Cancer and Sleep

The average adult spends one-third of their lifetime sleeping. Sleep plays a vital role in the restoration and revitalization of brain and body function. There are few activities that contribute as much to our quality of life as our sleep does. Without adequate sleep quantity and quality, we can experience:

  • fatigue
  • depressed mood
  • irritability
  • impaired concentration
  • reduced creativity
  • decreased performance

According to the American Academy of Sleep Medicine, approximately 10% of the general population has sleep problems severe enough to cause daytime consequences. Unfortunately, a diagnosis of cancer and the resulting treatments puts individuals at a higher risk of developing insomnia. Research indicates that 30-50% of individuals treated for cancer will experience insomnia symptoms and that these will often persist for years past the completion of treatment.

A diagnosis of cancer and its treatment can put an individual at risk for insomnia for the following reasons:

  • Emotional and psychological distress associated with the cancer diagnosis
    • Stress
    • Anxiety
    • Depression
    • Anger
    • Concern for family and friends
    • Worry about future
  • Treatment-related effects
    • Pain related to surgery or treatments can prevent sleep onset and cause frequent nocturnal awakenings
    • The use of narcotics for pain control can disrupt sleep architecture
    • Chemotherapy treatment can have side effects including nerve and muscle problems, nausea and vomiting, dry mouth and mouth sores, all of which can make falling and staying asleep difficult
    • The use of steroids (e.g. prednisone) to combat treatment effects can make you feel energized and disrupt sleep, especially if taken in the evening
    • Hot flashes related to menopause or hormonal medication can cause frequent nocturnal awakenings
    • Frequent need to use the bathroom during the night
    • Disrupted sleep can worsen treatment-related daytime fatigue
    • There is recent evidence suggesting that chemotherapy itself may disrupt circadian rhythms
  • Long-term adjustment
    • Disruption of daily routine while in treatment can make it difficult to return to normal functioning
    • Residual treatment effects (i.e. pain, fatigue) may negatively impact ability to engage in previously enjoyed activities
    • Worry about cancer recurrence