Sleeping With Cancer

I am sorry to read of the author’s challenges of living with cancer, along with trouble sleeping. After a lifetime of chronic insomnia, I have found a weighted blanket has helped tremendously, (combined with some other evening treatments such a Melatonin ). I don’t know if the comfort and calming effect would be the same for those who have insomnia for other reasons than circadian rhythms-but it might be worth a try. I like my 12 lb quilt-while some people swear by heavier weights. Best wishes.

My cancer is 16 years in the past, but I struggle with insomnia. Like you, I tried Ambien and Sonata. I also use Zzzquil and find that works fairly well. Recently, I have been using an app called Pzizz (all these sleep remedies love Z, apparently) and It helps quite a bit, even without the Zzzquil. My goal is to eliminate the chemical help. Btw, Pzizz is not free though I think they may have a free version with fewer options. There are also free apps, but I've not tried them. There are a lot of choices for guided meditations on YouTube that are free. Good luck.

Thanks to the drug Tarceva, my Stage IV luncg cancer has been in remission for almost 10 years. But Tarceva makes sleep elusive without my old friend Ambien. Specifically, sleep of more than a one-hour duration. Sound like a junkie? Perhaps, but in a decade I have performed many experiments with dosage amount, timing, and substitutes. Conclusion: Ambien gives me eight hours of sleep on a 7 mg dose; nothing else helps; I've never cooked a meal or driven a car under the influence, and I can't drink more than a small glass of white wine. Of all the evils possible, this is one of the least.

Ambien is harder to wean from than the pain medicines. Like you, I cut them into halves and fourths, and finally was able to not take it, but now I use Tylenol PM and Sleep MD, which has GABA, melatonin and valerian root.

Thank you for sharing your story. After my cancer treatments bedtime became grief time and getting to sleep was difficult. I started listening to Nothing much happens, bedtime stories for grown-ups. It took a while, but now I seldom hear the end of a story before falling asleep.

Thank Y-O-U, 1 and all, As a person who was treated early for cancer as it was on the verge, I have not seen signs in 9 years. I used to take Ambien but the VA said "No" and they were firm but did not give me the full scoop, the eople on here have opened my eyes for me. I do have to take a drug available over here to sleep, named Esilgan. I do wish I could find out something on this drug but not likely in SE Asia. I can't get data on it but I take .5 mg when I wake in the middle of the night to go to the bathroom. Not long ago, I was drinking 1 beer each day and before that, I did some hard liquor. Have gotten rid of both and feel much better, more focused. I am very reluctant to take any drug, not even MJ and do not allow MJ or other type drug users around me. Never have used and don't plan to start. Now, I just do strenuous exercise and eat the healthiest food that I can find, lots of raw fruit and veggies and plain oat meal for breakfast. There is so much that I can relate to here so this is ANOTHER GREAT ARTICLE.

Sleeping, for the most part, is not a problem for me. I am on Doxil for my second treatment for ovac in a year (stage 4). My problem is that I'm sleeping for 9-10 hours and getting out of bed is so difficult. I have always had to read in bed before I sleep, I like a very cool room (no heat in the winter in my bedroom). I feel fortunate that I can sleep through all this messy cancer business. On rare occasions, when I have stayed up too late, I will chew on one children's Benadryl . No kidding, for me it works. Trying to live with cancer is difficult but I also feel for people who have sleep problems and to have both......

Ah yes, sleep and cancer. For a month after each of the three surgeries there was little sleep unless I hit the Ambien. And now I have a rotation of half an Ambien, a few drops of Xanax or a glass of wine, and I often try nothing at all (not nearly as effective). Sleeping next to a snorer doesn’t help either. I also half wonder if there is a fear of sleeping that I may never wake up. I was never a morning person but after my diagnosis mornings became very special to me. I hope to have many decades more of them, and a good nights sleep isn’t as high on the priority list.

I’m 72 and have slept reasonably well despite chronic severe migraines with only occasional periods of insomnia triggered by various stimuli until six months ago. Since then, living hell. I have excellent physicians and we have tried many different combinations of prescription and otc meds since the insomnia exacerbated the migraines and the pain prevents sleep. I’ve tried many of the sleep aids and meds mentioned by others with minimal results. But finally a solution: Gabapentin. It works!Started with 200 mg and worked up to 500 mg. and hallelujah! 6-7 hours of restful sleep. I still have migraines but I know how to deal with those.

What beautiful writing. Wishing you many nights of deep sleep...

