping to short periods or avoid them completely if you can 
  • Exercise daily, being sure to avoid exercise 2 to 3 hours before you plan to go to bed 
  • Avoid caffeinated beverages or alcohol in the hours before bedtime. Instead, try drinking warm, decaffeinated beverages in a relaxed and quiet setting as a way to prepare for sleep 
  • Explore certain therapies, like relaxation therapy or cognitive behavioral therapy (CBT), to help promote sleep.3 CBT is especially useful for helping control negative thoughts and anxiety which may prevent restful sleep. These types of therapies help you discover better ways to fall asleep, including avoiding caffeine and alcohol before bedtime. They also help retrain your body to progressively relax and develop healthy habits that make better sleep possible, such as sticking to a strict bedtime 
  • Talk to your doctor — he or she may be able to prescribe medications to help with sleep and pain management 

While insomnia can be a challenge when you're fighting cancer, you do have options. It’s important to address any sleep issues you have with your doctor as soon as you can so you can get a good night's sleep to help you persevere through treatment. By working together with your cancer care team, you can find effective solutions for managing insomnia and achieving a restful night’s sleep. 



1. Sleeping well with cancer: a systematic review of cognitive behavioral therapy for insomnia in cancer patients. Neuropsychiatric Disease and Treatment. Accessed May 1, 2020.
2. Sleep problems. American Cancer Society. Accessed May 1, 2020.
3.  Cognitive behavioral therapy for insomnia. National Sleep Foundation. Accessed May 1, 2020.



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