Updated December 17, 2014
Persistent or long-term sleeping problems can impact your life in many ways. Poor quality sleep affects your self-esteem, mood, emotions, relationships and work. It gets in the way of your ability to think clearly, take care of yourself and your family, socialize and more. Family, friends and coworkers may not understand your situation and expect too much of you. Finding the words to describe how you feel may be challenging or frustrating.
Your sleeping problems could be caused by a variety of factors, including:
- Lifestyle habits, like going to bed and waking up at different times each day, drinking caffeine at night or doing lively activities before bed
- The trauma and stress of coping with a breast cancer diagnosis and treatments
- Uncomfortable symptoms or side effects
The sleep disorder insomnia has been associated with fatigue. With insomnia, you have trouble falling asleep or staying asleep three or more nights a week over a long period of time.
When dealing with the stress of cancer and its treatment, it is normal to have a night or two of restless sleep. This can be unpleasant and annoying and make you feel tired during the day, but it normally goes away on its own.
Insomnia is different. The symptoms of insomnia are:
- Trouble sleeping most nights
- Lying awake in bed for hours without sleeping, or falling asleep quickly but waking up during the night and having trouble falling asleep again
- You rarely feel refreshed or well rested when you wake
Insomnia makes it hard to concentrate, stay awake during the day and finish daily activities. It impacts your body’s ability to fight infection and increases your risk of developing anxiety, sadness or depression.
If this sounds like your experience, then you may have clinical insomnia that you should discuss with your treatment team.
Fatigue related to cancer or its treatments is a constant feeling of tiredness or exhaustion unrelated to recent activity. This exhaustion interferes with your ability to function normally. Symptoms of fatigue are:
- You feel tired, weak, sluggish, exhausted or drained
- You move more slowly than usual or need help getting around
- A night’s sleep no longer brings energy
Short-term fatigue lasts for days or weeks and is related to your lifestyle. The persistent fatigue associated with cancer and its treatments is different. Cancer-related fatigue lasts for long periods of time and takes away your energy to do even the easiest everyday tasks.
Fatigue is common during active treatment, and it may begin to improve several weeks or a month after treatment ends. It can take as many as six months to one year for you to feel that you have your energy back. Some women have long-term fatigue after treatment.
Tips for Managing Insomnia and Fatigue
If you feel tired, it is important to talk with your healthcare provider. Just because you have cancer does not mean you must put up with being tired all the time! Doing what you can to ensure good quality sleep is an act of self-care that helps you handle everyday stresses and traumas. Lifestyle changes, medicines and complementary therapies are ways to help you manage insomnia and fatigue.
Adapt Your Lifestyle
You can improve your sleeping patterns by changing your habits. Researchers have found that changing your sleeping habits is as effective at fighting chronic insomnia as sleep medicines and has longer lasting effects. Some things you can try are:
- Make sleep a priority and set aside seven to nine hours for sleep each night.
- Use your bed for sleep and intimacy only; avoid working, eating or watching television in bed.
- Go to bed at the same time every night.
- Don’t stay in bed tossing and turning. Get up, spend some time relaxing and return to bed when you feel tired.
Take ‘Power Naps’
“Power naps” give you the boost you need to make it through the next important task or event. These naps of 30 minutes or less, taken early in the day, give you rest but won’t put you into a deep sleep, which can make it harder for you to fall asleep and stay asleep at night. After a power nap, you may feel groggy at first but better within the next half-hour. Set an alarm clock to control the length of naps.
Regular, low-intensity exercise prevents and improves fatigue caused by treatment. Exercise also helps you sleep more soundly and can even improve your outlook.
Exercise need not cost much or take a lot of time. Start with a 20-minute walk each day.
Walk as briskly as you can. By night, this small amount of exercise will help you to fall into a deep sleep and stay asleep.
To save energy during treatment, you may need to make choices about how you spend your time. It may not be realistic to do everything you did when you felt well. Think about which of your regular responsibilities is important for you to do yourself.
When you can, ask for help. Family and friends may not be sure what to do. Let them know what you need—chances are they will feel honored that you asked.
Sometimes talking with other women or joining a support group can help you connect with others who have fatigue or insomnia. They may have ideas to help you manage what you are going through. Call the Breast Cancer Helpline at (888) 753-LBBC (5222) to talk to someone who has been there.
Talk with a Healthcare Professional
If insomnia and fatigue are interfering with your daily life and your doctor doesn’t mention them, you should bring them up. Be open, clear and descriptive. Rate how tired you feel on a scale of one to ten. Your doctor may be able to prescribe medicines to help you sleep, give you energy or help you deal with side effects that are keeping you awake.
Read our Guide to Understanding Insomnia and Fatigue and learn more about the providers who helped us write this page.