Thank you to the author and all commenters. What helps me are .25 to .50 of Ativan used sparingly for fear of its losing effectiveness, supplements containing a low dose of phenibut, and L-tryptophan. Abruptly, with menopause 25 years ago, no trouble falling asleep but waking up 6-8 times a night. A good night now is 3 times with quickly falling back to sleep. Otherwise no energy for exercise, seeing friends, maintaining cheerfulness at home. This morning, having taken .25 Aiivan last night so our last day of vacation would be pleasant, feel fully human. Too bad there is not a solution that works for all.With the one Ambien I took years ago, had amnesia for an event during the night. Ativan and phenibut seem addictive for some, not for me. Morpheus, where are you?

Chronic heart patient here. Every year seems to bring new issue, unrelated to weight/smoking/diet or any “self-inflicted” problems. It’s all electrical, new and exciting types of arrhythmia. I’ve had four surgeries in 15 years. And I can’t sleep. But taking a small dose of Xanax seems to work for me. I started at 1mg, and cut that in half to 0.5 mg. It puts me to sleep quickly, and I’m not groggy the next day. My sister refers to my “addiction,” and my general cardiologist warned that I could get hooked on it. I laughingly told her that I got hooked a long time ago. She pondered that for a moment, and said there were a lot of worse things I could get hooked on. So Xanax and I are still friends.

A martini and melatonin at bedtime works for me.

As a psychiatrist I treat many people who have difficulty sleeping. I always try to get them off the sleep aids and offer information and practices to promote sleep hygiene. One patient with schizophrenia said poignantly, “if you had my thoughts, you wouldn’t be able to sleep either.” Not every problem has a solution that we prefer. In her case, sleeping meds were the solution. Sometimes they are the right answer and I still prescribe them if needed. I know the risks. There are other risks to be considered as well.

Stage 4 lymphocytic cancer is in remission. As is sleep, unless I use RSO (medical marijuana). I happily take a tiny dose and fall asleep an hour latter. And RSO may be keeping the cancer at bay. I’m happy it’s legal.

A glass of red wine and a couple tokes of Indica. Done, finished.

Thank you, Susan! I have been dealing with metastatic breast cancer for the last five years. The absolute most difficult side effect I've had is insomnia. I've tried just about everything - pills, CBD, and sleep hygiene, including exercise, getting up on little sleep with a regular routine, not napping in the afternoon, etc. I've just had to make peace with my insomnia but it helps to know I'm not alone.

For me, breast cancer, diagnosed last year. After a lumpectomy, both my pcp and oncologist recommended CBD oil and then marijuana, if I could get it, primarily for pain. The marijuana, especially, worked beautifully and also for sleep, but also caused me to lapse into some seriously depressive episodes. I tried Ambien too, which makes me miserable every day after, and also interrupts my sleep. I continued that for a couple of months and then stopped. The thing that's worked beautifully for me is Xanax. I've continued that since the lumpectomy, chemo and radiation, taking only very small doses which helps me fall asleep and doesn't affect me adversely the following day. It's been enormously helpful.

:) For my legitimate medical reasons, I grow two strains of marijuana that I created. One is for daytime, one is for nighttime. The locals (who are used to potent stuff) try my nighttime and always hand it back after 2 or 3 puffs. They always say the same thing - what on earth is this stuff and why can't we get it in the stores? I turn to it around 10 p.m. and can't tell you how many times a commercial comes on and I suddenly can't remember whether I'm watching NCIS: Los Angeles or NCIS: New Orleans. I can remember that we're looking for some bad guy named Abdul who has a chemical weapon but can't remember which city we're in. I smile, turn off the computer and all of the lights, and moments later I am asleep like a baby. In the morning, its back to coffee and the daytime stuff which makes me want to reorganize closets, go for long bike rides, and eat like a horse. Ask your doctor if cannabis is right for you:) (use only as directed)

I do not have cancer. I have had insomnia since the onset of menopause and have been taking ambien two or three times a week for the past ten years, because I had a job to go to and needed to be rested. I was hoping my insomnia would disappear in retirement. One year in it hasn’t. Ambien isn’t so bad. I imagine I will take it a couple of times a week for the rest of my life. Happy talk therapy and “sleep hygiene” is useless.

Wishing you--and all of us--a good night's sleep.

It is important for people to know that dietary supplements like melatonin are not "approved by the FDA". Drugs go through an approval process to show that they are safe and effective. Drugs are approved by the FDA. Dietary supplements are not regulated as drugs. You can read here about the FDA's regulation of dietary supplements. https://www.fda.gov/food/dietary-supplements/information-consumers-using-dietary-supplements. This information says, in part, "dietary supplements are under the "umbrella" of foods" and "FDA is not authorized to review dietary supplement products for safety and effectiveness before they are marketed." People basically take dietary supplements at their own risk and it is important to know that.

