Sleep During Cancer Treatment

Sleep often changes during treatment — and that is normal

Many people with cancer have trouble sleeping. According to the National Cancer Institute, sleep problems affect a substantial share of people receiving cancer treatment. The causes are real and physical as well as emotional: pain, medicines such as steroids, hospital stays that interrupt the night, nausea, hot flashes, worry, and changes to daily routines can all disturb sleep.

Knowing this matters, because poor sleep is often treated as a personal failing — "I should be able to sleep." It isn't. It is a common, recognized side effect of cancer and its treatment, and it deserves the same attention as any other side effect.

What can help

NCI's patient guidance on sleep problems describes several approaches that people find helpful, always in conversation with a healthcare team:

• Keep a regular rhythm where you can. Going to bed and waking around the same times helps the body's internal clock, even during treatment.
• Make the sleeping space comfortable. Cool, dark, and quiet where possible; comfortable bedding; and reserving the bed mainly for sleep.
• Be careful with daytime naps. NCI's sleep guidance lists avoiding naps among the habits that may improve night sleep. If treatment fatigue means you need daytime rest, ask your team how to balance the two.
• Watch caffeine and screens late in the day. Both can quietly push sleep later.
• Move a little, if your team says it's okay. Light activity during the day is associated with better sleep for many people in treatment.
• Tell your healthcare team. Sleep problems can be treated. Your team can look for treatable causes — pain, medicines, anxiety, depression — and may suggest behavioral approaches or, when appropriate, medication.

When to talk to your healthcare team

Mention sleep at your next visit if sleeping problems happen most nights, leave you exhausted during the day, or feel like they are getting worse. Call your care team right away if sleeplessness comes with new pain or feelings of hopelessness. If you have severe trouble breathing, call 911. If you have thoughts of harming yourself, call or text 988 (the Suicide & Crisis Lifeline).

There is more on rest without pressure in Rest When Sleep Won't Come and calming practice in Gentle Breathing.