Try Not to Worry About Sleep If You Have Advanced Breast Cancer

No doubt you know sleep can be hard to achieve while living with advanced breast cancer (ABC):

• Both anxiety and depression can disrupt sleep, post-diagnosis.¹
• Sleep may suffer when undergoing radiation, chemotherapy, and surgical procedures.²
• Cancer routinely messes with circadian rhythms.³
• Insomnia and broken patterns of sleep (including too much daytime sleep) routinely occur in people with cancer.⁴
• As if living with and managing cancer isn’t enough, external concerns — such as job changes, career disruptions, caregiver relationships, and immune-system threats like the flu or, other viruses can create further distress.

Poor sleep is an expected and “normal” outcome of living with cancer. Unfortunately, worrying about getting enough quality sleep (something is also known as orthosomnia) can further shortchange the sleep you need.

What do people with metastatic breast cancer need to know about orthosomnia?

What is orthosomnia?

A 2017 article in the Journal of Clinical Sleep Medicine⁵ raised concerns about patients who worried obsessively about their wearable sleep tracker numbers.

The authors suggested that these new devices, which measure sleep health data, might generate further anxiety about sleep, suggesting that the patients inferred correlation between sleep tracker data and daytime fatigue may become a perfectionistic quest for the ideal sleep in order to optimize daytime function.”

Preoccupation with imperfect sleep

Orthosomnia, then, describes disordered sleep caused by one’s preoccupation with imperfect sleep data, patterns, or habits.

Our sleep patterns — even when we’re healthy — can vary widely from one night to the next. However, stress and anxiety can arrive following fears of losing or getting less-than-perfect sleep, making it harder to do so.

Not just a wearable worry

If you’ve used a sleep tracking device, you might have found your data distracting, worrisome, and detrimental. But even if you’ve never used one, it’s also possible that, as someone with cancer, you’re anxious about your sleep.

After all, you’re advised to get as much sleep as possible in order to best manage cancer.

It’s true: sleep helps your immune system manage cancer, improves your mood, and provides your body a needed break after undergoing treatment.

Sleep disruptions is normal

What’s more, it’s normal to experience sleep disruptions and daytime fatigue based on the biological course of the disease itself. You’re at war, in a sense, and that can mean sleepless nights and dozy days.

But have you ever tried to force yourself to sleep but simply couldn’t? Probably. It’s frustrating, isn’t it? Trying to do the right thing while being unable to?

However, as sleep physician, Dr. Michael Grandner said in a recentUS News & World Report interview, “Sleep isn’t something that you do — it’s something that happens.”⁶

A common source of anxiety

Worrying about getting enough sleep is a common source of anxiety for people living with cancer.

The phrase, “What, me worry?” was popularized in the 1950s in Mad magazine. Its covers featured the fictional character, Alfred E. Neuman, who said it as a way to level some sarcasm at the concerns of the times.⁷

Fortunately, using anti-anxiety tricks—such as defending against worry with humor—can mitigate your concerns over lost sleep. Here are some other tips:

Keep a worry journal

Write down the day’s worries; it can help improve sleep onset. Think of it as locking up your racing thoughts in jail so you can get some zzz.

Avoid sleep trackers

Wearables that leave you obsessed with your personal data aren’t worth the lost sleep. Put them away.

Track caffeine

“Jitters” and a “racing mind” happen during fatigue-ridden days when we seek out energy pick-me-ups. Consume all caffeinated products before lunch; choose decaffeinated options later.

Take a nap

There’s no law that says you can’t sleep during the day while dealing with ABC! Give your exhausted body the rest it needs.

Stick to a regular bedtime and rise time

Practicing this very basic sleep hygiene technique can support a daily circadian reset.

Expose yourself to natural sunlight first thing in the morning

Your eyes, when receiving bright morning light, deliver the message to your brain to complete your circadian reset.

Get some exercise early in the day

Take a walk, practice yoga, or do other exercises in the morning to complete the circadian reset trifecta. Do it outside, if possible.

Try CBT-I

Cognitive behavior therapy for insomnia is a group of easy-to-learn techniques that can help you manage your behavior in response to sleep problems.

Consider chronotherapy

Chronotherapy — the practice of dosing and delivering medication based upon a predetermined time of day for optimal benefit—is something doctors practice in their treatment strategies. Chronotherapy includes melatonin supplements. Ask your doctor about dosing and timing if you want to go this route.