Insomnia is the experience of not being able to fall asleep or stay asleep during the night. It can cause problems during the day, such as tiredness, low energy, poor concentration, and irritability.

Most people experience insomnia at some point in their lives, but the risk of insomnia increases with age and with serious illnesses, such as cancer. In one study, 44% of people with breast and lung cancers experienced insomnia. In another, more than half of people with advanced cancer experienced insomnia.

Insomnia can cause other cancer-related conditions and symptoms to worsen, such as pain, fatigue, or anxiety. It can also decrease a person's ability to cope and cause feelings of isolation.

Diagnosis

Understanding what is causing insomnia is important to knowing how to treat it. When finding the cause of insomnia, your doctor will ask you about the following symptoms:

• A history of a sleep disorder
  
  
• Depression, anxiety, or delirium (confusion)
  
  
• Pain, shortness of breath, cough, nausea, or itching
  
  
• Use of caffeine, alcohol, or tobacco
  
  
• Withdrawal from medication
  
  
• Side effects of other medications
  
  
• Poor sleep habits
  
  
• Emotional distress or worry
  
  
• Unfamiliar, noisy, or uncomfortable sleep environment

Treatment

The goal for managing insomnia is to achieve restful sleep and a better overall quality of life. Medications may help relieve insomnia but should only be used in the short term, unless other treatments are ineffective. Behavioral techniques are usually more effective for long-term relief. (See below for more on behavioral techniques)

First, identify any sources of insomnia, such as pain, depression, anxiety, stimulating medications, or sleep disorders. Ask for assistance from your doctor or nurse to help manage these conditions.

The following suggestions may be helpful in managing insomnia:

• Go to sleep and wake up at the same time each day.
  
  
• Avoid caffeine, alcohol, and tobacco, especially at night.
  
  
• Eat a light snack if you are hungry before bed, which may help bring on sleep, but avoid drinking too many fluids.
  
  
• Exercise regularly, if possible.
  
  
• Sleep in a quiet, dark room that is not too hot or too cold.
  
  
• Start a bedtime routine, such as reading or taking a bath.

In addition, the following behavioral techniques may help:

• Relaxation techniques, which can include listening to relaxation tapes, praying or meditating, doing breathing exercises, or seeking professional therapy to learn biofeedback or hypnosis
  
  
• Limit the time spent in bed and asleep. If you maintain a constant state of mild sleep deprivation, it may help you sleep at normal times.
  
  
• Stimulus control, which means that the bed should be used only for sleep and not for reading, sex, tossing and turning, or watching television.

More Information

Strategies for a Better Night's Sleep

Cancer.Net Podcast: Strategies for a Better Night's Sleep

Last Updated: September 11, 2009