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Shakespeare was right: It is “sleep that knits up the raveled sleeve of care.” Everyone can relate to the feeling of being tired physically, mentally, and emotionally. However, cancer-related fatigue is more severe than this. It can also be more distressing. Cancer-related fatigue can be defined as a persistent and subjective sense of tiredness or exhaustion. Research suggests that about 90 percent of people in treatment for cancer have fatigue.
Exactly what causes cancer-related fatigue is still unknown, but certain conditions are often present with fatigue. Sleeping issues are among these conditions. There are other conditions that may contribute to fatigue (anemia, poor nutrition, even too much sleep, etc.), so it is important to discuss your particular fatigue with your health care team. However, getting a good night’s sleep is always good medicine and the following suggestions may help.
Tips for a Good Night’s Sleep
There is no single method that guarantees a good night's sleep, however, experts now recognize that there are some techniques that may help promote peaceful, recuperative sleep. The same technique does not work for everyone. So, try as many of the following techniques as possible to see which one or ones work best for you:
Prepare your bedroom for sleep
Make the thought of “going to bed” an appealing, attractive proposition by making your bedroom appealing and conducive to sleep.
- Keep sheets fresh, clean, and neatly tucked in so that they are as free from wrinkles as possible.
- Try to achieve complete darkness in the room. Even the tiniest bit of light in the room can disrupt your natural circadian rhythm. If necessary, wear an eye mask to block out light. If you have an adjacent bathroom, keep on only the smallest of lights, such as a nightlight.
- Keep the temperature in the bedroom no higher than 70 degrees Fahrenheit.
- If you have a clock in your bedroom, turn it around or remove it from view so you don’t wind up staring at it if you can’t sleep.
- Have a pair of soft, lightweight, sleep socks by the bed. Especially if you have a tendency to have cold feet, wearing these can help reduce middle-of-the-night awakenings due to chilled feet.
- Consider purchasing a soothing-sound or white noise generator to block out any distracting noises. Relaxation CDs can be helpful, too.
- Dedicate your bedroom to sleeping, not bill paying, TV watching, or work.
- Experiment with calming scents in an aromatherapy regimen. Essential oils may be sprayed on pillows or the tops of sheets to create an envelope of relaxing fragrance.
Prepare your mind and body for the bedroom
That hour or two before you actually go to bed can be critical to how well you sleep.
- Avoid watching TV right before bed; it can be too stimulating to the brain, making it harder to fall asleep.
- Avoid reading anything too stimulating as well, such as suspense or mystery novels.
- Put your work away at least one hour (preferably two hours or more) before bed. This will give your mind a chance to unwind so you can go to sleep feeling calm instead of anxious about the next day’s activities.
- Avoid before-bed snacks, particularly grains and sugars. These can raise blood sugar and inhibit sleep. When blood sugar drops later, you might wake up and not be able to fall back asleep. Instead, try a high-protein snack several hours before bed.
- Don’t drink alcoholic drinks for at least two hours before bedtime. They sound appealing because they make you drowsy, but that effect is short-lived and you may wake up in a few hours, unable to fall back asleep. Alcohol can also keep you from falling into the deeper stages of sleep, where the body does most of its healing.
- Drink plenty of water during the day. Don't drink a lot of fluids within two hours of going to bed. This will reduce the likelihood of your needing to get up to use the bathroom.
- Drink a small glass of warm milk with honey about two hours before bed to help you relax.
- Take a warm shower or bath before bed.
- Use the bathroom right before bed, reducing the chance that you'll wake up to go in the middle of the night.
- If you are taking medication for pain or sleep, take it at the same time each night
- If you smoke, don’t do so before bed. Nicotine is a stimulant and can keep you awake.
Establish a “now I lay me down to sleep” routine
Go to bed at the same time every night. This will help your body to get into a sleep rhythm and make it easier to fall asleep and get up in the morning. Generally speaking, it is best to be in bed by about 11 p.m. Some evidence indicates that our bodies' systems do the majority of their recharging and recovering during the hours of 11 p.m. and 1 a.m. Once in bed, engage in your own routine with one or more of these tips.
- Practice simple deep breathing techniques, expanding your lungs fully, then slowly releasing your breath.
- Try gentle, light stretches of the feet: point toes toward the foot of the bed, holding and then releasing the stretch. Then point toes to the sides of the bed and then toward your head, holding, then releasing the stretches each time.
- Practice the time-honored technique of slowly telling each part of your body to go to sleep: toes go to sleep, ankles go to sleep, calves go to sleep, and so on. Many people awake to find they never even made it to their waists!
- If you have a willing partner, indulge in a very light massage with aromatic essential oils.
Improve your sleep while you’re awake
A number of things you do or don’t do during the day can impact your nights. Try to keep the following in mind as you seek to improve your sleep:
- Limit caffeinated drinks or limit them altogether. Some people do not metabolize caffeine efficiently and can feel the effects long after consuming it. An afternoon cup of coffee or tea will keep some people from falling asleep that night.
- If possible, try to exercise regularly. You’ll be amazed at how just 30 minutes a day of moderate exercise, such as walking briskly, can help you fall asleep at night. However, don't exercise too close to bedtime, or it may keep you awake.
- Try to discuss and deal with your fears, anxieties, and problems early in the day. This will help you refrain from dwelling on them at night as you are trying to fall asleep.
- Take a short nap during the day if you're tired, but keep it brief – about 20 minutes. And do it early in the day.
- Consider taking up Tibetan yoga. At the MD Anderson Cancer Center in Houston, researchers studied people who were either being treated for lymphoma or had finished their treatment in the previous year. Half of those studied took seven weeks of Tibetan yoga classes while the others did not. At the end of the study, the patients who did yoga reported falling asleep faster, sleeping better and longer, and using fewer sleep medications than people in the other group.
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