Treatments for insomnia and fatigue

Sleep medicines have not been studied in people with cancer, but while you are in treatment, they may be one of the best ways to help you cope.

Medicines that doctors sometimes use to manage fatigue and insomnia include:

• Stimulants such as methylphenidate (Ritalin) can help boost energy and focus.
• Over-the-counter sleep aids may help with a short-term sleeping problem.
• Older sedatives called benzodiazepines are sometimes used to treat insomnia, but they can cause side effects including dizziness, weakness, unsteadiness, depression and headaches. There are many different benzodiazepines, but some you may have heard of are alprazolam (Xanax), clonazepam (Klonopin) and lorazepam (Ativan).
• Newer prescription sleeping medicines that are not benzodiazepines such as eszopiclone (Lunesta) and zolpidem (Ambien) can improve insomnia with perhaps fewer side effects than benzodiazepines. But these medicines can also cause side effects and are not recommended for long-term use.
• Antidepressants.
• Medicines to treat anemia.

Always talk to your cancer care team before starting any new treatment, whether prescribed or over-the-counter. Possible side effects of sleep medicines are:

• Daytime drowsiness
• Feelings of anxiety
• Unwanted interactions with other medicines
• A disruption of sleep patterns over time
• Mild memory loss
• Dependence

Medicines not in the benzodiazepine family are less likely to cause dependence and have fewer side effects. In most cases, if taken correctly and under your doctor’s care, sleep medicines can be helpful and safe during treatment. If you want to try supplements or herbs, talk to your healthcare team first to make sure they won’t interact with other treatments.

Before starting on a recommended treatment, talk with your provider and insurance company about costs and consider the price differences between generic and brand name medicines. If you do not have insurance or your plan does not cover the recommended medicine, your social worker or nurse can direct you to patient assistance programs that may help cover the cost.