Sleep problems can affect up to 80 percent of people who are undergoing chemotherapy.
Traci Gordon never had a problem falling asleep or staying asleep. In fact, she has a sleep disorder that causes her to sleep too much. “I could sleep through a whole weekend,” Gordon says.
That all changed when Gordon, a 47-year-old administrative assistant in New York, began chemotherapy for breast cancer about seven years ago. The treatment threw her body into an artificial state of , which caused unrelenting night sweats.
“My memory of it was waking up five, six, seven times a night, absolutely dripping,” Gordon says. Each time, she would change her clothes, stand in front of the air conditioner and wonder how much of her fatigue was caused by the cancer, how much was caused by the treatment and how much was caused by her through the night. “It was really having an impact on top of everything else,” she says.
Sleep problems during cancer are ubiquitous, affecting up to 80 percent of people undergoing chemotherapy, says Oxana Palesh, an assistant professor in the Department of Psychiatry and Behavioral Sciences at Stanford University Medical Center who develops and tests sleep interventions for cancer patients and survivors. One of her found that is about three times more prevalent among cancer patients being treated with chemotherapy than it is in the general population. When you have cancer, Palesh says, "it's much more common to have sleep problems than not."
But at the same time, sleeping well during cancer treatment is critically important in fighting the disease. Without solid rest, the body’s level of cortisol – known as "the stress hormone" – goes up and the count of “natural killer cells,” or NK cells, that help fight cancer go down, says Dr. Laeeq Shamsuddin, medical director of the sleep clinic at Cancer Treatment Centers of America at Midwestern Regional Medical Center in Zion, Illinois.
might even shorten some cancer patients’ survival, Palesh’s preliminary work suggests. “There is a lot of comorbidity between poor sleep and depression, poor sleep and post-traumatic stress disorder, poor sleep and increase in pain,” says Palesh, who directs the Stanford Cancer Survivorship Research program. “Literally, it doesn’t make one thing better.”
When Good Sleep is Out of Reach
Anyone who’s ever lain awake counting sheep, or ruminating after a fight with a partner knows how hard it is to get a good night’s rest just when you need it most.
Now add cancer to the mix, and it’s easy to see why quality sleep is fleeting. A cancer diagnosis is scary, stressful and anxiety-provoking; cancer treatment can cause side effects including pain, and nausea; and life with cancer often means sleeping at odd hours or in unfamiliar places like a hospital. “Everything they say to promote healthy sleep habits … you’re not doing that,” says Gordon, who’s currently undergoing chemotherapy again for breast cancer in her other breast.
For Kym Sinclair, a 31-year-old nurse in Santa Cruz, California, some of the most significant sleep disruptions from cancer were psychological. As a former college athlete with no family history of cancer, Sinclair’s Hodgkin’s lymphoma diagnosis at age 27 came as a shock. “I went from being the single ER nurse living in downtown Sacramento with my own cute little apartment to ‘I’m dependent on other people, I’m not working and I’m now the patient,’” she says.
That abrupt loss of identity sent Sinclair on a tailspin toward anxiety and . “All I wanted to do was sleep and get away from it … but the anxiety and depression keep you up,” she says. “That’s your first dance with not being able to sleep but wanting to do nothing but sleep.”
As she began chemotherapy, Sinclair struggled with side effects, including bone aches, vomiting, nausea, gastrointestinal distress and the chills – all of which put a good night’s sleep further out of reach. “You just can’t ever get comfortable. You just constantly feel like you have the flu,” she says.
And when Sinclair tried to catch up on the sleep she missed by napping during the day? There was the neighbor mowing the lawn or the other neighbor’s dog barking. “All you want to do is sleep, but life goes on,” she says. “It can’t just stop because you want to take a nap.”