By: Ellie Foster, MPH
Are you having trouble sleeping during cancer treatment? Or, are you having problems getting to sleep during cancer treatment? You’re not alone. Many people have sleep problems during – and even after -- treatment. And, there can be many reasons for it, from pain to depression. Carrie Maynard, oncology social worker with Maine Medical Center’s Cancer Institute is here to talk about what you can do to get a better night’s sleep.
How Can I Sleep Better After a Cancer Diagnosis?
Talking with your doctor is your first step to getting a better night’s sleep.The next step is using Cognitive Behavioral Therapy (CBT) strategies. CBT helps people examine the negative thinking around sleeplessness, such as “Nothing I do helps.” We then look at ways to reframe our thoughts, using affirmative statements, such as “this will pass” or “I have survived a sleepless night before.
We also look at how our behaviors can influence our sleep. Examples include, increasing daytime activities, using the bed for sleep and sex only, establishing a bed time routine and a consistent wake up time. CBT can also include learning new coping skills to increase relaxation and respond to worried thoughts.
Some patients are interested in medication to help with insomnia. Sleep medications can be combined with CBT for a more immediate effect, but keep in mind that CBT shows a greater long-term success rate than medications alone and has fewer side effects.
Bringing Awareness to Your Body
Body scan relaxation is a method where you use your mind to scan your body and simply focus on each area. This brings awareness to your body and by doing so can help you notice areas that are relaxed and areas that are tight. There are free programs available online that can guide you or check out a CD by Jon Kabat-Zinn.
Practicing Relaxation Breathing
Focus on the sensation of the air entering your nostrils and count as you exhale (“1, 2, 3”) this helps distract your mind and relax your body. Make sure your breathing is comfortable and that your exhale is slightly longer than your inhale. Free smart phone apps are available to coach you through breathing. Practice a few minutes every day.
How Constructive Worry Time Helps
Plan 15-20 minutes of “worry time” during the day. Write concerns on one side of the paper and action steps on the other. Notice which thoughts are problem solving and which thoughts are rumination about past events or attempts to predict the future. If you awake at night tell yourself you can wait until your next “worry time”.
Associate Bedtime With Sleep
Get out of bed if it has been about 20 minutes since you went to bed (you can estimate, don’t watch the clock!). Do a quiet activity and avoid TV, computers, or bright lights that block the flow of melatonin “the sleepy hormone”. Then return to bed when feeling tired again. You can repeat this until you are able to sleep.
If you are worried about your trouble sleeping, contact one of the oncology social workers for further support and suggestions.