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The Link Between Insomnia and Cancer Treatment

Medications, tubing and stress can steal away the ZZZs you need

Tired cancer patient reading at night

Cancer treatment taxes your body in so many ways. The fatigue can be almost paralyzing. Quite simply, calling chemotherapy, radiation therapy and other treatments “exhausting” seems like an understatement.


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And yet somehow, sleep frequently remains an elusive dream for those battling the disease.

“It’s a cruel irony that sleeplessness often goes hand in hand with fatigue following cancer treatment,” says oncologist Tiffany Onger, MD. “It’s one of the most common concerns we hear.”

So, let’s look at some of the reasons behind these restless nights — and what you can do to get those much-needed ZZZs.

How cancer treatment causes insomnia

If you’re undergoing treatment for cancer, there are definite forces that can leave you wide-eyed at night. “It’s multifactorial, with many different things working against getting good sleep,” says Dr. Onger.

Common reasons include:

  • Medications. Many cancer treatments include corticosteroids (such as dexamethasone) to ease pain and swelling. There can be a tradeoff for that energizing relief, though: “It can really impact your sleep,” states Dr. Onger.
  • Treatment side effects. Your body goes through a lot during treatment. Lingering pain and discomfort are not the best at bedtime.
  • Tubing. A buildup of fluid following a procedure or treatment may require the use of tubing for drainage. “As you might imagine, tubes are not the most comfortable things to sleep with,” says Dr. Onger.
  • Napping. Being tired and falling asleep during the day can disrupt your sleeping rhythm at night, creating a vicious cycle that somehow makes you more tired and need more naps.
  • Stress. Uncertainty and anxiety come with cancer. It can be a deadly disease, after all. “That’s something that understandably can keep you up at night,” recognizes Dr. Onger.

Finding solutions if you can’t sleep

Sleep deprivation can affect you physically and emotionally. If you’re in the middle of cancer treatment, that’s a side issue that works against the healing process.

Talk to your healthcare provider if you’re unable to fall or stay asleep at night for more than a few days, recommends Dr. Onger. They can help you identify the potential cause and work toward a solution.

Keeping a sleep diary may help the process. Chart the times you’re asleep and awake, as well as what you think may be contributing to any insomnia. It may provide the clue behind your wakefulness.

“Don’t let sleep problems linger,” encourages Dr. Onger. “Start a discussion, because there are always options to help.”

One important note, though: Don’t adjust any prescribed medications on your own to try to address sleep issues. Talk to your doctor about options.

Can sleep aids be prescribed?

Medication can sometimes be used to bring on those needed ZZZs — but they’re not right for everyone. “Sleep aids can play a role, but we want to be thoughtful and careful as we’re adding in more medicines during the cancer journey,” says Dr. Onger.


Tips to sleep better

Good sleep starts with good sleep hygiene, a fancy term describing your overall bedtime routine and bedroom environment. Sometimes, making simple changes can lead to a restful night. Here are 10 things to try.

  1. Make your bedroom conducive to sleep by keeping the room dark, quiet and cool.
  2. Maintain a regular sleep routine by going to bed and waking up at the same time. This consistency can help solidify the sleep-wake cycle on your body’s internal clock, or circadian rhythm.
  3. Limit daytime naps to an hour or less. Save those ZZZs for later!
  4. If you’re able, try to get some mild to moderate physical activity (such as a 20-minute walk) during the day. Being tired from physical exertion has a way of helping you fall asleep. (But don’t exercise right before bed, as that may rev you up.)
  5. Reduce or eliminate overall caffeine consumption — and definitely stay away from caffeine in the late afternoon and evening.
  6. Avoid alcohol, which can hurt your quality of sleep.
  7. Limit screen time in the hour before bed to help your brain begin to unwind. That means turning off the TV and putting down your smartphone, tablet or laptop to avoid stimulating light.
  8. Avoid late-night snacking so your digestive system can clock out for the day. Aim to not eat in the three hours before you lie down for the night. (Go easy on fluids, too, to avoid getting up to go in the wee hours.)
  9. Calm your mind and relax through meditation, gentle yoga stretches or listening to soothing music.
  10. If worries are keeping you up at night, try journaling earlier in the day. The process may help you process and remove issues from your thoughts so you don’t bring them to bed with you.

Final thoughts

There’s no question that cancer treatment brings challenges. Know that you’re not alone in dealing with issues like insomnia. And during those difficult times, realize that the situation is temporary.

“Treatment side effects like sleeplessness don’t last forever,” reassures Dr. Onger. “They may persist longer than anyone wants, but the expectation is that things will get better.”


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