Sleep Loss During Cancer Treatment

"I just want a good night's sleep, doctor." This is something I hear very frequently from my cancer patients on our weekly visits.

Insomnia is common in cancer patients as well as the general population. Chronic lack of sleep can lead to a host of medical problems, including chronic fatigue, depression, obesity, diabetes and heart disease.

Insomnia can be caused by a number of medical conditions, medications, stress, lifestyle and diet. Before assuming all sleep issues are due to medical conditions alone, I frequently run through the following healthy sleep hygiene list with my patients. Many make some of these adjustments, and their sleeping problems vanish.

Here's what you can do to help get a good night's sleep.

• Power down. The blue light from cell phones, tablets, TV and computer screens suppresses melatonin, which directly interferes with sleep. So, shut off your electronic devices in the evening, and leave them off until morning. If you just can't say no, purchase a blue light filter to help reduce eyestrain.
  
  
• Rituals. Revert to childhood. Make sure you keep a bedtime and wake up ritual, even on the weekends. Every night around the same time, take a bath, read a soothing book or listen to music. Then, it's lights out.
  
  
• S & S only. The bedroom is for sleep and sex only! Don't use if for an office, a gym, a craft center or a movie theater. It is important to associate your bed with sleep.
  
  
• Cool it down. Check the temperature of your bedroom. Some studies show that the optimum bedroom temperature should be between 65 to 72 degrees for sound sleep.
  
  
• Socks. Wear socks if your feet are cold. Cold feet increase mental arousal.  Happy, warm feet mean more sleep.
  
  
• Leave the room. If you cannot sleep within 5 to 10 minutes of lying down, get out of bed and read a magazine or book that is soothing or boring. (If you're reading on a tablet or a mobile device, make sure to use a blue light filter. Spend time in prayer or meditation to calm the mind. Once you feel tired again, go back to bed.
  
  
• White noise. Many people are sensitive to background noise. A good way to calm the mind and block out ambient noise is to use a fan or white noise devices that mimic soothing sounds such as an ocean, a rainforest, a river or a thunderstorm.
  
  
• Limit your food and drink intake. Avoid heavy meals, alcohol, chocolate or caffeine products, such as soda, coffee or tea, three to four hours before bedtime.
  
  
• Avoid naps. Keep your daytime naps to 30 minutes or less. And, don't take a nap within several hours of bedtime.
  
  
• Exercise. Try to do some form of exercise daily. This can be as simple as an evening walk, riding a bike, stretching, yoga or using light weights. Physical activity helps the body to dissipate stress which enhances sleep. The American Cancer Society recommends that cancer patients and survivors do at least 150 minutes of moderate physical activity or 75 minutes of vigorous physical activity each week.
  
  
• Don't smoke. Stay away from all forms of tobacco. Not only has it been linked to several types of cancer; the nicotine in tobacco can keep you awake.
  
  
• Pull down the shades. Your bedroom should be like a cave.  It should be dark, cool and quiet. Blackout blinds, shades and fabric can get rid of ambient light and help you sleep. Also be sure to cover clocks or other electronic devices that emit light in your bedroom.
  
  
• No pain equals gain. Pain can interfere with sleep. Make sure you talk to your doctor about the pain medicines you take. Together, you can come up with a plan to help you sleep soundly and pain-free.
  
  
• Write it out. Keep a pen and paper by your bed if you are prone to wake up and worry about the next day's events. Jot down your reminder and fall back to sleep.

Sleep is vitally important for your health. So, don't hesitate to discuss insomnia and other sleep issues with your doctor.  Sometimes a sleep aid can be prescribed temporarily, but it generally should not be used long term. If your sleeping issues persist, ask to be referred to a sleep specialist or visit MD Anderson's Sleep Center.

Sweet dreams!

Pamela J. Schlembach, M.D., is associate professor of Radiation Oncology at MD Anderson in The Woodlands.