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If you’re having trouble sleeping, you’re not alone: in a survey published in June, 98% of respondents reported new sleep problems post-lockdown. The pandemic, financial concerns, general uncertainty, and sudden changes in the rhythms of everyday life can all exacerbate stress and sleep problems. Even if you had a healthy sleep routine prior to the pandemic (and many people struggled with sleep before), it may have been disrupted. A cancer diagnosis, concerns about recurrence, or side effects of treatment may further affect sleep.

This month, our Wellness installment covers this crucial but overlooked (and under-studied) component of cancer treatment and recovery. We’ll review the basics of sleep hygiene from our guide devoted to health and cancer prevention, The Science of Living Well, Beyond Cancer, and then find out how PCF-funded researcher Dr. Stacy Loeb is shedding light on the need to address sleep quality in prostate cancer patient care.

Tips for Improving Your Everyday Sleep

In the guide, we highlight the importance of sleep. Your body undergoes vital repair and recovery processes in order to get you prepared for the next day. That makes getting a good night’s sleep—prostate cancer patient or not—absolutely key! Here are a couple of tips from The Science of Living Well, Beyond Cancer that continue to hold true, especially in today’s uncertain climate.

• Have a better bedtime routine – Before bed, pick a routine that you find relaxing. This can be a hot bath, dimming the lights in your bedroom, listening to music, or reading a few chapters of a book.
• Ditch the device – We spend much of our day glued to our phones, laptops, and TVs, be it for work, keeping up with the current events, or maintaining social connections. Studies indicate that smart devices make it more difficult to relax and are linked with worse quality of sleep. Consider powering down at least 30 minutes before bed and keeping your phone away from arm’s reach.
• Get active – Usual exercise routines have been disrupted: the gym is closed, we get outside less and are more sedentary. But physical activity has been linked to improved sleep, especially in insomnia patients, and better sleep quality. Regular exercise may even protect against the negative cognitive impacts of sleep deprivation.
• Eat a balanced dinner – Lean proteins like turkey and fish, or healthy fats can boost serotonin levels aiding in a better sleep. Try to eat a healthy, balanced dinner about 2-3 hours before you hit the hay.

Sleep Barriers in the Prostate Cancer Community

Patients with prostate cancer and their caregivers are also not alone in their difficulties with sleep. A team led by Dr. Stacy Loeb, a urologist at the NYU School of Medicine and the Manhattan VA, recently published an article describing sleep barriers reported by this population.

Dr. Loeb’s team conducted an analysis of sleep-related posts in the Inspire UsTOO Online Prostate Cancer Support and Discussion. Researchers reviewed nearly 700 anonymized posts in detail in order to uncover important insights about sleep and overall quality of life among prostate cancer patients and caregivers. The article included representative quotes, further illuminating the truly universal human need for sleep, and the suffering when sleep is lacking.

The most common sleep-related problem reported was “general sleep troubles.” Side effects appearing more frequently in the posts included low energy/fatigue, pain, and hot flashes, all of which were more common among patients with advanced prostate cancer (vs localized disease). Sleep medications such as zolpidem were reported in 22% of posts – which raises concern, given the potential for daytime side effects associated with these medications, particularly in the elderly. “We wanted to look closely at these real-world comments to really understand the lived experience for men with prostate cancer and their caregivers,” says Loeb. “Our analysis reveals several areas that merit further study, such as how specific side effects of prostate cancer treatment impact sleep. It also suggests that more emphasis is needed on the impact of prostate cancer on sleep, and that doctors should proactively ask patients and caregivers about sleep so that these issues can be directly addressed.”

More Research on Effective Interventions

These rich findings underscore the need for continued research. Ideally, this information will help guide future studies to better understand the effects of prostate cancer – and other cancers – and treatment on sleep, as well as interventions for patients and their loved ones. While more work needs to be done, there are some promising options grounded in science. For example, a randomized controlled trial of 410 cancer survivors demonstrated that a gentle yoga intervention markedly improved sleep quality and alleviated cancer-related fatigue. Another study suggests that cognitive behavioral therapy methods may be effective in helping cancer patients fall asleep.

In this changing world, we hope that our tips help you find peace and comfort during the night hours. Talk to your doctor if your sleep doesn’t improve after trying a few of these, and certainly before taking any sleep medications. There may be ways to manage side effects to lessen their impact on your sleep. Be patient with yourself – sleep is one of your body’s “habits,” and some adjustments may take a few weeks. It won’t happen overnight.