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Many people with cancer have trouble sleeping. Sleep problems can affect you in different ways. Any change in your usual sleeping habits can make it harder to do everyday activities. There are treatments available and steps you can take to help manage your cancer-related sleep problems.
Getting at least seven hours of sleep each night is advised for most adults. But many things can affect your sleep, including your age, stage in life, home and work life, stress level, and other non-cancer related problems.
For some people, sleep problems are short-term, lasting less than 3 months. But for other people, these problems might last several months or years. Sleep problems can also come and go based on your emotions and the side effects of your treatment.
If you have sleep problems, you might notice you have less energy than usual. Sleep problems can also affect what you are able to do at home, work, or school. It might make it harder to enjoy social activities, friends, family, or hobbies.
There are a few different types of sleep problems you might have.
Having trouble falling asleep or staying asleep is called insomnia.
Insomnia can be short-term (lasting for a single night, a few days, or a few weeks), or it can be chronic (lasting for three months or longer).
People with insomnia don’t get as much sleep as they need. This can lead to fatigue (a physical, emotional, and mental feeling of tiredness). It can also lead to feeling sleepy during the day or having trouble doing your usual daily activities.
If you have cancer and insomnia, you might:
If you had insomnia before you were diagnosed with cancer, you are more likely to continue having trouble sleeping after your cancer diagnosis. If this is true for you, then you might need to try some new ways of managing your sleep problems.
People with hypersomnia feel very sleepy during the day or want to sleep for longer than normal at night. Signs of hypersomnia include:
Hypersomnia can make it hard to take care of your family, home, and work responsibilities. Because you are so sleepy, you may find it difficult to enjoy activities.
Hypersomnia and fatigue are similar, but they are not the same. Hypersomnia is feeling too sleepy during the day and includes sleeping for a long time at night. Fatigue is a lack of energy and exhaustion that does not get better after you sleep.
For some people, sleep problems can make cancer-related fatigue worse. Cancer-related fatigue can also make sleep problems worse, because you might want to nap during the day. Daytime naps often make it harder to sleep at night.
Restless legs syndrome (RLS) makes you feel like you have to move your legs when you’re trying to rest or sleep. Your legs may also feel itchy or irritated, often causing jerking movements that keep you awake. RLS usually happens more during the evening hours.
RLS can happen to people who don’t have cancer, but some people get it during chemotherapy.
Sleep apnea is short pauses in your breathing while you are asleep. Each pause can last as long as ten seconds and can happen many times in one night. Many people with sleep apnea snore and wake up during the night. It can prevent normal sleep and make you feel tired or sleepy during the day.
Sleep apnea is rarely caused by cancer or cancer treatment. It is usually something a person has before they are diagnosed with cancer. But if you have sleep apnea, it’s important to keep up with the treatment you are already getting.
It’s also important to let your cancer care team know if you have sleep apnea.
There are many reasons why people with cancer have sleep problems. Some of these reasons are related to cancer, but some are not. You may have already had sleep problems before cancer.
Tell your cancer care team if you are having trouble sleeping, or if your sleep patterns change over time.
Sleep problems can be caused or made worse by:
Many side effects of cancer and cancer treatment can cause you to wake up during the night and make it harder for you to fall asleep. This includes:
Learn more about managing cancer-related side effects.
Having cancer can cause many emotions. This includes worry, distress, anxiety, and depression. Some of these emotions might cause sleep problems.
Learn more about coping with mood changes during and after cancer treatment.
Your daytime habits sometimes add to your sleeping problems. Habits that can affect your sleep include:
Sometimes the place where you sleep also makes a difference. You might have trouble sleeping if the room is too hot, cold, or noisy.
Other times, sleep disruptions can’t be controlled as easily, such as if you need to use the bathroom often, have nightmares or sleep terrors, or sleepwalk.
People with cancer and sleep problems report:
Sleep problems can be very different for each person. Start by describing your symptoms to your health care team. This helps them figure out the best way to treat your problem.
Your health care team might suggest that you meet with a sleep specialist. A sleep specialist may be able to help you figure out why you’re having trouble sleeping. Ask your health care team about a referral, if needed.
