It has been the same agony for many, many nights. It has been 3 hours since Joe has lain in bed. Dawn is fast approaching. But the Sandman hasn’t visited him. The chemotherapy drugs in his system, coupled with prescribed steroids, are preventing him from getting some decent shut-eye. He stands up, leaves the room, and starts pacing the hallway, angry and frustrated.
Joe is just one of the millions of cancer patients who find the tiniest bit of sleep elusive. In this article, we will discover more of Joe’s ailment, and why it’s difficult to sleep for cancer patients like Joe. Lastly—and thankfully—if you know someone who has cancer, share these tips so he or she could finally have a good night’s sleep!
Every day, our cells grow and multiply. When you lift heavy weights, your muscles respond to the physical stress by producing more muscle cells to add more layers of muscle tissue. Millions of red blood cells die every day, and our body produces new red blood cells as replacements. Infants grow quickly in their first few months due to the rapid growth of cells.
The death and growth of cells are a natural process of our body. In most cases, certain genes regulate the production and growth of cells. Sometimes, however, genetic errors caused by one or more factors may impede our body’s machinery in producing new cells. These factors can cause cells to multiply uncontrollably. Old cells grow out of control rather than die; and they form new, abnormal cells. These cells grow into a mass of tissue called a tumor.
The uncontrolled growth of abnormal cells is called cancer. Cancerous cells may invade and spread to other areas of the body, hampering how our systems normally work. In worse cases, cancerous cells can damage or even destroy organs altogether. There are over 100 kinds of cancer that can affect humans, according to researchers in the medical field.
Cancer affects millions of people around the world—around 90.5 million individuals in 2015. This number increases around 14.1 million new cases annually. Cancer kills about 8.8 million people in a year. The statistics increase as people grow older or as they continue to live unhealthy lifestyles.
Causes of Cancer
There are a lot of factors that can cause cancer to develop. Researchers have identified the most common ones as follows:
Around 50 forms of cancers are hereditary in nature, although less than 0.3% of the world population is considered “carriers” of cancer-related genetic mutation. So if a family has a history of cancer, there is a chance that the offspring may be prone to cancer as well. Inherited genetic disorders are the primary causes of hereditary cancers.
Many substances used in various industries are carcinogens. These are agents that can cause cancer after prolonged exposure. Examples of carcinogenic substances include the following:
- metal compounds such as cobalt and nickel
- certain industrial chemicals
Radiation and overexposure to the sun
There is a reason why doctors do not allow people to have frequent X-rays. Although ionizing radiation such as those emitted by X-ray machines is not a strong mutagen (an agent that may cause genetic mutation), it is considered a risk factor for cancer.
In addition, the World Health Organization’s International Agency for Research on Cancer considered radio frequency from mobile phones, televisions, or electric power transmission structures as possible carcinogens. However, many studies are unable to show a reliable and consistent link between such kinds of radiation and cancer.
Overexposure to the sun is considered a skin cancer hazard. That’s because the sun’s ultraviolet rays can alter cellular machinery to produce more cells than normal.
18% of cancer deaths worldwide are caused by infectious diseases. A high proportion of infection-related cancer occurs in Africa and less in more developed countries. Oncoviruses (a family of viruses that cause cancer) are the main culprits of the disease. However, certain types of bacteria may also cause cancer.
The vast majority of cancer is linked to unhealthy lifestyles. Smoking, for example, causes 80% of cancer of the lung, larynx, stomach, kidney, and pancreas. Tobacco smoke is known to contain more than 50 known carcinogens. Yes, we’re telling you to stop smoking!
Too much alcohol can also cause cancer. In fact, the World Health Organization classified alcohol, specifically acetaldehyde, as a Group 1 carcinogen. Over-indulgence of alcohol can amplify the risk of the development of cancer in the mouth, pharynx, stomach, liver, and colon.
A diet of too much red or processed meat increases the risk of developing breast, prostate, and pancreatic cancer. That’s because cooking the meat at high temperatures releases carcinogens. Also, diets that are high in salt are known to be associated with gastric and liver cancer.
Obesity is known to cause many types of cancer. In the United States, obesity accounts for 14% to 20% of all cancer-related deaths. Obesity is also responsible for almost 85,000 new cancer diagnoses annually.
