Breast Cancer and Sleep

Sleep issues are very common for people with cancer. Up to 95% of people experience sleep disturbances during cancer treatment and recovery. One study reported that over half of women with breast cancer experience poor sleep quality.

Cancer treatments like chemotherapy and radiation, as well as anxiety, depression, and other conditions, may disrupt sleep for some people. A good night's sleep can help you cope during cancer treatment and is also linked to the overall quality of life in people with breast cancer.

This article discusses the connection between breast cancer and sleep.

Connection Between Breast Cancer and Sleep

You may find that your sleep quality worsens before, during, and/or after breast cancer. Many factors affect sleep. Your sleep problems may include poor sleep quality, not sleeping long enough, or other kinds of sleep disturbances.

Sleep issues, including fatigue, have been studied in patients with breast cancer. Some studies have looked at sleep issues by themselves. Others have grouped sleep problems into a cluster of symptoms that include mood, cognitive issues, fatigue, insomnia, and pain.

Daytime naps or other changes to your schedule can affect sleep. Changes to your nutrition or exercise levels can also impact sleep quality. For some people, breast cancer treatments can disturb sleep.

Surgery

After a breast cancer diagnosis, tumor removal will be recommended and includes either a lumpectomy or mastectomy. Surgical sites are typically tender for several days to weeks. Spacers and additional surgical areas can cause even more discomfort if breast reconstruction has been initiated.

Finding a comfortable sleeping position can take some time. It is typical for sleep to be somewhat disturbed in the immediate postoperative period.

Chemotherapy

Chemotherapy is one type of treatment used for breast cancer. One study showed that over half of the women receiving chemotherapy for breast cancer treatment experienced insomnia around two months into treatment. The study also showed that lack of sleep correlates to chemotherapy side effects, including headache, nausea, frequent urination, and night sweats.

Radiation Therapy

Radiation therapy is frequently used as part of the treatment plan. It is also associated with insomnia during breast cancer treatment. As with chemotherapy, other side effects may play a role in sleep issues, including headache, fatigue, nausea, shortness of breath, and night sweats.

Hormone Therapy

If your breast cancer treatment involves hormone therapy, you may have issues with sleep. Night sweats and hot flashes are common side effects of some medications and may make it hard to sleep well through the night.

Types of Sleep Issues Likely Caused by Breast Cancer

Sleep issues can occur at any time throughout your cancer experience. Common sleep issues in people with cancer include:

• Insomnia
• Sleep apnea
• Restless legs syndrome
• Cancer-related fatigue

Waking up during the night, less deep sleep, and changes to emotional dreaming can also impact people with breast cancer. These issues can lead to daytime sleepiness and increased fatigue.

Sleep disturbances can occur before, during, and after breast cancer treatment:

• Before: People newly diagnosed with breast cancer report sleep issues at a rate of about double the typical population. The exact cause of sleep issues is unknown, but it can be stressful worrying about finances, lost wages and time away from, side effects, and prognosis.
• During: Despite ongoing research, it is unclear if sleep issues worsen or improve during breast cancer treatments. Some people become used to the treatments and find that decreased anxiety from knowing what to expect permits better sleep. For others, the side effects add up, making sleep more difficult.
• After: About 40% of breast cancer survivors continue to have insomnia after treatment. This is about 3 times more than the general population. For these women, breast cancer stage or type of treatment did not seem to increase the risk for insomnia.
  

Treatments of Cancer-Related Sleep Issues

A variety of treatments exists for different sleep problems related to breast cancer. The best combination will depend on the type of sleep issue you are experiencing and the suspected cause of the disturbance.

Treatments for sleep issues are important because ongoing lack of adequate sleep can cause other serious side effects. If you cannot sleep well with self-directed approaches, reach out to your healthcare team for help.

Sleep Hygiene

Sleep hygiene refers to developing good habits around your bedtime and sleep routines. There are some simple things you can do to promote a good night's sleep:

• Have a consistent bedtime.
• Sleep in a dark, quiet room.
• Make sure your room is at a comfortable temperature.
• Avoid screens in the bedroom.
• Exercise regularly.
  

Consider keeping a sleep log to record your bedtime, approximate sleep time, wake time, caffeine intake, and any measures you are taking to help your sleep quality. Note if you have trouble falling asleep, how often you wake up during the night and if you experience hot flashes or night sweats. Your healthcare provider can review this to determine how to best improve your sleep.

Therapy

Cognitive behavioral therapy (CBT) is recommended as the first-line treatment for chronic insomnia. Other treatments (including medication) can be added as patients discuss their treatment options with their providers.

Cognitive behavioral therapy plus coping management (coaching on coping skills) showed significant improvements in sleep quality, anxiety/depression levels, and overall quality of life in women during breast cancer treatment. However, there is no documented protocol for this approach. You may need to work with your healthcare team to determine what is best for you.

Medications

Over-the-counter (OTC) sleep aids are available. However, they may have interactions with your cancer treatment or other medications you might be taking. Be sure to speak with your healthcare provider before starting any medication.

Medications can be used for a short time to help you fall asleep more easily or stay asleep at night. Other medications can help manage side effects that may be interrupting your sleep.

Complementary Therapies

Some people find that yoga, acupuncture, meditation, and other relaxation approaches can help improve sleep. Deep breathing, guided imagery, and muscle relaxation may also be helpful. Journaling, talking to loved ones, and other stress management techniques may also be beneficial.

When to See Your Healthcare Provider

An occasional poor night of sleep can make for a difficult next day. However, prolonged difficulty sleeping can become dangerous as it increases your risk for accidents, injuries, and chronic health conditions.

People with breast cancer can experience sleep disturbances from other health issues. Let your healthcare provider know if you are having trouble sleeping, especially if you are experiencing symptoms.

Summary

It is normal to occasionally have trouble sleeping, especially during periods of high stress. Getting the right amount of sleep as much as possible is important for your overall health. Too much or too little sleep is associated with higher cancer rates, and having breast cancer can disturb sleep in many different ways. If you are having sleep issues while dealing with breast cancer, there are things your healthcare team can do to provide support and assistance.

A Word From Verywell

Lying awake in the middle of the night thinking about how much sleep you are not getting can add to an already stressful situation. Being diagnosed with breast cancer is emotionally upsetting, and sleep deprivation can make things much harder. Many approaches can help you sleep better. Your healthcare team is ready to support you, so reach out and keep them informed of any difficulties you are experiencing.