Susan Gruber I read your bio in 2011 after my 49 year old sister was diagnosed with stage 4 ovarian cancer. In 2017 in May she called to tell me her treatments stopped working and the cancer was in her mesentery and lungs and stomach and near her heart. She passed 12 weeks later. Never doing stem cell treatment. Going into hospice at age 55. You are a miracle. I want to know why you survive well and others with the same disease course do not. My sis had a father in law on the Board of Directors at Mass. General. My sister had the best doctors a wealthy family money could buy. As a retired nurse with a brain tumor whose siblings and parents succumbed to cancers..... ovarian , pancreatic , lung , breast , stomach , I don’t see oncology as the answer when there are such inconsistency in 5 year survival for the cancers my family has to deal with. What is your path Susan that after all yu go through you had success at survival with a good quality of life and my dear sister did not? I struggle for answers. I imagine treatment options ignored by big pharma and cancer researchers. Are there other survivors questioning the treatment paths that work inconsistently. Advocacy for early detection testing of cancers is practically non existent. Only the chemotherapy industry seems to receive funding. I watched my sister turn gray as her first infusion of Cisplatin was administer; by the time she called 5 years later she told me she was Cisplatin resistant. End of the line for her.

Reading this touched home for me. As a two-time cancer survivor, I have been taking 50mg of Trazodone for getting to sleep for almost 20 years. I have tried to wean myself off and have been unsuccessful. I also tried other sleep aids and nothing worked. Meditation and audio relaxation has been mediocre at best. I know the benefits of a good nights sleep but it evades me. I'm retired now and enjoy taking a daily nap.

In my 8 years of using Ambien occasionally, I have never had any problems. I originally asked my doc for an Ambien RX ( 5 mg) because I had horrible tinnitis ( now THAT made me want to kill myself). Ambien was the only thing that allowed me to sleep. I also use a herbal OTC pill with melatonin because I know that taking Ambien regularly is not good. Ambien helps me & I'll be very unhappy and sleepless if I can't get an RX for it.

500 mg of Magnesium taken at bedtime greatly helps with the falling asleep and staying asleep. Only downside is you have to allow for a good 8 hours of sleep, otherwise you will feel groggy the next day.

In Sleeping With Cancer by Susan Gubar - NYT Re: “It never caresses or croons lullabies, but instead hisses innuendos into the wee hours, turning wakefulness into a wake.” I think the last space in the sentence above should not be there (unless you were attempting black humor.) While it may or may not be unlikely, it’s not impossible. Thank you. Michael Enright

Perhaps Ms. Gubar, and some readers, might find the material at cet.org helpful. CET is a non-profit go-to site for information on sleep and mood. It advocates evidenced-based strategies, including CBT-I, as well as others not mentioned in the article. We do not have articles specifically for people dealing with cancer, but we do have content specifically for older people burdened with insomnia, and tips on sleep for people of all ages. Articles include: Why Seniors Have Sleep Problems and How To Fix Them With age, two changes occur in our bodies which make it harder to get a good night's sleep. What are they, and what can you do to fix them? https://cet.org/seniors-sleep-problems-fix/ and Light and Sleep Across the Lifespan https://cet.org/light-and-sleep-across-the-lifespan/ In the old days, Mother Nature turned off the lights at bedtime. Now we have artificial light 24/7, and its unintended consequences. We also post questions our visitors have asked about sleep problems over the years, and the answers our experts have provided. Elizabeth Saenger, PhD Director of Education Center for Environmental Therapeutics

Having been through a Bone Marrow Transplant ,cannabis helped like no other drug.It helps me relax, sleep and helped with my appetite.It has been over ten years , but you never get over having cancer.

