Sleep-Wake Disturbances and Fatigue in People with Cancer

by Nancy McHone

Thirty to forty percent of patients with cancer have problems with sleep-wake disturbances. That is more than twice the general population. Sleep-wake disturbance has been defined as a symptom of perceived or actual changes in night sleep resulting in daytime impairment.

Insomnia is the most common form of the sleep-wake disturbance and takes several forms. Insomnia can be difficulty going to sleep, difficulty staying asleep or waking up too early and not being able to return to sleep, or a non-refreshing sleep. Insomnia can result in the following forms of daytime impairment:

• Fatigue or malaise
• Attention, concentration or memory impairment
• Social or vocational dysfunction
• Mood disturbance or irritability
• Daytime sleepiness
• Motivation, energy or initiative reduction
• Proneness for errors or accidents at work or while driving
• Tension, headache
• Gastrointestinal symptoms
• Concerns or worry about sleep

(Berger, 2009)

What can a person do to help themselves if the sleep/wake disturbance is a problem? You can improve sleep habits by making changes. Developing specific ―sleep hygiene‖ is key. Go to bed at the same time every night and get up at the same time every day. The bedroom is for sleeping and sex only – get rid of those TV‘s! Avoid day time napping. If you must rest, limit it to 30 minutes.

Create an environment for yourself that will enhance sleep. Lower the noise and dim or turn off the lights. Sleep ‗cool‘ by adjusting the room temperature and using bedcovers for warmth. Wear comfortable, loose fitting clothes to bed and use pillows for support – under your head, between or under your knees if necessary. Sometimes what you eat can affect your sleep.

Avoiding alcohol, caffeine and smoking 4-6 hours before bedtime may help. Replace those spicy, sugary bedtime snacks with a high protein one about 2 hours before bedtime. Cancer-related fatigue lasts for long periods of time and is unrelieved by a night‘s rest or a change in lifestyle.

Fatigue is a common side effect of cancer therapies. It may begin to improve weeks or months after therapies are finished. Some people have long-term fatigue issues even after treatments are done.

There are some interventions you can make to cope with cancer related fatigue. Try keeping a daily diary of fatigue symptoms, 

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