Disruption of a normal sleep pattern is common after a diagnosis of cancer. There are a lot of things to worry about, the diagnosis, the treatment, how you will feel, financial and family issues and it is normal to wake up thinking about them at night. If this is associated with depressive thoughts, particularly waking in  the early hours and is persistent it may be worth talking to your GP as this as it may be signs of early depression. Apart from anxiety there are also several reasons why sleeplessness may be a problem during cancer therapies and these may be amenable to specific strategies or medication:

Sleep Hygiene Guidelines

• Discontinuing or reduce the use of caffeine (tea, coffee, energy drinks)  after 4pm and preferably after 2pm. If this does not help, try cutting coffee altogether.

• Alcohol may make you initially sleepy but often you then have a restless night waking throughout the night

• Nicotine is a stimulant which can keep you awake so avoid smoking at night. 

• Heavy smokers actually suffer withdrawal of nicotine at night so they wake up anxious and alert

• Avoid drinking large amounts of liquids prior to bedtime - it fills the stomach and causes you to have to pass water often

• Avoid hunger or excessive eating prior to bedtime

• Avoid taking daytime naps unless essential.

• Establish a regular pattern of sleeping - set a time to go to bed & when to wake up.

• Sleep only as much as you need to feel rested.

• Go to bed only when you are sleepy

• If you are unable to fall asleep within 20 - 30 minutes leave the bed and perform a relaxing activity until drowsy and ready for sleep (avoid light - see below).

• It is important not to expose yourself to bright or artificial lights at night even from smart phones or computers. This interferes with the melatonin pathway - the body thinking it's day time - this not only disturbs sleep but if you have regular exposure to light at night it upsets the normal circadian rhythm. Studies have linked night time exposure to light to an increased risk of cancer

• Exercise regularly but do not exercise within 2 hours of bedtime.

• Engage in a quiet relaxing activity before bedtime

• Do not watch exciting TV programs or read stimulating books in bed last thing at - read something boring!

• Avoid temperature extremes, noise and light when in beds

• Ensure room is dark - use black out curtains if necessary

• Try to ensure the room is quite - wear ear plugs if necessary

 

Helpful resources and links

Cancernet-UK: What is cancer;  About specific cancers; Breast | Prostate | Bowel.  About cancer treatments; Chemotherapy | Radiotherapy | Hormones | Biological agents | Complementary.  Lifestyle advice; Exercise | Diet | Smoking | Sunbathing | Alcohol.  Cope with symptoms;  Traveling | Insurance  | Tests for cancer | Clinical trials. ...site map

Micro-nutrient testing Empower yourself to make dietary choices specific to your personal make up. This Cancer Risk Nutritional Profile, analyses your blood profile and recommends specific dietary and supplement advice to ensure you have the best possible nutritional status to fight cancer an aid recovery from treatments....read more

Download a free chapter describing how to avoid cancer forming chemicals (Carcinogens) in our diet and environments  from the new edition of the best selling evidence based book    "Lifestyle after Cancer - the facts"

Make a will (or living will)  Cancernet has teamed up with a leading UK lawyer to drive down the cost of making a solicitor checked will.  This reliable, easy to use, online resource ensures your assets (money, property, jewellery, etc) go to the person you want and not those you least want such as the taxman. Cancernet-glossLegal wills start from £39....read more

Protect your lips during chemotherapy There is evidence that natural oil based creams are better than petroleum based creams. natureMedical lip balm has been specifically design to soothe and moisturise the lips during and after chemotherapy or after sun exposure. It only contains only natural waxes and essential oils selected for their anti-inflammatory and DNA stabilizing properties...read more/order

Protect your nails during chemotherapy. Nails can become painful and disfigured during and after chemotherapy. We describe the latest nail care guidelines and  number of useful tips to keep them healthy, including cooling and moisturizing ...read more

Poems and cancer   Cancer is emotional and stressful time not only for the patients but friends and relatives. This emotional can inspire reflection, sentiment and creative writing and poetry. Hundreds of poems have been kindly submitted by users of cancernet. Caution: take a tissue some of these are real emotional bombshells!.. Read poems or...submit your own poem

Look after your family after cancer - A diagnosis of cancer can cause a strain on family harmony. With emotions running high its not a good time to be upset further by destructive arguments. This practical little book has identified the situations where arguments are most likely to happen and provides simple tips to navigate around them...download £1.99

Lifestyle and cancer - the facts. This 2011, edition with a foreword from Paula Radcliffe has been extensively re-written with evidence from the latest research from around the world which demonstrates how diet, exercise and lifestyle changes can; help avoid cancer (read chapter 9 free), cope with treatments side effects; slow the rate of progression of cancer and help prevent  relapse.  This comprehensive essential lifestyle guidebook can be ordered online (£8.95), or downloaded via kindle

Prepared for cancer treatments. Patients and professionals, teamed up with Sue Lawley to produce this 21 minute film which explains chemotherapy & radiotherapy while you watch patients, describing their experiences, side effects and methods to alleviate them. Awarded the NHS communication prize ...  read more / order individually or in bulk for your oncology department

Keep-healthy.com Practical evidence based advice on healthy living including ways to naturally reduce cholesterol, reduce blood pressure, keep healthy eyesight, hearing, maintain a healthy weight and level of fitness. Includes advice on supplements and other useful products...link

Support groups and self help organisations throughout the UK and internationally. Links to Asian support organisations; Read patient stories, poems and links to the Cancer active website addressing a wide range of complementary issues related to cancer and their a quarterly magazine (ICON)..  submit a link to your group