Sleep Effect In Oncology
Updated: Dec 21, 2022
Don't underestimate the importance of sleep!
Eat a healthy plant based organic diet?
Still not sleeping well?
The anxiety of not sleeping well, if aware of the side effects, and implications of poor sleep are causing a worsening cycle of anxiety?
Your subconscious mind is telling you it's time to work on your sleep!
Click below for a FREE Assessment to work out what YOU need to focus on to get you started:
So what is optimal sleep?
Falling asleep within 5-10 minutes of switching off your light,
Remaining asleep for 7-9 hours,
Going through all 4 stages of sleep: light, non REM, deep and REM sleep,
Waking feeling refreshed.
When do we address our sleep?
When our sleep affects our health, daytime activities and work performance.
How does sleep change with age?
We sleep more as a baby and in adolescence.
Between 20-25 we sleep less and don't usually worry about it.
Between 60-65 we sleep less in one stretch and are more likely to take day time naps.
What are misconceptions about sleep?
"Alcohol helps me sleep better."
After alcohol you may fall asleep quickly, but will be unlikely to go through all 4 sleep stages and wake refreshed.
"Exercise and nutrition are most important for optimal health."
Without sufficient sleep, exercise and nutrition will not have optimum benefits. We need quality sleep to recover from exercise and become stronger, otherwise we cannot recover sufficiently and are more at risk of injury and exhaustion increasing risk of long term health problems.
Correct nutrition is hard to follow after poor sleep, as hormone levels cause cravings for high sugar foods. Good nutrition is part of a healthy lifestyle but does not replace adequate sleep, both are required to avoid long term health problems.
When we sleep well we feel more like exercising and eating healthier.
"If I sleep less I will be more productive."
Sleep deprivation makes it harder to concentrate, makes it harder to get tasks done and you will make more mistakes, so in fact you will be less productive.
"It doesn't matter what time I go to bed as long as I get 8 hours sleep."
Evidence has shown around 10pm is the optimal time to go to sleep. Due to circadian rhythms, daylight exposure and hormone levels, 8 hours uninterrupted sleep from 10pm is better for long term health, than from closer to midnight or later.
What are the long term effects of lack of quality sleep?
More prone to high blood pressure, diabetes, cancer and strokes.
Weight gain due to hormone leptin levels, which tell you to stop eating, declining if sleep deprived. The hormone grelin increases with the combined decrease in leptin causing weight gain. You eat more and your metabolism is slower when you are sleep deprived.
Decreased quality of life.
Increased cancer risk and cancer recurrence.
Premature ageing as during sleep the skin's blood flow increases and collagen rebuilds, delaying and reducing wrinkles and age spots.
Difficulty returning to normal life and taking on new activities post cancer.
Increased anxiety and depression.
Decreased sex drive.
Getting caught in the vicious cycle of not feeling great, causing poor sleep and poor sleep resulting in not feeling great.
What are the causes of poor sleep?
Worries and stress due to health, concerns something is 'off' with your body, taking care of family or finance.
Obesity causing snoring or sleep apnoea.
Delayed sleep phase syndrome, seen commonly in teenagers who go to bed late and rise late.
Shift workers, due to inconsistent sleep times, disrupting hormones and circadian rhythm.
Room not dark enough to promote sleep hormones.
Room too warm or too cold for optimum sleep.
Poor sleep hygiene.
Scanxiety causing lack of sleep before seeing specialists.
After surgery, physical pain, discomfort from drains and catheters.
After surgery emotional stress.
Due to chemotherapy or steroids.
Due to hormone therapy with side effects including mood swings, hot flashes and joint stiffness.
Due to menopause oestrogen hormonal falls causing elevated heart rate, increased sympathetic activity, hot flashes and night sweats causing waking.
After treatment, worrying whether you did enough to prevent recurrence, changes moving forward, ability to return to work and normal life.
When through the stress of 'fight or flight' during treatment the slow and quiet times when trying to fall asleep allow negative thoughts to surface which disrupt sleep.
Organic causes including anaemia and hormone issues.
Children with cancer are 5 times more likely to develop sleep apnoea and emotional disturbances affecting sleep.
Stress of hair loss and weight loss or gain, as it hits home when you see physical reminders of your diagnosis.
Awareness and education with appropriate resources, as health care professionals are often too short on time to deal with sleep issues.
How do I know what my sleep problem is?
Apps which check how good quality sleep is, can't diagnose but can indicate reason for waking unrested as a start point.
Sleep study at home or in a lab to measure sleep. Identifies whether sleeping well and another cause for exhaustion.
Questionnaires to establish what's happening and why.
What can be done to improve sleep?
Brief behavioural therapy for coping mechanisms.
