Managing insomnia

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on April 29, 2022.

Many cancer patients experience insomnia as a result of their cancer or cancer treatment. Extended hospital visits, unmanaged pain or high levels of stress are among the many factors that may affect cancer patients' daily sleep habits.

Regular sleep is needed to fight infection, lower blood pressure and maintain cognitive health.

Insomnia may be frustrating and difficult to manage, but there are steps patients may take to reduce sleepless nights.

Learn what may be causing the insomnia, and which holistic approaches are available, in addition to the care team’s recommendations.

Causes of insomnia in cancer patients

Due to the stressful nature of the news, patients may experience insomnia immediately following a cancer diagnosis. Difficulty sleeping isn’t uncommon. About half of all cancer patients have sleep-related problems during treatment.

It’s important for patients to take care of their behavioral health during cancer treatment. Cancer patients should take the time to process how they’re feeling, as the lack of sleep may increase the risk of experiencing anxiety or depression.

Insomnia in cancer patients may result from:

  • Uncomfortable environment, such as the hospital
  • Disruptions during the night
  • Pain or fatigue
  • Hot flashes at night
  • Nausea, constipation or diarrhea 
  • Medication side effects Inactivity during the day
  • Changes in breathing
  • Co-existing medical conditions
  • Infection or postoperative complications
  • Anxiety, fear or depression

If sleep issues persist, an assessment may be conducted to diagnose the problem and determine whether the patient has a sleep disorder. Diagnosis may include a physical examination, as well as a review of the patient's health and sleep history. A sleep study, called a polysomnogram, may also be conducted.

How to deal with insomnia

Not being able to sleep is stressful. Patients may feel weak and fatigued. They may be napping frequently throughout the day, causing sleep disturbances at night. Waking more often with nightmares or to use the restroom are also common among cancer patients.

Insomnia may have a direct impact on a cancer patient's ability to enjoy daily aspects of life, such as engaging in social activities, working or spending time with family or friends. It may also negatively affect the patient's mental health, making it that much harder to fall asleep or stay asleep.

The good news is that sleep management is possible. Below are some steps to try that may help with insomnia.

Address existing pain

Uncontrolled pain may impact many aspects of a patient's life, including mood, eating habits, energy levels and the ability to sleep. If the patient is experiencing sleep problems as a result of pain, it's important speak with the care team about a pain management plan. Everyone’s plan is different.

While medications may help with the side effects of cancer and cancer treatment, it's important to make sure the patient's behavioral health isn’t being negatively impacted.

Practice good sleep habits and stay consistent

A good sleep routine, also referred to as good sleep hygiene, may help prevent sleep deprivation and lead to better sleep. If possible, aim for seven hours of sleep every night. If patients are having trouble sleeping for this duration, they may add short naps to their days, but they should try not to nap for longer than 30-minute increments. The fewer sleep-wake disturbances, the better the chances of getting a good night's sleep.

Adjust bedtime preparations and environment as needed. Try these tips:

  • Turn down the lights
  • Change the room temperature
  • Add pillows
  • Dress in loose-fitting clothes

Other lifestyle habits that may help patients improve their sleep include regular exercise, reducing time in front of a screen, especially at night, and only going to bed when they get tired.

In addition, try to avoid caffeine a few hours before bed to help improve sleep patterns and support a positive sleep schedule.

Seek professional support

When insomnia is caused by feelings of fear or anxiety, speaking with a mental health professional such as a psychologist, psychiatrist, counselor, behavioral health therapist or religious counselor may help patients process their feelings, learn coping strategies and feel better.


Patients who are experiencing chronic insomnia may consider trying mindfulness meditation as supportive care. It doesn’t require any tools and may be practiced anywhere, at any time during the day.

Relaxation therapy such as guided imagery and muscle relaxation may also help with sleep. Free resources online offer guidance. The patient may also ask his or her therapist, sleep specialist, pharmacist or doctor about the best options. They may recommend other cognitive behavioral treatments, such as breathing exercises or hypnosis.

Consider sleep medicine

The patient's care team may recommend sleep medications, which may offer immediate relief in the short term. Before taking any sleep aids or supplements, ask the care team about the possibility of interactions with other medications.

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