Written by Dr. Michelle Ní Raghallaigh, Insomnia Specialist, and Neuroscientist PhD.
Insomnia is an important but overlooked side effect of cancer. Cancer sufferers are 2-6 times more likely than the general population to experience insomnia, with implications for recovery in terms of mental health, quality of life, fatigue and immune function.
Sleep disturbances are a common challenge for many cancer patients. Studies show that up to 60% of those diagnosed with cancer suffer from chronic insomnia, which can persist long after initial treatment. The toll of insomnia on mental, emotional, and physical health is significant, often amplifying pain, stress, and fatigue. However, Cognitive Behavioral Therapy for Insomnia (CBTI) offers proven techniques to help cancer patients achieve better sleep (Holwell et al., 2014; Matthews et al., 2018).
In this article, we’ll explore why insomnia occurs and how CBTI can support better sleep health for cancer patients.
Understanding Insomnia: Why Cancer Patients Struggle with Sleep
Insomnia in cancer patients isn’t just an occasional sleepless night—it’s a chronic issue characterized by difficulty falling asleep or staying asleep for at least 30 minutes, three nights a week, for three months or more. Here’s how CBTI addresses insomnia and the contributing factors that lead to sleep issues:
The 3 P’s Model of Insomnia
- Predisposing Factors: Some individuals may be more likely to experience insomnia due to genetic or psychological factors.
- Precipitating Factors: Cancer diagnosis, pain, hospitalizations, hormonal changes, emotional distress, fatigue, and treatment side-effects can all disrupt sleep.
- Perpetuating Factors: Spending too much time awake in bed, cancer-related fatigue, or relying heavily on sleep medications can make insomnia worse over time.
Understanding these factors helps create a personalized insomnia treatment plan through CBTI, allowing patients to regain control over their sleep.
What Makes CBTI Effective for Cancer-Related Insomnia?
CBTi is widely regarded as the most effective treatment for chronic insomnia and is particularly helpful for cancer-related sleep disturbances. Research supports CBTI as an effective non-drug treatment for improving sleep in cancer patients. By addressing both physical and mental components of insomnia, CBTI helps patients establish healthier and more consistent sleep patterns.
8 Practical Tips to Improve Sleep for Cancer Patients:
- Exposure to Natural Morning Light
Exposure to natural light in the morning helps reset your circadian rhythm, regulate melatonin production, and reduce cancer-related fatigue.
Tip: Sit or lie facing a window, with the curtains or blinds fully open.
Even on dark, cloudy, rainy day, this will still work!
- Create a Distinction Between ‘Day’ and ‘Night’ Mode in Bed
When possible, try to limit long periods of time spent awake in bed, as this strengthens the association between your bed and wakefulness. Ideally, try to be in a different space while awake e.g. by creating a ‘nest’ that is lovely, comforting and appealing to go to; anywhere that is not your sleeping spot in the bed.
Tip: If staying in bed is necessary, try creating a clear distinction between your bed in ‘day mode’ vs. ‘night mode’ e.g. have it look visually different (different coloured throw), or stay on top of blankets, or sit upright.
- Take Naps Wisely
Naps may be needed for cancer patients. By trying to have them earlier rather than later in the day, and taken in bed as opposed to the sofa, will improve your chance of sleeping better at night.
Tip: Limit naps to 20–30 minutes before 3 pm to maintain your nighttime sleep drive.
- Try to Set a Consistent Wake-Up Time
Waking up at the same time daily helps your body maintain a consistent sleep-wake cycle.
Tip: Set an alarm for the same time every morning, including weekends, to stabilize your body clock. Note: this doesn’t have to be an ‘early’ time; the important thing is that the time is kept consistent.
- Jot Down Thoughts Before Bed
A racing mind can keep you awake. Writing down your thoughts before bed can help clear mental clutter.
Tip: Spend just five minutes each evening jotting down thoughts, including any small positives from your day too.
- Try Progressive Muscle Relaxation (PMR)
Progressive muscle relaxation helps release physical tension that may keep you from falling asleep or returning to sleep if you’ve woken during the night.
Tip: Tense and then relax each muscle group, noticing the change in the level of tension in your muscles.
- Use Guided Imagery for Relaxation
Guided imagery is a mental relaxation technique that can help quiet a busy mind before bed or during the night.
Tip: Check out The Sleep Sphere’s free guided imagery audio library
- Have a ‘Sleep Pack’ prepped in advance for any hospital stays
Because of disruptive noise and bright night lighting in hospitals, having a little kit of ear-plugs, a good eye mask, and perhaps blue-light blocking glasses prepared in advance will be a godsend when staying in that environment.
Conclusion: Improving Your Sleep Is Possible
Insomnia is a debilitating condition, but it’s one that can be managed with the right tools. For cancer patients, CBTI offers an effective, non-pharmaceutical approach to better sleep. By implementing these tips, you can start seeing improvements in your sleep quality and overall well-being. If sleep issues persist, consider seeking professional support through CBTI for a tailored approach to managing insomnia.
For more information and free resources like Progressive Muscle Relaxation, contact us at michelle@thesleepsphere.com.