Recover Overcoming Treatment Insomnia

Is getting a sound good night’s sleep something that has plagued you since being diagnosed with breast cancer? Do you still experience sleepless nights even though you’re done with treatment?

Insomnia, difficulty getting to sleep or difficulty staying asleep, is a common side effect of breast cancer treatment. It affects between 30 percent and 50 percent of patients.

When a woman is treated for breast cancer, her body is subjected to various physical and psychological factors that contribute to insomnia – healing after surgery, medications, change in hormone balance, stress and anxiety, etc. It’s a vicious cycle:  Anxiety about breast cancer can make it harder to sleep well. Poor sleep makes fatigue worse. Fatigue can increase the risk of anxiety and depression. Women with depression are more likely to have insomnia. All this can have a severe impact on a woman’s quality of life.  In some cases, women with breast cancer may have had poor sleep habits and fatigue even before the start of chemotherapy. But chemo can often make all the insomnia worse.

According to Ann Berger, Ph.D., R.N., A.O.C.N., F.A.A.N, and Niedfelt associate professor and advanced practice oncology nurse at the University of Nebraska Medical Center, breast cancer survivors experience more problems with sleep disturbances than survivors of other cancer diagnoses. This is because women, in general, are more likely to suffer from insomnia than men. Younger pre-menopausal women, who are thrust into menopause because of their breast cancer treatment, are most likely to have difficulty sleeping. Hot flashes and other symptoms of menopause make it harder to achieve uninterrupted sleep through the night, making the problem of insomnia and fatigue even more complex.

So, why is overcoming insomnia critical to your recovery?

Sleep is a restorative process that allows the body to replenish its immune system, and it plays a crucial role in our health and well-being. It is the time when the body rejuvenates and regenerates.  Poor-quality sleep and insomnia shortchange that process. Consequently, we develop a sleep debt that we never get back. If not addressed, insomnia can, on its own, create health complications. Therefore, adequate sleep is something our bodies need – it provides essential nourishment for both body and mind.
For women, sleep under normal circumstances plays a major role in promoting our health and well-being. Getting the sleep that you need enhances your overall quality of life.

So, it is important to make sleep a priority.

While there are many drugs to treat insomnia, there are risks involved with some of these medications. The most effective treatment for insomnia in breast cancer survivors involves addressing both physical and psychological factors. Improving your physical activity, managing stress and eating nutritiously are the best ways to combat insomnia and get to the root of the problem.  

Here are some things you can do to help you sleep better at night:

Avoid taking naps during the day. Try not to take naps during the day. But, if you do take a nap, take a power nap, which would last about 30 minutes.

Practice relaxation techniques. Within two hours of your bedtime, stop work-related activity. Other helpful relaxation strategies include doing taped relaxation exercises (focusing on breathing and muscle relaxation). Tapes are available commercially, often in drug and health food stores. Or, take a warm bath or a shower; have a massage, read, listen to soft music; or do muscle relaxation activities such as yoga. 

Quiet your brain. Let your body reduce its tension and cut out intrusive thoughts that you take to bed. If you’re worried about something, it’s important to deal with that in the early evening, then relax. Otherwise, relax and have a plan for how you’re going to handle what you’re worried about the next day. 

Other things you can do to help get a good night’s rest are:

Exercise.  Exercise has a direct, beneficial effect on several factors that affect insomnia. It reduces the effects of stress, improves mood and deepens sleep. Regular, daily exercisecompleted at least 4 hours before bedtime usually improves the ability to sleep significantly. While exercise will give you energy, it can also help you fall asleep at night. By regularly getting physical activity, you can easily get yourself into regular and healthy sleeping patterns. A simple walk after lunch or dinner could be all you need to fall asleep easily tonight.

According to ScienceDaily, women should aim for half an hour’s gentle exercise three times a week to aid their recovery from breast cancer.

Practice good sleep hygiene. The “20-minute rule” is a technique often used in conjunction with sleep hygiene practices. The goal is to associate being in bed with being asleep. If, after turning the lights out or waking up, you don’t fall asleep in what feels like 20 minutes, you should get up and only return to bed when feeling "drowsy-tired."

Clock watching is an arousing activity. It you happen to wake up during the night, don’t watch the clock. Instead, turn it away from you so that you don’t see what time it is or look at it as you go through the night.

Avoid caffeine. Caffeine may be in a lot of things that you consume – from coffee (even decaf) to chocolate, from cold medications to energy drinks. Sometimes it is hard to avoid caffeine, but it is critical to do so in order to overcome insomnia.

If you suffer from insomnia and you don’t want to risk relying on drug-based sleeping pills, consider addressing the psychological factors with natural sleeping aids such as:

Chamomile Tea. Chamomile tea is one of the best natural sleeping aids. Not only is it warm and soothing, but it also soothes the nerves, stomach and body. It relaxes the system and forces you to come down after a long and hard day. Additionally, it fights anxiety, kills worry and just helps you to relax.

Valerian. Valerian may not smell pleasant, but it’s a fantastic sleep aid. Essentially, it’s a minor tranquilizer that binds to benzodiazepine receptors in the brain, the same receptors that respond to Dalmane, Valium, Xanax and other sedating drugs.

Taking Valerian doesn’t lead to morning grogginess or trouble waking up. Instead, people report waking up feeling great and ready to take on the day. Remember, though, Valerian is a sedative and should only be taken before bed.

Hops. Hops isn’t just an ingredient in beer, it’s also a fantastic sleep regulator. Hops have been used for centuries both as an ingredient in beer and as effective remedy for sleeplessness and anxiety.

Women who are pregnant, nursing or at high risk for breast cancer should not take hops for long periods of time. This is because hops contain estrogen, which can cause an imbalance in women’s levels of the hormone. As a breast cancer survivor, you’ll need to be cautious about this.

Kava-kava.  Kava-kava is one of many natural sleeping aids that originate on the islands of the South Pacific. There are significant clinical studies that suggest it may be just as effective as prescribed drugs in its ability to relieve anxiety. It’s most commonly used as a sleeping aid and is completely natural, though users are advised not to take it with alcohol or other sedatives.

Melatonin.  Melatonin is a very popular sleep aid that is a natural treatment for insomnia. Melatonin has other uses aside from improving sleep. Studies show that it can be used as an antioxidant, cancer protective agent, skin protective agent and as a treatment for seasonal affective depression.

For more information, read WebMD’s article on “Natural Sleep Aids and Remedies.

To try some of these and other natural sleep aids and remedies at home, go to our Partner Shopping page.

To understand more about insomnia and breast cancer, go to Living Beyond Cancer “[the Guide to] Understanding Insomnia and Fatigue

For more information on overcoming insomnia, go to Breast Cancer Partner’s Resources. You can also share your knowledge with other survivors in our Partner Forum or at Survivor Tips.