Lowering the Risk of Cancer Development
Fortunately, there are many easy ways in which cancer can be prevented. Most of the prevention methodologies revolve around simply avoiding risk factors.
- Stop smoking! Due to the many carcinogens present in tobacco, smoking is considered a major risk factor in many kinds of cancer.
- Have a healthy, balanced diet with an emphasis on fresh fruits, vegetables, whole grains and fish. Intake of red meat, processed meats, refined carbohydrates, animal fats, and salt should be limited or avoided
- Engage in regular physical activity. It has been proven that exercising regularly can reduce cancer risk of up to 30%.
- Avoid too much exposure to the sun. Apply high-SPF sunscreen on your skin every time you go outdoors. The sunscreen wears off in time, so you need to re-apply sunscreen regularly
A better way is to wear clothes that mostly cover your body. Long-sleeved shirts, long pants, and rashies are great for protecting your skin from the sun. Don’t forget your sunglasses to protect your eyes. Finally, slap on a wide-brimmed hat as your first defense against the sun’s harmful UV rays.
Sleep Disturbances and Issues of Cancer Patients
Having trouble sleeping? Don’t worry because it is bound to happen to everyone at some point. It may be too hot in the room, or the mattress might be too firm for comfort. Perhaps there’s too much light coming from the windows. We may be thinking too much of our work, school project, or hobby that the mental burden prevents us from having a good night’s sleep. There are also other factors such as the lack of proper nutrition, physical activities late in the day, or the ingestion of stimulants a few hours before turning in.
For cancer patients, however, this is a common and frustrating occurrence. In fact, 25% to 50% of cancer patients complained that they have nightly experiences of sleep disturbances. That percentage is nearly double than that of people who don’t have cancer. In addition, 30% to 75% of cancer patients who are under treatment suffer from sleep problems, mostly due to the side effects of the treatments. Finally, around 25% of cancer survivors said that they continue to put up with sleep issues even after treatment.
So what are the most common sleep problems that people with cancer face?
Cancer patients usually need to take medication. But many of these medicines, particularly steroids, can disrupt sleep. Drugs used in chemotherapy have very disruptive side effects that can make a patient unable to sleep soundly. While insomnia is already a problem in itself, the worse thing is that the lack or inability to sleep aggravates cancer symptoms or treatment side effects.
Cancer patients report that they experience having much difficulty falling asleep, frequent awakenings at night, or waking up very early.
Finally, cancer patients are constantly worried, stressed, and anxious about having a terminal illness. The gnawing emotional distress keeps them up at night.
Sleepiness at daytime and fatigue
The immune system of a cancer patient devotes most of its energy into fighting the disease. As such, the cancer patient often feels exhausted throughout the day. It is also noteworthy that drugs for chemotherapy and other treatments can make the patient fatigued. Those who are undergoing radiotherapy are even more fatigued after each treatment. As such, they tend to nap for a few hours during the day.
Unfortunately, because he or she is already rested during daytime, he or she will have difficulty sleeping at night.
Antiemetic medications can induce nausea and vomiting. This can do either of two things: 1) they feel sleepy during the day due to the effort of vomiting, or 2) they can’t sleep properly at night because they need to wake up in order to throw up.
Restless legs syndrome
Cancer patients may experience this strange, strong compulsion to move their lower limbs while in bed. Often, they feel that their legs are being punctured by hundreds of pins and needles. The sensation is particularly intense when they are trying to sleep on their backs.
This sensation is called restless legs syndrome (RLS), often a side effect of chemotherapy. Obviously, RLS impairs the person’s ability to fall into a comfortable sleep. While RLS affects 5 to 10% of cancer-free people, cancer patients are twice as prone to experience RLS. Women with breast cancer and men who have prostate cancer are particularly vulnerable to RLS.
How to Get Better Sleep for Cancer Patients
It is important for a person who has cancer or is undergoing cancer treatment to have adequate and good-quality sleep. The disease itself and the drugs used to treat the disease can lower the effectiveness of his immune system. A reduced immune response can make the body prone to more infections and diseases.
Sleep can help boost the immune system. According to the National Sleep Foundation, “Without sufficient sleep, your body makes fewer cytokines, a type of protein that targets infection and inflammation, effectively creating an immune response. Cytokines are both produced and released during sleep, causing a double whammy if you skimp on shut-eye.”
