Tips for Improving Sleep During Cancer Treatment
- Quality sleep is essential for the body to recover during cancer treatment and to maintain a strong immune system.
- According to the American Academy of Sleep Medicine, roughly 1 in 10 U.S.
- Persistent difficulty in falling and staying asleep is linked to higher levels of pain, longer hospital stays, and a greater risk of complications.
Quality sleep is essential for the body to recover during cancer treatment and to maintain a strong immune system. However, many individuals living with cancer, including those diagnosed with non-small cell lung cancer (NSCLC), experience significant disruptions to their sleep patterns.
Insomnia is particularly common among cancer patients. According to the American Academy of Sleep Medicine, roughly 1 in 10 U.S. Adults experience insomnia, but after a cancer diagnosis, that number can increase to as many as 5 in 10 people.
Persistent difficulty in falling and staying asleep is linked to higher levels of pain, longer hospital stays, and a greater risk of complications. Conversely, improving sleep can help patients maximize the effectiveness of their treatments and improve their overall quality of life.
Managing Respiratory Challenges and Physical Comfort
For those with NSCLC, a persistent cough is a frequent barrier to restful sleep. Dr. Jun Zhang, vice president of oncology research at OSF HealthCare Cancer Institute, notes that mucus can accumulate in the throat or lungs when lying down, which triggers coughing spells.
To clear and soothe airways before bedtime, experts suggest using a warm-mist humidifier or inhaling steam from a bowl of hot water for 20 to 30 minutes. Sipping warm broth, herbal tea, or warm water can thin mucus, and a teaspoon of honey may help coat the throat.
Physical positioning also plays a critical role in breathing. Elevating the head and upper body to a gradual incline of 30 to 45 degrees using a wedge pillow or multiple firm pillows can help keep airways open and encourage mucus to drain.
Dr. Zhang cautions against propping the head forward with a single pillow, as this can kink the neck and worsen breathing. For patients with pleural effusion, or fluid around the lungs, sleeping on the affected side while keeping the head elevated is recommended.
Dr. Meghann Schenk, a palliative medicine physician at Karmanos Cancer Institute, suggests using a fan directed at the nose and cheeks to help reduce the sensation of shortness of breath.
Addressing Medication and Treatment Side Effects
Certain medications used in cancer treatment can interfere with sleep. Corticosteroids, such as prednisone and dexamethasone, can be stimulating. Patients are encouraged to ask their oncologists if these doses can be taken in the morning or early afternoon so the effects wear off by bedtime.
Pain management also requires strategic timing. Short-acting medications may wear off after four to six hours, leading to middle-of-the-night awakenings. Dr. Zhang suggests discussing a switch to long-acting medications with a pain management team and taking them 30 to 60 minutes before bed.
Other treatment-related disruptions include nausea, night sweats, and hot flashes. To manage nausea, patients may benefit from eating a light, bland snack—such as a banana, toast, or crackers—about an hour before sleep.
To combat night sweats, health providers recommend keeping the bedroom cool and using breathable cotton sleepwear and sheets. Keeping a fresh set of pajamas nearby allows patients to change quickly and return to sleep with minimal disruption.
Psychological Strategies and Sleep Hygiene
The emotional toll of a cancer diagnosis, including anxiety and stress over finances or prognosis, often makes it difficult to quiet the mind at night. Journaling or using voice memo apps to record thoughts can help unload these worries before bed.
Relaxation techniques can help the body shift out of stress mode. These include:
- Progressive muscle relaxation, which involves slowly tensing and releasing muscle groups from the toes to the forehead.
- The 4-7-8 breathing technique (inhaling for 4 counts, holding for 7, and exhaling for 8).
- Meditation and focusing on gratitude.
For those with chronic insomnia, Cognitive Behavioral Therapy for Insomnia (CBT-I) is considered a first-line treatment. This therapy helps patients change the habits and thoughts that prevent sleep and can be accessed through a psychologist or digital tools like the CBT-i Coach app.
General sleep hygiene improvements also contribute to better rest. Recommendations include avoiding sugary items, spicy foods, or heavy meals close to bedtime, and removing electronics from the bedroom.
Complementary therapies such as yoga, acupuncture, meditation, shiatsu, and foot baths have also been found useful in reducing insomnia and increasing sleep efficiency.
Patients experiencing persistent sleep issues should consult their primary care provider or oncologist, who can provide medication adjustments or referrals to sleep specialists.