Managing insomnia and fatigue

Being patient with yourself and others may seem impossible when you feel tired all the time. Working toward good sleep habits can be difficult, especially during treatment. Give yourself permission to feel tired, your body and mind are going through something traumatic. To get through each day, take steps to improve your sleep schedule and exercise habits, and find ways to preserve your energy.

Improving your sleep

Changing simple habits can lead to big results. Researchers have found that changing your sleeping habits is as effective at fighting chronic insomnia as sleep medicines and has a longer lasting impact. Here are some ideas:

• Set aside 7 to 9 hours for sleep each night.
• Go to bed at the same time every night.
• Use your bed for sleep and intimacy only. Avoid working, eating or watching television in bed.
• Have a bedtime routine. Give yourself at least 30 minutes to wind down before going to bed. Go to bed only when you feel sleepy.
• Do not spend time tossing and turning. After 20 minutes of not sleeping, get out of bed and go to a restful place to relax or read with a dim light. Return to bed when you feel tired.
• Get up at the same time every day.
• If you think your emotions may be keeping you up, your healthcare team can help. Your doctor may recommend medicine or suggest counseling or a support group to help you manage the emotional aspects of cancer.

Menopause & your sleep

Menopausal changes can interrupt sleeping patterns. Hot flashes and night sweats can prevent you from falling asleep quickly or wake you during the night. Mood changes, anxiety or depression can make you fatigued or unable to sleep at night.

To lessen the impact of hot flashes:

• Avoid spicy foods
• Wear comfortable, loose-fitting cotton clothes to bed.
• Sleep on cotton sheets.
• Keep a cool pack by your bedside to put on your forehead. Keep your room cool at night.
• Try our other tips to manage menopausal symptoms.

Studies have shown that some antidepressants are useful for treating menopausal symptoms but may disrupt your sleep in other ways. To learn more, talk to your healthcare provider. Be sure to mention other medicines you take, especially hormonal therapies such as tamoxifen.

Reducing fatigue with exercise

Regular, low-intensity exercise helps prevent fatigue caused by cancer treatment. Even a daily 20-minute walk will help you sleep soundly and will improve your outlook. Other types of exercise depend on your body and physical needs, so ask your healthcare provider before you start. A physical therapist, rehabilitation specialist or a psychiatrist specializing in treating people with cancer can help create a safe and effective exercise routine for you.

Here are some ideas on how to keep moving:

• If you already exercise, try to stick to your routine during treatment. You may have to adjust your intensity level. If you can’t walk your usual brisk 20 minutes, start with 5 or 6 minutes, and then build up.
• If you are beginning an exercise program, start with 20 minutes of slow walking on flat ground or riding a stationary bike. Include a 5 minute stretching warm-up and cool-down. Stop exercising if you feel short of breath, chest pain or discomfort.
• If you are feeling very tired on a given day, try a slow exercise such as yoga or tai chi to relax your mind.
• Follow some of our other tips on fitness and exercise.

Saving your energy

You may want to make choices about how you spend your time and energy. Doing everything you did before treatment may not be realistic.

Consider which of your regular activities you need to keep doing and which can be given to someone else or skipped altogether. Here are some ideas:

• Ask for help when you can. Family and friends may not be sure what to do, so let them know what you need. Chances are they will feel honored that you asked.
• Schedule errands for a time of day when you have more energy. Limit trips out to once a day if doing more exhausts you.
• Take a “power nap” to boost your energy level. A nap of 30 minutes or less, taken early in the day, will revitalize you without making it tough to fall asleep later. Set an alarm clock to keep the nap short.
• Prioritize your life so you have energy for the things you value most. If you love going to a class or want to attend a child’s performance, schedule a nap beforehand. Order takeout instead of cooking, or ask family members, co-workers and friends to help with household chores and making food.
• During active treatment, consider changing work schedules, limiting hours or taking a leave of absence. Ask your healthcare team or social worker to help you write a letter to your employer.