This is nothing to do with sleeping, but since you mention of keeping immune system strong for the prevention of cancer, I would like to explain my findings from the research done by Dr. Bruce Ames, a professor of Biochemistry and Molecular Biology Emeritus at the University of California, Berkeley. We humans tend to lose strong immune system when aging starts, particularly in 6 area, quality and quantity wise. Main reasons are deficiencies of mocronutrients, particularly zinc in all 6 area, vitamin E in 4 area, B6 in 2 area, tryptophan (one of the essential amino acid) in 2 area, and vitamin A, folate and vitamin C. Nutrition is the least mentioned topic by the doctors, however it is important for the prevention of diseases. Please research nutritious foods for each micronutrients. This is his lecture to the general public. https://www.youtube.com/watch?v=ZVQmPVBjubw

I fall asleep most nights with Matthew McConaughey. You can imagine people’s initial reactions when I mention this if the topic of sleep or not sleeping comes up. Their look of confused skepticism, slight head nodding and possibly thinking, “Well, that’s strange. She’s a 70 y.o. retired grandmother, lives alone with her dog and oh yeah, she’s a lesbian! She must be demented. All is true except for the dementia part. I use the App CALM on which Matthew McConaughey reads a bedtime story called Wonder. I still don’t know how the story ends because his smooth, silky and calming voice has been my “sleeping pill” with no side effects. Good night Matthew. Same time, same place tomorrow.

Aromatherapy, the real kind not the pyramid scheme stuff, has been a blessing for us. I was introduced to this company involved with the cleveland clinic. Changed everything and kept me asleep through the night. https://www.shopascents.com/products/ascents-aromatherapy-starter-system-sleep

I have metastatic breast cancer. Apart from the Faslodex, Ibrance, and Ibrance that necessity compels me to take, I indulge in ONLY the following drugs: (1) The cross trainer and the stationary bike, twice a week. (2) Tap dance class, once a week (3) Wine, usually red, every single night. https://www.thecriticalmom.blogspot.com

I myself lie in bed most nights listening to the sounds of the woman in the attic. I once loved her—mad Folly of youth!—but now her bare feet pace the ceiling overhead, her sobs and muttering disquiet the small hours. At times she creeps down the stair as far as the locked door, and I hear the handle quietly turned. When will I find justice, a thin voice whispers through the keyhole. When ...?

In 40 years' experience as a "sleepdoc" I have seen and successfully treated thousands of insomniacs of all stripes. The most difficult cases are those who have taken sedatives, either prescribed or OTC, for years, so Susan is to be congratulated for stopping one. They are seldom physically addicting but psychological dependence on taking something overwhelms most patients and most are unable to make it through a single night without taking something. Susan's tapering down to "slivers" of her pills illustrates this quite nicely. Here's what I teach all insomniacs about sleep: The sleep schedule and not spending too much time in bed are the pillars of sleeping well. Pick a get out of bed time and get up at that time by alarm 7 days a week regardless of how you slept or feel or if you stayed up late. Bedtime to start with should be 6.5 or 7 hours before that and also the same every night. Sleep in as close to absolute darkness (a nightlight is OK but do not turn on bathroom lights). As soon as up in am get light exposure for 10 to 15 minutes, preferably outside but a bright room is OK. No TV, computers, smart phones in bed. Beds are for sleep and sex and nothing else. Minimize or stop caffeine and none after lunchtime. Look at a bad night as an investment in a better one, not a disaster. Accept that you are still going to wake up 2 or 3 times after about age 50. Do NOT EVER look at the clock during the night. If above unsuccessful after 2-3 weeks, see a sleep doctor.

I remember during treatment and recovery from throat cancer that sleeping was so random. I rarely got too little, as radiation causes deep and long-lasting fatigue, but it was unpredictable when I'd be able to sleep. Some days there were multiple naps, which often meant nights of wakefulness, to the extent that I'd get my nights and days turned around. As I cut my oxycodone back to just once a day, before bed, I was able to endure nights lying awake waiting for dawn if not sleep. Since sleep is so important to healing, sleep problems are cancer recovery problems.

The main issue of insomnia that rarely gets discussed is that we humans were not meant to live this long. From an evolutionary standpoint, our brains still think we're in the Stone Age. Life expectancy was about 38 years. Just because better health practices, medical advances, and cleaner air, water, and land does not mean our brains have adapted to the rapid advances in all of the above. We start losing stage 3 & 4 sleep after we hit our late teens and early twenties. We slept like rocks as kids because we got the five 90 cycles of sleep we needed. After your mid-20's, the second half of a night's sleep starts losing the 3rd & 4th stages of sleep, hence the "witching hour" of waking up in the middle of the night for what seems like no reason. By our 50's, we're losing a great deal of stages 3 & 4 sleep, by our elder years, we're barely getting any stage 3 & 4 sleep. Add chronic illnesses and major stressors like cancer, it's a wonder we sleep at all, never mind getting good quality sleep. This information is vital for people who have sleep problems who blame themselves for something they are told they should have control over, when really, it's a part of living such long lives now.

Thank you for this essay, and wishing you good days on the rest of your journey.

