How to Reduce Sleep Disturbances Caused by Cancerby Martin Reed Patient Advocate
Sleep disturbances such as insomnia are common in those with cancer. Studies have found that more than half of cancer patients experience insomnia symptoms and this prevalence of sleep problems led researchers to investigate the best interventions for cancer-related sleep disturbances. Their findings were published in the journal Support Care Cancer.
Cancer is a risk factor for insomnia
As stated by the authors of the study, cancer itself is known to be a risk factor for insomnia. Tumors can lead to an increase in steroid production, pain, breathing difficulties, and nausea — all of which can disrupt sleep. Furthermore, cancer treatment and cancer-related medications can also make sleep more difficult.
Other cancer-related risk factors for insomnia
Biological risk factors such as headaches, psychological and social risk factors such as hyperarousal, and the stress associated with a cancer diagnosis along with negative sleep behaviors and thoughts can also lead to insomnia symptoms. Despite these risk factors and the prevalence of sleep problems in those with cancer, the authors found that insomnia is a frequently overlooked symptom.
The importance of insomnia screening
The authors of the study argued that screening for sleep disturbances in adults with cancer is warranted and that reducing nighttime awakenings, reducing time spent awake during the night, reducing time taken to fall asleep, reducing daytime fatigue, and increasing perceived sleep quality should be the priority for any sleep-related treatment and care.
Insomnia treatment should be personalized
The study highlighted the importance of individualizing any treatment plan based on the specific biological and psychological issues that are disturbing a cancer patient’s sleep. The authors suggested that sleep services should be incorporated as part of cancer programs to help prevent insomnia and promote and tailor good sleep hygiene before, during, and after cancer treatment.
Treating mild sleep disturbances without medication
For occasional sleep disruption that doesn’t impair daily functioning, the study recommended sleep education intervention as a first step. This involves advising individuals to keep a regular sleep schedule, go to bed only when sleepy, use the bed for sleep and sex only, get out of bed if unable to sleep, limit naps, and correct inaccurate sleep expectations.
Morning light and nighttime worry
Since the hospital environment can restrict access to light, the study suggested that cancer patients actively seek light exposure soon after waking to help regulate the sleep/wake cycle. The authors also recommended allotting half an hour to problem solving, planning and addressing specific worries in the early evening to help prevent these concerns from interfering with sleep.
Evening light and a relaxing buffer zone
Exposure to a sleep-promoting and relaxing environment with reduced or dim light roughly 90 minutes before bed was also recommended. During this time, individuals should pursue relaxing and pleasant activities such as reading, meditating, doing crosswords, or listening to music or audiobooks to help them unwind before bed.
Treating insomnia symptoms and insomnia syndrome
The study found cognitive behavioral interventions to be the most effective at improving sleep problems and pointed out that treatment can be self-administered or offered through trained providers in a face-to-face or online format. With that being said, the authors suggested that short-term use of sleeping pills may be required until cognitive behavioral therapy takes effect or is available.
When to use sleeping pills
The study suggested that short-term sleeping pill use should be considered if there is no improvement after eight weeks of cognitive behavioral therapy. The authors recommended that daily consumption of sleeping pills should not be pursued for more than four weeks — and that a tapering-off plan should be followed as sleep improves.
The importance of addressing sleep disturbances
Sleep disorders such as insomnia are common among those with cancer. We need to do a better job of assessing sleep and addressing any sleep disturbances since effective treatments not only improve sleep, but may also improve cancer outcomes. If your sleep is suffering, don’t wait for your doctor to ask you about your sleep — raise the issue right away.