To make snoozes easier for cancer patients, check out these tips:
- Make the patient’s bed is comfortable. A comfortable and ergonomic mattress whose material can regulate temperature is ideal. That’s because many cancer patients suffer from hot flashes and overheating. A cool mattress paired with air-breathable pillows will help fix that problem
- For patients suffering from RLS, use weighted or heavy blankets. Patients often observe that putting weighted blankets on their lower limbs helps alleviate the symptoms of RLS. A blanket that weighs 10% of the patient’s body weight is recommended.
- Ensure that the bedroom is conducive to sleeping. The most optimal environment for sleeping is a cool and dark bedroom. Adjust the thermostat of the room’s HVAC system to a comfortable level. As a rule of thumb, it should be somewhere around 16 to 20 degrees Celsius.
To block the light coming from the window, use heavy, blackout curtains. Or let the patient wear an eye mask, although this can be uncomfortable for those not used to having something on their face. Finally, turn off internal light sources such as lamps and LED-display indicators.
- Lessen the frequency and duration of naps. For the cancer patient, it may be tempting to have a nice, long nap during the day. However, this only intensifies his or her insomnia later at night.
Interact with the patient so he or she avoids napping during the day. Having conversations, playing tabletop games, or engaging in a hobby or chore can help divert the patient’s urge to nap. If napping is irresistible, limit nap time to around 20 to 30 minutes.
- Stay away from stimulants and activities that impede sleep. Do not give the patient stimulants such as alcohol, caffeine, and tea a few hours before bedtime. In the same manner, doing heavy exercises and eating heavy meals before bedtime should be avoided.
When bedtime finally arrives, take away gadgets and puzzle games, turn off the TV and video games, close all books—everything that encourages mental activities. No other activity except sleeping and sex should be allowed in the bedroom.
- Practice good hygiene. Having a nice warm bath is a great way to lull one’s way to sleep. Also, make sure the patient’s sleeping environment is clean. Spotless sheets and fragrant pillow covers are all necessary for a relaxing sleep. You can include calming activities such as aromatherapy or meditation.
- Let the patient stick to a regular sleep schedule. Strictly adhering to a regular sleep schedule helps the patient’s circadian rhythm, or body clock, stabilize. Similar to muscle memory, the patient’s mind “remembers” the routine, and the body’s systems respond by slowing down at that particular time of the day.
Frequently Asked Questions
Light therapy involves using special lamps to help normalize offset circadian rhythms. The person sits in front of the light therapy device for a pre-determined time in the morning and afternoon.
Light is one of the factors that directly affect the circadian rhythm. As such, the goal of the therapy is to simulate illumination so the person’s body clock “trains” itself to induce sleepiness at a certain time.
A recent invention called light therapy eyeglasses is under clinical trial. The eyeglasses are designed to help cancer patients who are suffering from insomnia to fall and stay asleep.
Sleep by itself is not considered a risk factor for cancers. However, researchers have linked a variety of sleep orders as factors that may increase the risk of cancer development. The main sleep disorders under study are shift work sleep disorder, sleep apnea, and sleep deprivation.
* Is oversleeping cancer-inducing?
There are still ongoing studies regarding oversleeping and its association with cancer. As research results stand, oversleeping is linked to mood disorders, obesity, depression, and cardiovascular disease. There is no definite evidence yet points out to oversleeping as a risk factor in cancer.
But this should not be a reason for staying in bed for too long. A series of studies done in post-menopausal women showed that there is an elevated risk of liver cancer when a person sleeps more than 9 hours.
Cancer is a dreaded, traitor disease that eats away at the body. The disease, as well as the treatments, can equally cause a lot of suffering. One of the ordeals of a cancer patient is the lack or inability to sleep.
Understandably, sleeplessness, and other cancer-related sleep disorders can be frustrating for both the patient and his loved ones. But they should not lose hope. There are many easy ways to finally attain quality, restful, and sound sleep. In addition, oncologists can prescribe treatments and therapies that can help a person with cancer alleviate insomnia and other sleep disorders.
People like Joe don’t have to suffer excessively. A little support from medical experts and loved ones, a little bedtime behavioral change, and a little bit of lifestyle change will definitely help give them the relaxing snooze they truly deserve.