Thank you, Ms. Gubar, for sharing so well the lesser known effects of dealing with cancer. I’ve had multiple health issues over the last 15 years that have also severely impacted my sleep patterns. I’ve tried everything, but most drugs and OTC supplements either triggered migraines or caused such horrible nightmares, sleep was physically exhausting. However, recently I found L-Theonine, an amino acid in tea, gently lulls me to sleep without the awful nightmares or headaches. I also use earbuds to listen to my Calm app (specifically “raindrops on leaves”), which helps relax me back to sleep if I should wake during the night. Not sure if either will be a long term solution, but I’ll take it while it works. Thank you again and be well.

Simple aging, and the change in hormones, also changes our sleep habits, so I can't imagine what cancer and it's treatments do. Sleep was once a simple gliding into sweet rest. Now there's an inherent paradox: WORK on your sleep hygiene but RELAX! I use Melatonin, especially if traveling. I think it helps in falling asleep, in which case it may help with reestablishing a livable diurnal circle. For myself - getting physically tired is a gift. Exercise might be the most important thing, along with natural light exposure. In the last couple of years, I added magnesium supplement to avoid killer muscle cramps- which could strike any time, but can ruin sleep. Cancer treatments may deplete your body of nutrients, and adversely affect the body's ability to extract or create certain nutrients. Sometimes if totally off kilter - perhaps not smart if you aren't in decent health - - I do a full "reset". If I'm awake at, say, 3 AM, I get up and stay up the entire day, and sleep regular hours the next night. In the words of those FDA cautions, "Do not operate heavy machinery" that particular day. Keep it a low key day, then back to your schedule again When I am in bed I read. It used to be the Bill Clinton autobiography, which was interminably boring, Now I pick something I like and reread the parts I fall to sleep over. it works better than lying in the dark awake, thinking.

Right there with you, cancer and ambien. The rebound insomnia was, thankfully, transitory and has disappeared for good. My most successful intervention has been meditation. Not perfect, but tolerable nights and much better sleep even on bad nights than during the decade with ambien.

Congrats to the writer for persevering in her effort to free herself from Ambien! Tough tough job. Yes, we do whatever we can or must to get through treatment and then, we have to deal with the consequences. The fact that we and all we love are mortal continues to surprise and terrify us. Here is something no one is selling that can sometimes help. My 95 year old mother complained continually about her sleep. I began making sure she was exposed to natural light for 30 minutes every morning. It worked for her and it has worked for me. Don’t expect big pharma to mention that as an option. It took a few weeks. Of course it won’t work for everyone or all times. But free, with very limited side effects. Mostly good side effects. Sleep well, everybody.

I’m also a cancer patient. What really helped my insomnia was time-restricted eating, sometimes called intermittent fasting. I no longer have anything but water after 7 pm. That wasn’t my reason for doing it - improved sleep was an unexpected bonus. My sleepless nights have gone from four or five a week to maybe two a month.

This essay breaks my heart. Cancer is brutal for so many reasons, but especially because, unlike most other maladies, its very treatment causes so much pain and damage. Ms. Gubar, as with other cancer patients, must constantly grapple with mortality, which nighttime brings into even sharper focus. I have often wondered, having had to witness loved ones experience terminal cancer, how much damage is also done to the family, who must witness the unfolding of diagnosis, treatment and eventual death of their loved ones from terminal cancer. Observing the brutal treatments, their aftermath and the eventual passing of beloved family and friends after lengthy suffering is also very traumatic. One lives with almost constant anxiety. I still grapple with that these many years after.

The morning after I took my first Ambien, I awoke to look at the clock on my bedside table. Next to the clock was my dog’s dinner bowl, a huge rarely used kitchen knife and the remains of a cut-up apple. I had absolutely no memory of going downstairs to the kitchen, getting the apple, knife and dog dish and carrying them all upstairs. No memory whatsoever. Needless to say, it was the first and last Ambien I ever took. It sounds kind of funny now, but it was horrifying at the time. So many terrible things could have happened to me that night. Insomnia is an unfortunate condition but much preferable to the dangers of bizarre sleepwalking on Ambien. I would advise people to avoid taking it.

I use the Headspace app and highly recommend the 30 lessons (over a month's time) to improve sleep. The narrator Andy Puddicombe says that if you are lying in bed awake, you are still getting rest. https://www.headspace.com/fall-back-asleep The first lessons on Headspace are free so that you can see if you like it.

I listen to audio books (free via Libravox) as a sleep aid, using ear buds. On nights when that doesn't work, I am at least entertained.