Most people experience poor sleep from time to time. Maybe you went to bed too late, were too excited or stressed to fall asleep, took medication that kept you alert or had an alcoholic beverage before bed that interfered with your ability to fall asleep. There are many reasons that you might have a bad night of sleep.
However, for up to 35% of adults, insomnia prevents them from getting adequate sleep. For cancer patients, that number may be even higher, possibly impacting as high as 59% of all cancer patients.
A significant cause of sleep disturbance is sleep apnea. While many people with sleep apnea may not have issues falling asleep, this condition occurs when breathing repeatedly stops and starts during sleep and can cause many symptoms, including sleepiness, fatigue, and morning headaches among many other issues.
“Sleep disturbance is dynamic and non-discriminatory,” says David Visco, MD, Chief of Medicine & Medical Director of Sleep Medicine at Cancer Treatment Centers of America® (CTCA) in Philadelphia, Pennsylvania. “Many people have sleep disturbances before they are diagnosed with cancer. More than 20 million Americans have sleep apnea and many others experience insomnia or other sleep disturbances.”
There are many factors that contribute to sleep problems for cancer patients:
- Psychological stress associated with a cancer diagnosis
- Pain and other symptoms of cancer
- Side effects of treatment, including nausea, incontinence and hot flashes
- Schedule changes associated with treatment
- Medications that may cause insomnia as a side effect
- Inflammation resulting from treatment and the cancer itself
Adding sleep to your priority list
“Patients often worry about their nutrition or exercise and look to both to get stronger. But, I ask, what about the effects of sleep deprivation?” Dr. Visco points out. “Nutrition and exercise are very important, but sleep deprivation also impacts healing. It’s often under the radar and overlooked.”
Sleep deprivation not only makes you feel downright terrible, but also it might influence how well your body fights cancer. Chronic sleep deprivation impacts cortisol and melatonin levels, and both of these hormones have critical functions that may influence the behavior of cancer cells. Cortisol helps regulate immune system activity, including the release of natural killer cells that help the body battle cancer. The brain makes melatonin during sleep, which may have antioxidant properties that help prevent damage to cells that can lead to cancer.
“Your body is in a heightened stress state when you’re sleep deprived,” explains Dr. Visco. “Sleep deprivation is associated with a number of health concerns, including cardiovascular events, metabolic conditions and neurologic events, among many others.”
Furthermore, sleep deprivation can cause other medical conditions to worsen. Inadequate sleep may impact the severity of heart disease, hypertension, diabetes, respiratory disorders, anxiety and depression, and these conditions can negatively impact cancer treatment outcomes.
“Ninety percent or more of cancer patients experience cancer-related fatigue during treatment,” notes Dr. Visco. “If that fatigue exists even before treatment starts, it’s critical to identify what is causing the problem. In one case, I had a patient who we diagnosed with sleep apnea and she began using a c-pap machine while she slept. She said she felt better after using the c-pap machine while undergoing chemotherapy than she had felt even before being diagnosed with cancer.”
What can you do now to improve your sleep?
“Whenever I hear someone is having a difficult time sleeping, sleep hygiene is the first topic I address,” says Dr. Visco. He suggests the following five tips to help anyone struggling with sleep:
- Keep your daily schedule. Even on weekends or holidays, try to wake up and go to sleep at the same time every day. Our bodies operate on a 24-hour circadian rhythm and when it is disrupted, we feel more tired.
- Avoid screen time before heading to bed. Better yet, leave screens out of your bedroom. Research has found that the light from screens like tablets or smartphones can suppress the production of melatonin, an essential sleep hormone.
- Exercise often, and at the right time. Although exercise promotes restful sleep, doing it too late in the day may keep you up later than you expect. The physical activity from a cardio workout can increase adrenaline and brain activity, making it more difficult to wind down.
- Watch your diet. Limit foods and drinks with caffeine after 12 p.m. to be safe. If you experience an occasional night of insomnia, the traditional advice of drinking a warm glass of milk can help you feel more restful. Another alternative is tart cherry juice, which is rich in melatonin.
- Talk to your doctor. If sleep issues persistently keep you up at night, inform your doctor. Your doctor can help you determine the cause of your sleep problems and provide you with tips and recommended treatments to help you get the sleep you need.