• Night time side effects. I already have chemo brain, so I don't want to add any drugs that may affect mental funtioning. Any suggestions?

    Asked by nancyjac on Friday, August 31, 2012

    Night time side effects. I already have chemo brain, so I don't want to add any drugs that may affect mental funtioning. Any suggestions?

    I've been on anastrozole for 2 months now. I really don't know how to tell the difference between side effects of anastrozole, side effects of having less estrogen, latent side effects of chemo, or stuff that isn't realated to any of that. The thing I find weird is that just about all of my side effects happen only at night. Soreness, frequent urination, headaches, heartburn, and weird dreams are all waking me up during the night. I don't get any of this at all during the day. But it is getting to the point where I'm getting tired, sleepy, and cranky during the day just from the lack of quality sleep at night. I've never had a problem sleeping and have always been a very heavy, solid sleeper. I don't know whether I should just start taking sleeping pills to try to sleep through all of the side effects or if I should try to address each side effect separately and find ways to eliminate or at least reduce the impact of them on my sleep.

    8 Answers from the Community

    8 answers
    • leepenn's Avatar

      Hi NJ - sorry you're having so much trouble sleeping. I did to, and in the end, I realized that my biggest problem was actually anxiety. Once I worked through some of that, I started sleeping better.

      I highly recommend avoiding those sleeping pills if you can. For me, they were NOT worth it.

      Soreness - can you take ibuprofen or something similar? Does that help take the edge off?
      Frequent urination - I have a rule that I drink no more fluids after about 6p. If I follow that rule, I get up about once a night to hit the bathroom....
      Headaches - ibuprofen or something similar?
      Heartburn - have you considered keeping a food diary? I wonder if there are some specific foods causing issues. Also, is it possible eating a very light and gentle bedtime snack (or avoiding eating after 7p) might help? I love having a bowl of oatmeal before I go to bed....
      Weird dreams - hmmmm - I don't really have an answer to that one.

      Some other things to consider. When I was really struggling with sleep, I took melatonin for a few weeks. That helped a lot. I would sleep solid for around five-six hours, which was such an improvement! Another thing to consider - is your vitamin D level okay? I have found that in the winter, supplementing with vitamin D improves my sleep quality. Turns out, helps my better half too.

      Something that has ALWAYS helped me sleep is keeping my fitness strong. I find that I will wiggle if I haven't moved during the day. In other words, I think my body insists on getting the exercise regardless. I can skip 1-2 days... but more than that, I become a wiggle monster in the bed. So, I wonder if some additional activity in your day might help you? I don't know much about your situation... but I have heard that anastrozole is a tough drug to deal with.

      Final thing to consider - a wee bit of yoga - like a pre-bed routine - might help your body ease into sleep mode... I have a friend who does about five minutes of yoga poses - easy ones - before bed. And he swears by it. Says it's way better than drugs, and he has chronic insomnia...

      Good luck. Cruddy sleep is really hard to deal with.... on top of everything else...


      over 8 years ago
    • leepenn's Avatar

      PS - before cancer, I totally slept like a baby, unless something work-related or family-related was stressing me out. Even then, I'd have maybe 1 or 2 nights of poor sleep...

      over 8 years ago
    • nancyjac's Avatar

      Hi Lee, I think this could, or already has, become a vicious cycle. Not sleeping causing anxiety causing not sleeping, etc. The soreness is definitely a SE from the aromatase inhibitor. It goes away within a few minutes once I am up and about, but kicks in during the night when I am prone. At first I could sleep through it, but now it wakes me up sometimes, almost symptomatic of restless leg syndrome. By itself though, it isn't much of a problem since I wake up several times during night to urinate (this only happens at night too) and just going from bed to the bathroom and back is usually enough to ease the soreness for an hour or two. I'm already taking Aleve for osteoarthritis so don't really want to take any more NSIADS if i can avoid it.

      I don't usually drink much after dinner, but I do usually have a glass of water to sip on after dinner. Forgot to mention I also get dry mouth. I don't think that has anything to do with my cancer treatment, more a side effect of seasonal alergies that cause me nose to stuff up and then I mouth breathe. I might try using my inhaler more (it's not an asthma inhaler, just one containing menthol vapors to clear my nose) in the evening an see if that will let me cut down on the water.

      I'll try the food diary. I don't have the heartburn every night but frequently, so it could well be something in particular that i am eating that I could easily eliminate. Milk usually helps my heartburn so I could drink that before bed, but then that would also contribute to the frequent urination.

      Its not so much that the dreams are weird, its that it is weird for dreams to wake me up. Before this started, dreams very rarely work me up nor did I have any recollection of them in the morning.

      I had my vit D tested lately and it was a little bit low so MO put me on a supplement. I'm currently taking almost 5K IU/day. If anything, the sleep problems started about the same time as I started the vit D supplement, but that is probably just coincidental.

