Sleep Disorders

Sleep disturbance is common in cancer patients and may occur as a normal symptom of cancer. It is generally temporary. Patients may experience insomnia or excessive sleepiness as a side effect. This does not mean an additional problem exists; it is more often considered a normal psychosocial manifestation of a cancer diagnosis.

How Does It Develop?

• Pain
• Physical problems such as difficulty controlling urination, diarrhea, constipation and breathlessness
• Anxiety and depression
• Medications (long-term use and withdrawal)
• Discomfort with hospital and/or home surroundings

Older patients may address changes in sleep patterns considered normal by exercising more and resting during the day.

Strategies to Help You Sleep Better

Develop regular sleeping habits.

• Set an alarm and get up when it rings. Try rising at the same time on nonworking days too.
• Spend time in bed only when sleeping. Do not watch TV, read or eat in bed.
• Set times for sleep and wakefulness.
• Optimize your sleeping environment (for example, it should not be a noisy, dark and cold room).
• You can minimize sleep disruption by avoiding fluids before bed, using the toilet beforehand and taking medications before bed.

Relaxation Therapy

• Worry and anxiety before bed can keep you awake.
• Wear loose, soft pajamas or a nightdress.
• Relax your body with a hot water bottle compress. Hot water relaxes muscles and relieves the day's tension. However, I do not recommend a hot shower because it makes you feel more tired and sleepy.
• Exercise moderately as recommended 4-7 hours before bed. Avoid exercise immediately before bedtime because it makes falling asleep harder.
• Linden or chamomile tea helps relaxation. Plenty of green leafy vegetables and walnuts, providing minerals, calcium and magnesium, also benefit you.
• A warm cup of milk relaxes you and helps comfortable sleep.
• Try watching TV or reading when unable to sleep. Focusing on one point tires your eyes and makes you sleepy.

What Not to Do

• Do not nap during the day, even when very tired.
• Do not worry that you will be unable to sleep.
• Avoid stimulating caffeinated drinks. Caffeine also has a diuretic effect, causing frequent urination. Coffee contains substantial caffeine. Certain drinks such as tea, cola and Scotch whisky, and foods such as chocolate, also contain some caffeine. Nicotine in tobacco products also disrupts sleep. Although I hope you do not smoke at all, reducing nighttime smoking benefits health and improves sleep quality.
• Sedatives affecting the central nervous system, such as alcohol, can cause sleep disturbance. Although alcohol induces sleep for the first hour or two, it later causes frequent waking.
• Heavy meals near bedtime cause indigestion and gastroesophageal reflux, preventing sleep. Reflux means stomach contents flowing back into the esophagus. Increased stomach acid there causes burning and pain, keeping you awake.

Medications That May Be Used

• Methylphenidate and certain steroid-containing drugs may help you sleep. These may be used under medical supervision for sleep disturbances.
• Take prescribed drugs as directed. When combined with alcohol, sedatives, antihistamines, phenothiazines or antidepressants, they may cause dependence.
• Use sleep disorder medications under your doctor's supervision.

Consult Your Doctor

Consult your doctor about sleep disturbances. Your doctor will decide the appropriate treatment. Also consult them if prescribed medication causes a problem affecting daily life. Never follow hearsay advice on your own without your doctor's knowledge. Your doctor will perform necessary tests and prescribe the appropriate medicine after deciding on any additions, changes and/or administration method needed.