For those who have gone through cancer PTSD is common and resources are required to unpack the impact on lives and work out whether a referral is required.
Referral to a Psychologist or Psychiatrist if more help required.
Awareness and education with appropriate resources as health care professionals are often too short on time to deal with sleep issues.
Support groups with others experiencing similar symptoms.
A constructive worry time. Keeping a journal early in the evening, not too close to bed time, (4-6pm). Write down all the worries preventing you sleep, or worrying you, and write solutions for each worry. Can you do anything about it at 3am? No!
If suffering with cancer related fatigue after chemotherapy or radiotherapy, hold off sleep until after 7pm, maintaining a bedtime routine of not going to bed too early.
Take short naps, not substituting for night time sleep, ideally 15-20 minutes, no more than 30 minutes and not too late in the day, (before 3pm), or naps will affect your night sleep. It is at night time you will go through all the 4 necessary stages of sleep, not while napping.
Use affirmations and visualisations - based on neuroplasticity reframing your brain. "I am safe." "All is well."
Don't beat yourself up if you are following all strategies and have a bad night's sleep.
Look into and develop appropriate strategies and make long term change.
Melatonin is tried by many with the hope it will help, however a high dose over a limited time is necessary to be effective during cancer treatment. After active treatment has concluded melatonin can be used for a longer period with limited results. Melatonin is not the answer but does have specific implications, requiring a prescription, and is expensive in most countries.
Steroids are used with correct implications and can be prescribed specifically for a short time only, without dependency and can be life saving. They can assist with nausea and vomiting. Oncologists need to be aware of their patient's amount and regularity taking steroids and any side effects.
With hormonal therapy side effects should be discussed and managed with the patient's oncologist so informed choices can be made. There are many new drugs available as substitutions or that can be taken to counterbalance the side effects of drugs. Correct balance can be established by communication.
C.P.A.P. machine if indicated following sleep study.
How can I sleep better at night naturally?
Exercise is pivotal but often hard during treatment when feeling dreadful.
Research shows some movement helps. Before you are able to manage a walk round the block, mind-body techniques help, such as restorative yoga or tai chi, providing minimal, but some movement.
Build up to moderate exercise 4-5 times a week to help with fatigue management and improve sleep.
Avoid high intensity exercise within one hour of bedtime. Gentle exercise at least 90 minutes before sleep assists sleep.
Morning exercise when less tired, is preferred as it helps with circadian rhythm and cortisol, causing waking, melatonin and vitamin D helping with sleep.
Prescribed exercise is recommended after cancer which is monitored and progressed appropriately for how much the body can take at a particular stage, not overdoing it, slowing recovery.
An appropriate bed time routine, like we use with babies, is effective. This includes a hot or warm shower as a vasodilator, so the body temperature drops, which signals time to sleep.
A face routine before bed as a signal to your brain to sleep.
No technology in the bedroom, as blue light signals the brain's hormones to be awake and the bedroom should be a signal to your brain to sleep.
Reading on your phone is fine if scrolling helps you to relax and wind down, but not in your bedroom. Be mindful of news content prior to sleep, using reliable resources and a healthy time frame to avoid additional stresses to cope with.
A carbohydrate rich meal before sleeping and carbohydrates, included in snacks helps support your body's additional nutritional support needs during stressed times to assist sleep. Kiwi fruit, as rich in serotonin and antioxidants and cherry juice, a great source of tryptophan and melatonin, have been shown to assist with sleep.
Click below for a FREE Assessment to work out what YOU need to focus on to get you started:
What if I wake in the night still and can't get back to sleep?
If waking figure out what is waking you? Hot flash. Worry? Stress about the next day?
What is keeping you awake?
If your heart rate is elevated use body scans, meditations and breathing techniques to lower.
Supplements such as Black Cohosh and St John's Wort can be of assistance but medical advice should be sort before trying either, if on cancer medications, as they can change effectiveness.
If waking 3-4 times a night strategies to get back to sleep include sips of water, melatonin, (if previously tried successfully), body scans, natural or prescribed medications.
Consider the psychology behind waking.
Cognitive Behavioural Therapy, (C.B.T.) proves to be helpful, with hot flashes not stopping them entirely, but so they are more easily managed.
Gabapentin prescribed by a doctor, has an analgesic effect, in addition to assisting with hot flashes.
Sleeping pills prescribed by a doctor, which are non-sedative, so fully awake during the day. They should be only used short term and tapered off so not addictive and used in conjunction with other non-pharmacological techniques.
What we do in between our doctors appointments will set the stage for how we emerge from our journey.
"Have you had your high protein breakfast?"
"Did you sleep well?"
Sleep well, exercise well, eat healthy & feel amazing!
Without sleep we have nothing
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