For the millions of Americans who are diagnosed with cancer each year, there is no doubt how powerful its impact can be on many different facets of life. More than just the physical ramifications on the disease, the emotional toll that cancer can take on a survivor is great—and often remains long after treatment is over. That includes the effect it has on sleep. In fact, new research from the American Cancer Society is showing how sleep disruptions continue to be an issue for many cancer survivors nearly a decade after their diagnosis.
On top of the myriad of health issues it can precipitate, cancer has also been shown to be a major disruptor of sleep. It is estimated that half of all people who cancer have sleep problems—with certain types and stages of cancer reporting more issues (70% of people with breast and gynecologic cancers report having insomnia, while 72% of people in the advanced stages of any type of cancer do as well). There are a number of different factors that can contribute to sleep issues during active cancer treatment, from pain caused by a tumor to the side effects of certain medications and the disruption of overnight hospital stays.
Sleep Disruption & Cancer By The Numbers
To better understand how these sleep issues evolve after diagnosis, the American Cancer Society surveyed 1,904 people who had been diagnosed with either breast or prostate cancer about nine years earlier. Examining the respondents’ physical, mental and social health, the research found that 51% reported experiencing a high number of sleep disturbances in the month prior. That is an uptick from the 35.2% of all adults in the US who report sleeping less than seven hours a nights on average. This new research also found that 20% of the cancer survivors surveyed reported poor sleep quality, and 17% reported both poor sleep quality and high sleep disturbances.
By focusing specifically on people who had been diagnosed nearly a decade prior, this study highlights just how long-lasting sleep problems can be for those fighting cancer. It pinpointed a range of cancer-related problems that continue for years following diagnosis, including physical distress, emotional distress, economic distress and fear of recurrence. They found that the presence of these problems correlated with a higher likelihood that the survivor was also experiencing sleep issues. Physical distress had the strongest association with poor sleep quality and high sleep disturbance, but both emotional and economic distress also contributed to overall poor sleep duration and quality.
Stress & Anxiety Can Cause Sleep Disruption To Linger
Many of the cancer-related factors that contribute to poor sleep are rooted in stress and anxiety. Even years after completing their treatment, many survivors still struggle with elevated distress around their health and well-being. Previous research has shown that it is common for cancer survivors to worry about recurrence of their cancer. That stress can wreak havoc on one’s sleeping habits. According to the National Center for Biotechnology Information, ”a state of mental hyperarousal, frequently marked by worry, has been identified as a key factor behind insomnia.”
There are also socio-economic factors can contribute to the emotional distress that impedes sleep. In the United States, cancer treatment can be an expensive experience. In addition to initial treatment, many patients also have to cover the costs of managing ongoing symptoms for years to come. Additionally, the physical toll of both cancer itself and treatment often requires survivors to change their work situation or stop working all together—which can also have a lasting impact on their future career opportunities. While not an inevitability, the financial precarity caused by a major health crises can further add to the stress that disrupts sleep.
Habit-Based Sleep Loss Among Survivors
For others, ongoing sleep issues may be more habit-based. A patient receiving radiation therapy may need to take extended naps during the day due to extreme fatigue. But following the completion of treatment, the survivor may simply continue that routine without realizing the negative impact it can have on nighttime sleep.
While there is more research that needs to be done on the long-term effects of cancer on sleep, simply recognizing that it is common for these types of issues to continue for years after treatment may come as relief to some survivors. It also provides greater insight on what kinds of interventions can provide meaningful improvement to their sleep. The American Cancer Society found that 28% of cancer survivors reported using medication to help them sleep at night—a move that can be helpful in the short-term, but poses some risks in the long-term. Understanding the underlying anxieties connecting cancer and poor sleep, experts may instead recommend cognitive behavioral therapy as a more effective tool to help survivors tackle their sleep issues.