Are worries about cancer keeping you awake at night or interrupting your sleep? You might find yourself navigating your day without any intrusive thoughts, but then it’s time to go to bed, and although your body is exhausted, you might find you are kept awake with worries about cancer.
Most cancer survivors report that anxiety around cancer does fade with time. But many will find that certain events can trigger fears and bring about intrusive thoughts and restless nights. When you find yourself in this situation, what can you do to encourage a restful nights sleep and break any bad habits?
Why do many cancer survivors experience insomnia?
There are many reasons that you may have trouble sleeping, including:
Physical changes caused by cancer or surgery.
Side effects of drugs or other ongoing treatment.
Stress about upcoming scans, medical reviews or test results.
Menopausal sleep disturbance.
Fear of cancer reoccurrence.
If you are experiencing insomnia or difficulties sleeping you are not alone. Insomnia is a common experience for cancer survivors and it is estimated that half of all people with cancer have experienced sleep problems.
Whether your insomnia is caused by medication, side effects or an overactive mind, the result is the same- lying in the dark with your brain flitting from one intrusive thought to the other.
Why do our thoughts turn negative in the dark?
One explanation is that when there are no external distractions and all is quiet, there is more opportunity for worry and rumination. Have you ever wondered why your restless thoughts are almost always negative?
These negative intrusive thoughts are referred to as the brain's negativity bias, which neuroscientist Rick Hanson describes as "like Velcro for bad experiences but Teflon for positive ones".
Simply put, our brains are really good at focusing on negative things, regardless of our positive experiences.
How can I improve my insomnia?
Sleep deprivation can have a major impact on your functioning, quality of life, and overall health. This may be even more so if you are experiencing post-cancer fatigue.
Luckily, there are sleep strategies to help you manage your anxiety. Here are just a few exercises and apps that our Life after Cancer community have found helpful.
Sleep hygiene
Making your bedtime routine calming and quiet will encourage a restful body and mind. Basic sleep hygiene includes :
Sleeping and waking up at regular times.
Starting to relax for at least 90 min before going to bed.
Creating a dark, comfortable sleep environment with a cool temperature.
Avoid watching television, using a laptop, or working in bed.
Getting ample daylight during non-sleep hours.
Avoiding day naps.
Avoid stimulants such as caffeine before bedtime.
Avoid intake of liquids 2 hours prior to sleeping.
Getting regular exercise but no closer than 3 hours before bedtime.
Relaxation Exercises
We know that blue light from screens interferes with our body's ability to prepare for sleep, so go back to basics with these tech-free bedtime relaxation techniques:
Journalling:
Empty your thoughts, worries and fears down on paper before you go to sleep.
Another exercise is in the moment when you are unable to sleep ask yourself :
How do you want to feel? Write it down.
What one thing could you do to take you closer to this? Write it down.
When will you do this? Write it down.
4-7-8 Breathing technique:
Dr Andrew Weil developed this technique to aid relaxation by helping replenish oxygen in the body. Focussing on your breathing also takes the power out of your thoughts by shifting the focus.
Allow your lips to gently part.
Exhale completely, making a breathy whoosh sound as you do.
Press your lips together as you silently inhale through the nose for a count of 4 seconds.
Hold your breath for a count of 7.
Exhale again for a full 8 seconds, making a whooshing sound throughout.
Repeat 4 times when you first start. Eventually, work up to 8 repetitions.
Being present in body and mind:
Mindfulness practices help you shift the focus away from the thoughts in your head and onto what is actually happening in the here and now. The exercise helps you to recognise that you do not have to react to every thought that pops into your mind and encourages you to shift that focus onto the present.
It is a skill that can be learned through activities such as mindfulness meditation, which can be practised at any time of day and employed when you need 'grounding'. Alternatively, you can listen to guided mindfulness apps to help you achieve this.
Visualisation:
Focused relaxation involves concentrating on a specific object, sound, or experience and visualising in order to calm your mind. This becomes your ‘safe space’ to visit when you are in need of calming, such as lying awake at night. It is proven to help improve sleep outcomes.
How to practise visualisation:
Lie down in a quiet, comfortable area.
Close your eyes. Take several deep breaths. Inhale and exhale deeply.
Imagine a peaceful scene or think of a place that makes you feel relaxed.
Think of the details in the scene. Imagine the sounds, scents, and sensations of being in this peaceful, calming place.
Envision a path in your scene. Picture yourself walking along the path, imagining the details and sounds as you walk this path.
Relax in your scene for several minutes. Continue breathing deeply.
After 15 minutes, count to three. Open your eyes.
Apps for relaxation
If you want to employ technology to help you relax, these are some of the best apps to help create better sleep habits or encourage relaxation:
Calm - A wide offering of fictional sleep stories to relax you before bedtime.
Better Sleep - For relaxing sounds and sleep meditations that help relax.
Headspace- Follow guided mindfulness exercises designed with sleep in mind.
These are just a few of the many online relaxation apps that are available, you may need to try a few before finding the right fit for you.
What to do if insomnia is affecting you every day?
You do not have to put up with the stress of insomnia or sleep deprivation in silence, especially if it is taking a toll on your health and wellbeing:
Get in touch with your medical team or specialist nurse who can re-evaluate your personalised care and support plan.
Contact your GP to discuss the issues you are experiencing.
The NHS website provides concise information about insomnia.
You can also check out Macmillan's resources on insomnia. They cover a lot of the concerns that those on active or post-cancer treatment might be experiencing.
Join our peer-support group to discuss your concerns with others from the cancer community.
Worries about cancer can often leave you feeling isolated. It can be helpful to meet with other people who understand what it's like to go through similar experiences.
Life after Cancer facilitates an online post-cancer treatment support group, who meet to connect, support, listen to each other and share their experience of cancer. Find out more information or maybe join our next support group.
Don't forget to sign up for our mailing list if you want to keep up to date with all our events and the latest news from Life after Cancer.