Getting a good night’s sleep with breast cancer

Sleep brings many benefits, from maintaining physical and mental wellbeing, repairing cells and strengthening your immune system, and improving your quality of life. As such, it’s especially important during and after breast cancer treatment, but the cruel irony is that sleep can be hard to come by. The most common sleep problems reported by women with breast cancer included trouble falling asleep or waking up, interrupted sleep and excessive daytime sleepiness. Between 67-90% of breast cancer survivors report sleep problems, such as poor sleep quality or not getting enough sleep, and this can last for a while after treatment ends.

Treatments like surgery, chemotherapy, hormonal therapy and targeted therapy can play a role in sleepless nights. Herceptin, for instance, has been associated with insomnia. The side effects of treatment, such as nausea and hot flushes, can often make sleep elusive, as can medications to help manage these side effects, such as steroids. An interesting study found that patients were more likely to experience waking up in the middle of the night during chemotherapy cycles, rather than in-between them, and these night-time wake-ups were at their peak during the first three cycles.

If you’re lying awake night after night, the foundations of sleep hygiene can set you up for a good night’s rest, no matter where you are in your breast cancer journey. You can set yourself up for good-quality sleep using the three steps below:

Create a good sleep environment

Your sleeping space should be quiet, dark and relaxing. If you experience hot flushes or night sweats from hormone treatment, try wearing cotton sleepwear or getting a pet cooling pad for your mattress. These cooling mats can be found at shops like Kmart or The Warehouse. Try to limit screens in the bedroom, as blue light from devices can hinder melatonin production (a hormone regulating your sleep and awake cycles that is only produced in darkness).

Relax your body

Preparing your body for sleep begins before bedtime. Exercising during the day can help to tire your body out (though exercising too close to bedtime can have the opposite effect), as can avoiding stimulants like caffeine, alcohol or spicy food late in the evening. A lot of advice says to avoid sleeping during the day, but if you’re going through treatment and feeling unwell, do rest when you need to – although you may not sleep for as long during the night.

At bedtime, you can prep yourself for a good night’s sleep by taking pain killers and medications before you settle down – timing these in line with your bedtime will allow you to avoid distress or sleep interruptions during the night. Many people find melatonin supplements helpful; these can be prescribed by your GP but you’ll need to pay for them yourself. Melatonin is more effective for older people than younger. If you’ve had surgery or reconstruction, pillows under your knees or arms can help support your body and protect tender areas.

Quiet your mind

Stress about your diagnosis, treatment, or even life after treatment, can understandably keep you up at night. Try to wind down before bed by reading or listening to relaxing music, and quiet a racing mind with meditation or mindfulness. If worries are waking you up during the night, keep a notepad by your bed to write down any thoughts – this will clear your mind and help you to relax. Worrying about not sleeping is also likely to keep you up – it’s better to let sleep find you. If you’re still struggling to sleep 30 minutes after going to bed, get up and go do a quiet activity in another room, such as reading. When you’re feeling sleepy, head back to bed.

Sleep is vital to your recovery and general wellbeing, so do ask for help if you need it. Your medical team can come up with a plan to improve your sleep, including prescribing medication. Our nurses are also happy to answer any questions or concerns – it’s free to call on 0800 226 8773 or email breastnurse@bcf.org.nz.