Below are some common ways to treat cancer-related sleep problems. You might need to use more than one way to help with your sleep.
Thinking or worrying about sleeping can make your sleep problems worse. Cognitive behavioral therapy (CBT) is one way to help you feel less anxious about sleep. The goal of CBT is to recognize your sleep habits and patterns and then find ways to manage them.
There are many ways to relax, calm your thinking, and wind down before bed. Relaxation methods can help you fall asleep, stay asleep, and go back to sleep if you wake up during the night.
Some examples of relaxation methods are:
You might be able to learn these methods on your own. But if you’d like help, ask your cancer care team for resources or a referral to a sleep specialist.
Learn more about mindfulness and other relaxation methods.
Sometimes, medicine is used to manage sleep problems. Your health care team can help you decide if this is right for you.
Other types of medicine can cause sleep problems. This includes steroids and hormones, and some medicines for pain, seizures, anxiety, and depression.
Don’t make any changes to your medicines without first talking to your health care team. Tell them about any medicines you are taking.
The side effects of your cancer or cancer treatment might cause sleep problems. Many of these side effects can be managed, and this might help you sleep.
You might sleep better if these cancer-related side effects are well managed:
Learn more about treating cancer-related side effects.
Cancer and cancer treatment are not usually the cause of sleep apnea, but many people with cancer have sleep apnea for other reasons. This needs to be treated to prevent other problems.
A continuous positive airway pressure device (CPAP) is the usual treatment for sleep apnea. A CPAP helps you breathe while you sleep. Tell your cancer care team if you have, or think you might have, sleep apnea.
There are many things you can do to help manage your sleep problems.
It’s important to have good habits before bedtime. (This is often called sleep hygiene.) Examples of good sleep hygiene include:
If you can’t fall asleep within about 20 minutes, or if you wake up and can’t go back to sleep, it’s time to try something new. Get up and go to a different part of your home. Stay in a darkened room and do something relaxing, like reading a book. Don’t go back to bed until you feel sleepy again.
What you eat and drink before bed can also affect your sleep.
It can also help if you set up your room for a good night’s sleep.
What you do during the day can make a big difference in how you sleep at night.
If you need help figuring out what physical activity or stretches to do, talk to your cancer care team. They might be able to help you find an exercise routine. Or they can refer you to a physical therapist to learn stretches that relax your muscles.
Sometimes it helps to keep track of your sleep habits so you can figure out patterns and problems.
Call your health care team if you:
The American Cancer Society medical and editorial content team
Our team is made up of doctors and oncology certified nurses with deep knowledge of cancer care as well as editors and translators with extensive experience in medical writing.
American Society of Clinical Oncology. Sleeping Problems: Hypersomnia, Somnolence Syndrome, and Nightmares. Accessed on cancer.net. Content is no longer available.
American Society of Clinical Oncology. Sleeping Problems: Insomnia. Accessed at cancer.net. Content is no longer available.
Braun IM, et al. Cannabis and cannabinoids in adults with cancer: ASCO guideline. Journal of Clinical Oncology. 2024; 42(13). Available at https://ascopubs.org/doi/10.1200/JCO.23.02596.
Büttner-Teleagă A, Kim YT, Osel T, Richter K. Sleep Disorders in Cancer-A Systematic Review. Int J Environ Res Public Health. 2021;18(21):11696. Published 2021 Nov 7.
National Comprehensive Cancer Network (NCCN). Palliative care. Version 1.2024. Accessed at https://www.nccn.org/ on April 12, 2024.
National Comprehensive Cancer Network (NCCN). Survivorship. Version 1.2024. Accessed at https://www.nccn.org/ on April 12, 2024.
Oncology Nursing Society (ONS). Symptom interventions: Sleep-wake disturbances. Accessed at https://www.ons.org/pep/sleep-wake-disturbances on April 12, 2024.
Last Revised: November 11, 2024
American Cancer Society medical information is copyrighted material. For reprint requests, please see our Content Usage Policy.
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