Half of all cancer patients have trouble sleeping. This is even more common for people who receive chemotherapy. Sometimes, these problems continue even after cancer treatment has ended.

Being well-rested can improve energy. It helps you cope better with the after effects of cancer and treatment. It is important to get a good night’s sleep. Over time, poor sleep can affect your physical and mental health.

If you need more help, your doctor can refer you to a sleep specialist.

What are sleep problems?

Here are the signs that you may have a sleep problem:

• Unable to fall asleep
• Unable to stay asleep
• Poor quality of sleep
• Snoring
• Feeling drowsy, or difficulty having trouble concentrating during the day

Pausing while you breathe or having restless legs can also mean you have a sleep problem.

It is normal to wake up 1 or 2 times each night. But, it is not normal to stay awake.

If you have these symptoms 3 or more times a week, you may have a sleep problem and you should talk to your family doctor.

What happens to my body if I do not get enough sleep?

Sleep problems can cause problems in your life, such as:

• stress
• problems with your social life
• changes in your mood and feelings (feeling grouchy)
• decreased quality of life
• depression
• trouble doing day to day things
• trouble concentrating
• trouble remembering things
• feeling tired during the day

Long-term sleep problems may increase the chance that you will have anxiety or depression. It can cause problems with relationships, work and general health.

What causes sleep problems?

Sleep problems can be caused by many factors in your life. It can be caused by stress and medicines used to treat cancer. Younger people are often more likely to have sleep problems than older people.

How long will it last?

Sleep problems related to cancer or cancer treatment can be short, and last for a few days at a time but then go back to normal. But sometimes sleep problems can become chronic, lasting more than 3 months.

If sleep problems happen more than 3 times per week and this lasts for several weeks without getting better, then you should talk to your family doctor.

What can I do?

Here are 15 tips to help you sleep better:

1. Check your medicines and supplements.
   Talk to your doctor or pharmacist about what medications and supplements you are taking. Changing the time you take your medicine may help improve your sleep. Medicines to treat cancer or the symptoms or side effects of cancer may cause sleep problems:
   • heart
   • blood pressure
   • asthma
   • anxiety or depression
   Some herbal or over-the-counter medicines can cause sleep problems as well.
2. Treat your health problems.
   Ask your health care providers if you have any health problems that may be affecting your sleep. Health problems such as depression, anxiety and stress can affect your sleep. Trouble sleeping can also be a sign of other health problems.
3. Do not rely on sleeping pills.
   Your doctor may give you sleeping pills or sedatives to help you sleep. Think of this a short term solution. Do not depend on it to sleep.
4. Do not have caffeine before bedtime.
   Do not have caffeine at least 6 hours before bedtime. Caffeine is a chemical stimulant. It can make it hard for you to go to sleep. Caffeine is found in coffee, tea (black, green and iced), cocoa, chocolate, energy drinks (like Red Bull) and some soft drinks (like colas and Mountain Dew).
5. Do not have nicotine before bedtime.
   Do not have nicotine at least 6 hours before bedtime. Nicotine, like caffeine, is also a stimulant. Nicotine is found in tobacco-based products such as cigarettes, e-cigarettes, chewing tobacco and cigars. Nicotine is also present in both prescription and over-the-counter nicotine replacement products used to help quit smoking like nicotine gum, patches and lozenges.
6. Do not have alcohol before bedtime.
   Avoid drinking alcohol at least 4 hours before bedtime. Alcohol may seem helpful in the beginning as it slows brain activity, but you end up having fragmented sleep. Use it in moderation.
7. Do not eat or drink right before bedtime.
   Do not eat a heavy meal within 3 hours of bedtime. Have a light snack if you are very hungry, such as a small bowl of cereal with low fat milk. Limit the amount of fluid you drink 2 hours before bedtime.
8. Get some sun.
   Go outside in natural sunlight for 30 minutes per day. Do this within an hour of waking up. Remember to wear sunscreen. Exposure to daylight is important in regulating sleep patterns.
9. Exercise regularly, but not right before bedtime.
   Regular exercise during the day helps you to sleep better. It will also give you more energy during the day. Do not exercise 2 to 4 hours before you go to sleep.
10. Go to bed only if you are sleepy.
    If you do not fall asleep within 20 to 30 minutes of lying down in bed, get up and do something boring. For example, keep dull reading material close by.
11. Go to sleep and wake up at the same time every day. (“Routininze” your sleep and wake cycle).
12. Take time to relax.
    Before bedtime, spend 90 minutes relaxing. It can be anything that calms you.
    Here are some things you can try:
    • reading
    • deep breathing exercises
    • crossword puzzles
    • meditation
    • prayer
    • taking a warm bath
    • listening to an audio book or pod cast
    • listening to relaxing music
    Relaxation techniques can be used during the day to help relax you in the day or before bed to help you fall asleep at night.
13. Set a time limit on stress and worry.
    Try to pre-plan “time to worry” so that you aren’t worrying before bedtime. For instance, in the early evening, allow yourself to spend no more than 30 to 45 minutes planning, problem solving (and worrying if you must). When the time is up, start your relaxation routine. This way, your mind can relax when you are ready to go to bed.
14. Make your bedroom comfortable for sleeping.
    Try these tips to help make your room comfortable:
    • Keep your room at a comfortable temperature. It is often better to have the room a little cool. Just have enough blankets to keep you warm.
    • Get into your favourite sleeping position.
    • Keep your bedroom quiet. Use ear plugs if needed.
    • Keep your bedroom completely dark. Use room darkening shades or eye masks if needed.
    • Use your bed for sleeping and sexual activity only. Do not use it as an office, workroom or play room.
15. Do not rest too much during the day.
    Stay active during the day. If you sleep or are inactive all day you will likely have trouble sleeping at night. If you need to nap, sleep no longer than one hour and ensure it is before 3:00 pm.