Sleep problems

Sleep problems are common when you have breast cancer. Not sleeping well is a normal response to the stress of a diagnosis or treatment.

It can help to know that there are lots of things you can try to reduce sleep issues. You may not have considered some of them before, but see what works best for you.

For many people, sleep problems associated with treatment go away in time.  

If your sleep doesn't improve, your doctor can help you work out what may be causing the sleep difficulties. They may suggest some strategies to help you.

What can affect sleep

There are many physical and psychological reasons why you may have difficulty sleeping, including:

• physical symptoms such as pain or nausea, which can be treated or managed
• having a lot on your mind and feeling anxious, worried or depressed
• the medications you are taking – particularly hormone-blocking drugs
• side effects from treatments such as chemotherapy and radiotherapy.

Some people find their sleep returns to normal once they have finished treatment. For others, sleep is affected for a longer period of time.

Sleep problems in hospital

Poor sleep is common when you stay in hospital overnight.

You may experience a mixture of discomfort or pain, worry and a bright, strange environment with noise at all hours. This is not a recipe for a good night’s sleep.

People have shared their tips to help you get as much rest as possible, even if you can’t control your environment:

• Take an eye mask and ear plugs, to block as much light and noise as you can.
• Take layers of clothing, in case hospital is cooler or warmer than you would like.
• Wear clothing that is easy to put on and take off, such as socks or a wrap or shawl, so you can keep the right temperature.
• Take a fleece or blanket.
• Take your own pillow, especially if you tend to get a sore neck.
• Keep a book, magazine, podcast or music beside your bed so you have something quiet to do if you really can’t sleep.

Let your doctor know if you have trouble sleeping – they may be able to give you medication to help you sleep.

Tips to help improve sleep

There are many things you can try that might help you to get a better night's sleep.

Prepare your body for sleep

• Take a warm bath or shower before going to bed.
• Have a relaxing massage (if you are having radiotherapy, avoid the area treated).
• Drink warm drinks such as milk, milk with honey, or chamomile tea.
• If you have pain, take pain relief before you go to bed to reduce the chance of the pain waking you.
• Avoid drinks with caffeine at night – coffee, black and green tea, cola, energy drinks and reduce your caffeine during the day. Aim for the equivalent of no more than 2 coffees per day, and none after lunch.
• Avoid drinking too much in the evening so you don’t need to go to the bathroom during the night.

Prepare your mind for sleep

• Establish good sleep habits (‘sleep hygiene’): aim to go to bed and get up at the same time each day, avoid laptops and phones in the 30 minutes before bedtime, use your bedroom for sleeping and intimacy only.
• Practise relaxation exercises such as yoga, mindfulness, meditation and slow, deep breathing. Some YouTube channels, such as Yoga with Adriene, have free bedtime yoga to help prepare your mind and body for sleep.
• Try a mindfulness app, like Calm or Allevi8, to help you fall asleep.

Prepare your bedroom

• Make your bedroom and bed comfortable: make sure your mattress and pillows support your neck, the room is quiet and dark, and that you are not too hot or too cold.
• If you are too hot at night, try layers of sheets and light blankets instead of 1 heavy quilt. This helps you ‘customise’ your bedding to the right temperature for you.
• Try not to have your phone in your room at night. If you need to, put it on 'do not disturb'.

Manage your routine

• If you wake up often at night, avoid taking naps during the day, or only nap before 3pm.
• Try to get fresh air during the day and exercise if you can.
• Try to keep a regular daily routine for exercise, meals and rest, although this can be difficult when you are having hospital treatment.
• Keep a sleep diary for a week to look for patterns or triggers for really bad nights.

Ask for support

It’s okay to ask people for support when you are tired and struggling with sleep. Be as honest and as clear as you can about what you need, such as:

• some space in the evenings to practise relaxation yoga
• no calls or texts after a certain time each day, or set a 'Do not disturb' schedule for your phone
• understanding if you find it hard to be on time for an early morning catch up.

Most people have experienced periods of bad sleep, so they know how awful it can feel.

When to contact your doctor

Talk to your GP or your treating team if:

• you think you might be depressed or anxious
• your sleep problems are affecting your quality of life.

They may be able to refer you to a psychologist or counsellor. There is good evidence that cognitive behavioural therapy (CBT) can be effective for sleep problems.

See Ways your GP can help or find out about Psychology and counselling support.

Your doctor can also check your medications, which can sometimes cause sleep issues.

If nothing has helped you, talk with your GP about prescribing medication. Today’s sleeping medications usually don’t make you feel drowsy the next day.