Mobility Issues and Fatigue

Sleep Disorders and Breast Cancer Treatment

PJ Hamel Health Guide February 05, 2007
  • As I write these words, it’s 5 a.m. on a Sunday morning. I was up till 1:30 a.m. working on tax documents and college financial aid forms. Hmmm, 3 1/2 hours of sleep–sound familiar?

    “How can you get by on so little sleep?!”

    That’s the question many of my friends pose to me, friends who A) haven’t been through cancer, B) haven’t been through menopause, and C) are still in their 30s, that wonderful decade when the main thing disturbing your sleep is a hungry baby.

    Me, I haven’t had a full eight hours of solid sleep in at least five years. And on the rare occasions when I sleep as long as three hours at a stretch, I awaken and think, “Ah yes, a good night’s sleep–I remember it fondly!”


    While one-quarter of Americans report having sleep issues, studies show that up to 90% of cancer patients in active treatment have trouble sleeping. And for some, that sleeplessness ultimately stretches way beyond the end of treatment.

    Tellingly, pharmacists at Houston’s M.D. Anderson Cancer Center report that Ambien®, a popular sleep aid, is one of the most frequently prescribed non-chemotherapeutic drugs. Why are so many of us having so much trouble falling asleep, and staying asleep?

    In the midst of treatment, there are multiple answers. Emotionally ravaged by what’s still a new and frightening shift in our interior landscape–living with cancer–we stay up late chasing down leads on the Internet about our particular type of illness, then fall into restless sleep only to awaken early, the challenges of the new day colliding with worries from the night before. Breast cancer drugs and radiation upset our delicate chemical balance, and sleep becomes a problem.

    Insomnia–the inability to fall asleep–keeps many of us awake deep into the night. Others of us fall asleep, only to awaken an hour or so later, then toss and turn the remainder of the night. My pattern during treatment was to fall asleep, then wake up 15 minutes later; after a half-hour or so of reading, I could fall asleep again, sleep maybe 30 minutes, then be wide awake. This cycle would continue all night, for weeks on end. Looking back, I’m amazed I remained functional; living with sleeplessness–in the midst of chemotherapy–is a testament to how tough and resilient our bodies really are.

    Menopause is also a huge sleep-disrupter. Our hormones thrown out of whack, neurotransmitters in our brains have trouble sending out the right sleep signals at the right time. So, if you’re a breast cancer patient who was in the midst of menopause when diagnosed, or who’s undergone menopause due to chemotherapy, you’re facing a double whammy: cancer and menopause are a pretty good guarantee you won’t be sleeping well in the near future.

    So what about the fact that even post-menopause, post-treatment, many of us still aren’t sleeping well? It may be that patterns of sleeplessness “learned” during those days have become imprinted in our brains, replacing our previous “norm” of eight hours of sleep.


  • Or we may simply be experiencing the effects of a well-known physical fact: as we age, we need less sleep. Whatever the reason, too many of us are wide awake at 3 a.m., staring at the ceiling as we try to will our way into comfortable slumber.

    Why, oh why, with everything else going on in our lives, can sleep be so difficult?

    Next time, I’ll focus on what’s actually keeping us up at night.