Martha lives in Illinois and was diagnosed with metastatic breast cancer in January 2015. She has a husband and three children, ranging in age from 12 to 18, a dog and a lizard.
Cancer can magnify problems with sleep and introduce new ones, but there are easy changes you can make to get better sleep tonight.
Confession: I’ve never been a great sleeper.
When I was a pre-teen and teenager, my sisters and I would get up early to ride our bikes to 6:30 a.m. swim practices several mornings a week during the summer. In high school, that continued with the addition of springtime early am practices, and in college, it was the same thing but with 2:00 am bedtimes thrown into the mix.
Getting up as early as 5:00 a.m. was my norm. When I started working, I often rode my bike from Brooklyn to midtown Manhattan, which also meant I was up early and I did the same for much of the year when we moved to Chicago. A few years later, parenting meant waking at the slightest noise.
Then came cancer.
Suddenly, my garden-variety poor sleep habits were thrown into hyperdrive. The National Cancer Institute has a FAQ about why good sleep is important for people with cancer, including its impact on mental wellbeing and physical health effects like immune function, repair of cells and tissue and regulating blood sugar.
There are countless reasons why people with cancer are more likely than the general population to have sleep issues. Anxiety, pain, drug interactions (in breast cancer, aromatase inhibitors can be a culprit, as can steroids), gastrointestinal problems and more can all play a role.
I’ve found ways of improving my sleep, but there are still times when I know I’m not getting enough sleep, or even any good sleep, and it takes a conscious effort to get back into habits that work, like these:
As with anything health-related, the first step is to let your healthcare team know that you’re having sleep issues. They may have suggestions or can refer you to a specialist.
Instead of adding to sleep stress with the problematic “I’ve got to get to sleep” mental refrain, which only keeps me awake longer, I’ve stolen bits and pieces from cognitive behavior therapy. This included practicing muscle-relaxing exercises and a technique of mental calming I learned as a competitive swimmer. Find small tactics like this to avoid adding to your sleep stress.
This is where I struggle most. There are days when I could crawl gratefully into bed by 7 p.m. even though I know that means I’ll be wide awake at 10 p.m., midnight, 3:30 a.m., until I fall soundly asleep from 5 am until 7 a.m. This is not a healthy behavior. My goal is to stay out of bed until 10 p.m. and stay in bed until around 5:00 or 6:00 a.m.
Ugh. Who among us cannot relate to how beds are now where we read news, scroll through social media, watch movies on tiny screens or play endless games on apps? Guilty as charged. Put the phone away, turn off the television, turn out the lights, cover the clock--help your body understand that the bedroom is where you sleep and not where you go to wake up again.
As with so much in living with cancer, basic healthy behavior can make a difference in sleep too.
I try not to eat a meal or heavy snacks for a few hours before going to bed, I only have caffeine early in the day and try hard to exercise every single day. All of these good habits pay off with better sleep and feeling better in general as well.
For me, so much of life with cancer centers around uncertainty. It’s hard to live that way, so I’ve tried to create routines wherever I can.
I read and have a couple of cups of coffee in the morning at the dining room table, I watch 30 minutes of TV with my husband after dinner, I try to think about my worries and concerns through writing rather than through rumination while lying in bed, and I give myself time to wind down before heading to the bedroom. All of these small routines help as I try to counteract my tendency toward too little sleep.