Roll Over Cancer Insomnia, Make Way for Melatonin

Insomnia can be a problem for many patients with breast cancer.

Insomnia. If you’ve never heard the word, be thankful! Many people suffer from insomnia on a nightly basis, and there are those who experience dread as nighttime falls because they know sleeping will be a challenge. For many breast cancer patients, insomnia has become their newest nighttime buddy. But let me speak from personal experience here, insomnia makes a sorry bedfellow!

According to the article Insomnia and its Treatment in Women with Breast Cancer by Lavinia Fiorentino and Sonia Ancoli-Israelon, “The population of women with breast cancer is prone to insomnia for various reasons including a possible disruption of sleep due to increased frequency and severity of hot flashes associated with the breast cancer treatment, and possible increased depression, anxiety and fatigue levels following the breast cancer diagnosis. The literature on insomnia in breast cancer reports severe levels of insomnia and debilitating physical and psychological correlates of poor sleep as well as reports of very promising treatment options.”

The National Heart, Lung, and Blood Institute says “Insomnia (in-SOM-ne-ah) is a common sleep disorder. People who have insomnia have trouble falling asleep, staying asleep or both. As a result, they may get too little sleep or have poor-quality sleep. They may not feel refreshed when they wake up. Insomnia can be acute (short-term) or chronic (ongoing). Acute insomnia is common and often is brought on by situations such as stress at work, family pressures, or a traumatic event. Acute insomnia lasts for days or weeks. Chronic insomnia lasts for a month or longer. Most cases of chronic insomnia are secondary, which means they are the symptom or side effect of some other problem. Certain medical conditions, medicines, sleep disorders, and substances can cause secondary insomnia. In contrast, primary insomnia isn't due to medical problems, medicines, or other substances. It is its own distinct disorder, and its cause isn’t well understood. Many life changes can trigger primary insomnia, including long-lasting stress and emotional upset.”

Immediately after I had both breasts removed, I began having difficulty sleeping. At first, it was because I had to sleep on my back because of the surgical drains. I had to be conscious of them because if I impinged the drainage tubes, the fluid in my body couldn’t drain properly and might cause a blood clot to form. After I had the drains removed, I was still uncomfortable as I waited for my incisions to heal. I was unable to find a comfortable sleeping position. I slept in my recliner for weeks after surgery. When I finally felt able to return to my own bed, I needed pillows under both arms to combat post-surgical swelling. This presented another challenge to my night time comfort and added to many sleepless nights.

Why is sleep so important? My oncologist told me that one of the greatest benefits for any breast cancer patient is good, sound sleep. He also said, “Sleep allows your body to heal. If you’re not getting quality sleep, your body won’t heal properly.”

If you’re going through treatment for breast cancer, no matter what type of treatment you’re receiving, your body is being assaulted. Chemotherapy, radiation therapy and even hormone therapy can cause disruptions in your sleep patterns. What may have been enough sleep for you in the past might not be enough for you now. You may have noticed not only your sleep patterns have changed, but your sleep schedule may have changed, too. There’s a misnomer that we all need eight hours of sleep but that generalization just isn’t true. Some people do well on five or six hours of sleep, and others need more. Whatever the case, if you’re not feeling rested and able to think clearly, you’re not getting enough sleep. You may need to make some adjustments to your schedule and you may find yourself having to take frequent naps during the day. If the inability to sleep is affecting your life, it might be time to talk to your doctor. Be prepared to ask for whatever help you may need in order to get a good night’s sleep.

When I talked to my doctor about the disruptions to my sleep, he prescribed medication to help. I tried it for several weeks and it seemed to work well, but I didn’t like the after effects. I often felt very groggy the next day and would sometimes be unable to think clearly. My memory seemed to be affected as well, and that scared me. I began searching for a natural way to combat insomnia and found a supplement called Melatonin. What is melatonin? Melatonin is a natural hormone secreted by the pineal gland in our bodies. It's a powerful antioxidant and free radical scavenger that helps combat inflammation. Melatonin is sold in health food stores, drugstores and on various internet sites. It is safe to use, but it is always best to talk with your physician first regarding any medication or herbal supplement.

Here are some helpful hints on other ways to fight Insomnia:

1. Try to keep a specific bedtime routine. This helps let your brain know what’s coming next.

2. Avoid watching TV or using your computer late in the evening. Your body normally produces melatonin between the hours of about 9 and 10 p.m. If you are on your cellphone or computer, the blue light emitted by these electronic devices can make your brain think it’s still daytime.

3. Make sure you get a daily dose of bright sunlight. Your pineal gland produces melatonin roughly in approximation to the contrast of bright sun exposure in the day and complete darkness at night. For breast cancer patients, this presents a challenge. If you stay indoors most of the day, your body will not differentiate the change between day and night as well and your melatonin levels will not be normal.

4. Have you bedroom as dark as possible. Keep all electronics out of your bedroom or if you must have a clock, cover it so no light is emitted.

5. If you use a nightlight for navigating at night, be sure to use a yellow or orange bulb because these colors don’t interfere with melatonin production.

6. Keep your bedroom cool! Try to keep the temperature lower than 70 degrees. Optimal temperatures for sleeping have been shown to be between 66 and 68 degrees.

7. Take a bath before bedtime. Hot water will raise your body temperature and help you relax. When you get out of the tub, your body temperature will drop and help tell your body you’re ready for sleep.

Sleep is vital for breast cancer patients and survivors. Fatigue is often a challenge we face on a daily basis and one of the best ways to combat fatigue is rest. If you’re suffering from insomnia, talk to your doctor. If you’re interested in trying melatonin as a sleep aid, be sure to mention it to your physician to insure it doesn’t conflict with other medications you are taking.