Q&A: Sleep and cancer
Cancer and its treatment can cause problems with your normal sleeping patterns. Here, we answer just a few of your questions about how to cope when sleep is disturbed.
What should I do if I have problems falling asleep?
Try creating a wind-down routine about an hour before bed.
This could include activities such as sitting down with a warm decaffeinated drink, listening to some gentle music, watching TV or reading a nice book or a combination of all these.
The aim is to try and help you slow down and unwind.
Think of parents with their children: they give their child a snack, a bath, put them in their pyjamas, turn the lights down and read them a story before putting them down for the night (some nights more successfully than others!)
Whereas, as adults, we might be in our living room feeling ourselves nodding off and before we get up to go to bed, we take our mug through to the kitchen, wipe down the counter (since we’re there), pick up the washing and take it upstairs, then finally get into bed and try to fall asleep without much success.
Your wind-down routine should be carefully planned but not inflexible.
If I can't sleep at night, but have time in the day, should I just sleep when I can, or stick to a schedule that helps train me for sleeping longer at night?
If you’re on treatment, then it’s important to listen to your medical team and your body, and rest when required.
If you have finished treatment and are experiencing sleep difficulties, then trying to reduce the number of naps you're having and eventually stopping is recommended.
When trying to overcome a problem with sleep, consistency is key. Try to get out of bed at the same time each morning including weekends if you can.
What should I do if I wake up in the middle of the night and can’t get back to sleep?
The aim is to try and strengthen the connection between bed and sleep.
When children are young, parents work hard to try and establish this connection.
Ask yourself what the current connection is between bed and sleep?
Is it tossing and turning and thinking about how difficult sleep is?
We want the connection to be ‘bed equals sleep’. To strengthen this connection, your bed must only be used for sleeping. That means not reading, watching TV, or checking your phone in bed.
When you wake in the middle of the night and can’t get back to sleep try the 15-minute rule.
If you can’t get back to sleep within 15 minutes you should get up out of bed and go into another room where you can read, listen to music or do something else that is relaxing before going back to bed.
You might be up and down a few times during the night but bear in mind this is to help strengthen the ‘bed equals sleep’ connection.
The 15-minute rule can also be used when you have difficulty falling asleep at the start of the night.
What’s the best way to prepare to go to sleep at night?
‘Sleep hygiene’ includes thinking about the way you prepare for bed, the bedroom itself and things in our lifestyle that can be changed to help improve sleep.
The main lifestyle factors which can affect sleep are caffeine, nicotine, alcohol, diet and exercise. Therefore cutting down on these may help improve sleep.
Make sure you’re not too hungry or too full before bed.
People who exercise regularly are likely to be better sleepers, but avoid strenuous exercise before bed and late in the evening as this wakes up the nervous system which can lead to problems falling asleep and staying asleep.
Thinking about the bedroom itself – noise, lighting levels, room temperature (ideally around 18°C), body temperature, air quality and your mattress and pillows: are they still comfy? You might now have a good reason to buy that new pillow or duvet cover you’ve been eyeing up.
Do you recommend herbal sleeping tablets? Even prescription sleeping pills?
If you're planning on taking herbal sleep remedies it’s important you discuss this with your medical team and/or pharmacist.
Although these remedies can be bought over the counter, they may contain active ingredients. Therefore, you must check they will not affect or interact with any of your prescribed medication.
A lot of people are prescribed sleeping tablets by their GP when they are going through treatment to help them sleep.
It’s likely your GP will prescribe them for as short a period as possible and will not prescribe a lot of them.
How do you get a good night's sleep if you are in hospital for treatment?
It can be challenging to sleep well during a hospital stay for a number of reasons, such as noise, lighting, night-time examinations, or effects of medication.
Speak to your hospital team and ask if there is anything they can do to help.
Although it can be stressful, try not to worry too much about it. Hopefully, your sleep will improve when you are back at home.
How do you know when your sleep problem is so serious you might need to consult an expert?
Most sleep problems resolve themselves, but if you experience difficulty falling asleep on three or more nights of the week, take more than 30 minutes to fall asleep or get back to sleep for more than six months, then your GP may diagnose you with insomnia.
However, you do not need to wait six months to get in touch with your nearest Maggie’s to get support for your sleep problems.
We can arrange for you to join one of our sleep workshops or speak to one of our psychologists.
Is there any way of avoiding nightmares which may be brought on by fear?
Nightmares happen spontaneously. However, they may be caused by underlying factors including certain types of medications, withdrawal from medications, sleep deprivation, anxiety and depression.
It may be helpful to speak to your GP to determine if this may be the case.
If your nightmares aren’t related to ill health or medication, there are still steps that can be taken to help reduce the frequency of nightmares.
Cognitive Behavioural Therapy (CBT) and imagery training have been shown to be helpful.
If your partner has cancer and struggles to sleep, is it best to be awake with them and talk or sleep in another room?
It’s often the case that both partners feel guilty. One for waking the other person up due to their sleep problems and the other for being able to sleep when the other can’t.
Talk to your partner and ask them what they would find helpful.
If they would like you to be awake with them when they can’t get to sleep or back to sleep agree on what you will do in advance.
Ideally, you won’t do anything too active at this point. You could get out of bed and listen to some relaxing music or do a relaxation exercise before going back to bed.
How Maggie's can help
We're here in our centres, on the phone and by email if you want to talk things over with a cancer support specialist and find out more about ways to manage sleep issues.
Our benefits advisors are here to talk through any money worries that may be adding to your sleeplessness.
Find your nearest Maggie's to get details of how to get in touch.