When Sleep Won't Come

by Jane Ashley

Do you have those nights when sleep won’t come? It’s a common problem during treatment. Estimates suggest that up to 75 percent of patients experience insomnia . A significant number of patients report continuing difficulty sleeping after their treatment ends. Sleep disorders include awaking early, problems going to sleep, waking up and not being able to go back to sleep or restlessness throughout the night. Many patients still feel fatigued upon awakening.

Up To75 Percent Insomia

We need to look at the whys we can’t sleep? Hopefully, then, we’ll have some practical solutions to getting the much needed sleep we need.

Reasons that we can’t fall asleep or stay asleep

The reasons are varied, but here are some common reasons for insomnia.

The diagnosis itself. Being diagnosed with cancer is stressful – the “what if” questions plague us. Worries about the financial aspects of cancer, including the cost of treatment or job loss, may contribute to insomnia. Depression related to our diagnosis is disruptive to sleep. Some researchers believe that tumor growth and its influence on the body may contribute to sleep issues. ~Stop The Worrying ~

Steroids before chemotherapy. Patients receive steroids to avoid allergic reactions/side effects, but the downside is that steroids may be the culprit when you can’t sleep.

Side effects of cancer or its treatment. Nausea, acid reflux, hot flashes, night sweats or diarrhea may disturb a patient’s sleep. Other common side effects include hiccups, shortness of breath, itching, shortness of breath, the frequency of urination and coughing will also interrupt sleep.

Pain. Uncontrolled pain from a cancerous tumor pressing on a nerve may prevent a patient from being comfortable enough to sleep.

Cancer-related fatigue. Yes, amazingly, the fatigue you experience from having cancer appears to contribute to insomnia.

Opioid use. Opioids help patients sleep because they relieve pain. But they can also cause breathing disturbances, worsen existing sleep apnea and cause anxiety causing insomnia. It’s a Catch 22 situation.

When Sleep Wont Come

Tell your oncologist

Cancer patients need good, high-quality sleep during treatment. Without quality sleep, a patient’s cortisol level rises, triggering stress and our natural killer cell count, known as NK cells, goes down. Cancer treatment causes fatigue. Couple the treatment-induced fatigue with the tiredness of sitting in a chemo chair for hours or daily trips for radiation, and it’s easy to see why cancer patients are worn-out.

Tell your oncologist that you are experiencing insomnia. They want to help us, but they can’t help us if they don’t know. They will try to learn the cause of our insomnia. Don’t be surprised if they order a sleep study. Discovering the true cause of insomnia is the first step in helping patients rest soundly at night.

Your medical team might prescribe a prescription sleep medication or suggest melatonin, but most probably, they can find a long-term solution.

12 helpful hints for occasional sleep problems.

These hints may help you with insomnia – simple behavior modification might be all it takes. I’m guilty of a couple of “potential insomnia causes” so I’m going to try these hints and tips too.

1. Limit caffeine after 3 p.m. Caffeine is a stimulant so it’s best to allow it to dissipate out of our system before bedtime. Caffeine is found in coffee, tea, sodas and energy drinks.

2. Cut back on alcohol and tobacco. Both of stimulants. Although alcohol might help us fall asleep, many people wake up one or more times in the middle of the night and are not being able to fall asleep again.

3. Allow 3-4 hours between a heavy meal and bedtime. Give your body time to digest a big meal. A smaller meal and a small bedtime snack like peanut butter crackers, cheese or Greek yogurt might work better for us.

4. Turn off your electronics at least one or two hours before bedtime. Using computer, tablets, and smartphones can trick our brains into believing that it’s daytime.

5. Develop a bedtime ritual. Maybe it’s a nice bath, reading, tranquil music , using lavender spray on our pillow or deep breathing. Try to go to bed and get up at the same time every day of the week. This helps reinforce our body’s natural circadian rhythm.

Create A Calm And Restful Retreat

6. Create a soothing bedroom environment. Use calming colors and soothing artwork. Reserve your bedroom for sleep and intimate relations. No computers, no exercise machines and no home office in your bedroom.

7. Consider a white noise machine . This affordable machine generates sounds that block outside noise and soothe your mind. Sounds include thunder, bird calls, ocean waves and a distant wind.

8. Maintain a comfortable temperature. Experts recommend between 65 and 72 degrees year-round. If you’re on a tight budget, install a ceiling fan to help your bedroom feel more comfortable. Use an electric blanket during the winter. Our body has an internal thermostat so you may wake up if it’s too hot or too cold.

9. Wear socks. Cancer patients may experience neuropathy in their feet causing tingling, numbness and coldness. Wear socks at night so cold feet don’t wake you up.

10. Exercise daily. A daily walk or some stretching exercises relieve stress and improve sleep.

11. Use curtains or blackout shades. Ambient light from security lights interferes with your sleep. Avoid placing a clock near your bed – that light may disturb your sleep.

12. Pain control. It’s difficult to sleep soundly when you’re in pain. Talk to your health team about pain medication.

Don’t suffer or try to tough insomnia out alone. Talk to your oncologist or radiologist or even the social worker … they are there to help. When sleep won’t come, our bodies and our minds suffer from the intense fatigue impacting our quality of life and our ability to think clearly.
We’re not the only generation that has had problems with “Tossin’ and Turnin’.” Check out this Bobby Lewis hit song from 1961.  

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