      I agree with you regarding the exercise. I do have to wiggle a lot during the night because the movement helps the soreness in my legs (almost like restless leg syndrome). And this sort of becomes another vicious cycle. I'm not getting enough quality sleep at night so I am tired and exercising less during the day which reduces my quality of sleep at night...sigh. Just gotta make myself do it, tired or not. The yoga before bed is a great idea and I can definitely do that....I'm really feeling DUH for not thinking of that one myself....Thanks, will let you know how it goes.

      over 8 years ago
    • cranburymom's Avatar

      I have been very tired lately too. I also noticed that I deal with stress differently, and not always better than before.
      I should be stronger as we are a fighter, and a survivor with smile on the face. But hey, I notice my limitation.

      I sleep longer when I can (even when I should be up and running or prep-ing breakfast for kids).
      I sleep less if I get too excited to rest. And tell myself it is OK to do this (not sleeping at night) sometime.
      Our body has an amazing healing power, and our brain does lots of wonder - both good and bad.

      I started with a simple breathing exercise - meditation, Yoga (simple one!), give your mind a break for 5 min at time.
      Try not to do exercise, even YOGA right before you go bed.
      If possible, get out and embrace nature - works for me --> try to count the different flowers you find, notice sounds of birds, insects singing and different shapes of clouds in sky. Summer is almost over - I smell the fall in the morning.

      I found running very therapeutic - too bad I cannot run all the time. I develop strange pains and aches, so I need to be careful. Cycling was an alternative for some time, and I will get back to it soon.

      Hang in there girlfriend, trust your gut, and you will find the answer that is right for you.


      over 8 years ago
    • lynn1950's Avatar

      Hi NancyJack, I take Arimidex at night because one of the SE's for me is sleepiness. I am mostly a heavy sleeper - always have been. Sorry to know that you are experiencing so much trouble. I wouldn't add sleeping pills - they have so many side effects of their own. Taking Ibuprofen proactively may help with the SEs that wake you up. I don't know about the heartburn though. I didn't know that was an Arimidex SE! If anxiety is keeping you awake, listening to a relaxation CD before sleep may help you drift off. During my season of high anxiety, that really helped me. Very soothing.

      over 8 years ago
    • nancyjac's Avatar

      I have been sleeping on the couch the last couple of nights. With every else waking me up, it doesn't help that my husband has a bad case of bronchitis right now and his hacking is just one more thing that was waking me up., Slept a little bit better last night and feeling more refreshed this morning. Didn't get a headache during the night and barely any heartburn last night. I've been either drinking some milk or having some yogurt just before bed and that seems to be helping. Have also cut down on liquids in the evening and that is helping some. Only waking up to urinate every 2-3 hours instead of every hour. The joint pain, especially in my arthritic knee is still making it a little bit difficult to get back to sleep, so I think I'm going to try doing a little more walking or yoga or something after each time I wake up. If I can get back to sleep right away anyway, I might as well use that time to do something that will make it easier to go back to sleep.

      over 8 years ago
    • attypatty's Avatar

      Dear Nancyjac:
      Ask your oncologist if you can try a different AI. I started on Arimidex (anastrozole) and took it for three months. The pains and side effects were almost unbearable - pain in all my joints (always at level 2, most days rising to 4 or 5, and sometimes reaching 7 or 8); could hardly open or close my hands and developed trigger fingers; slight nausea; burning and tingling in my feet. Arimidex can also cause insomnia, which I didn't experience but sounds like you are. I couldn't tell if the side effects were left over from the Taxol since I did suffer with neuropathy, or were new SEs caused by the Arimidex. My oncologist took me off the Arimidex to test whether the SEs were from left over from Taxol or new from Arimidex. After being off for a month, the SEs disappeared, except for the slight numbness in my feet ("Taxol toes"). She switched me to Aromasin, and so far, after one month, I have not had any of the horrible SEs of the Arimidex.
      So talk to your oncologist and see if you can switch. The AIs all work the same in cancer prevention by blocking the formation of estrogen and they are all equally effective. But they work in different ways - Aromasin is steroid based; Arimidex is not. You have to take Aromasin with food for absorption so maybe this helps with some people's metabolism.
      I would suggest strongly to ask about switching. I would have been content to put up with all the SEs because I though I had to and didn't know there were other options. Thank goodness for my oncologist - she could see my pain and knew I wouldn't complain. But she also knew I didn't have to put up with all that - and neither do you. A different drug may be better for you.
      Fight On,

      over 8 years ago
    • SunnyCloud's Avatar

      Hello, I myself only took nausea medicine or tylenol now and then. If I can handle the symptom, I prefer no meds. They always make me feel worse than whatever ails me. If you have frequent heartburn, it is better to stay away from ibuprofen. Speak to your doctor or nurse and they will help you sort things out. God bless.

      over 8 years ago

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