Hi, my name is Dr. Eric Zhou. I am a clinical psychologist here at the Dana
Farber Cancer Institute, and an assistant professor at Harvard Medical School.
Cancer is incredibly stressful. There are a number of different sleep issues that a cancer patient
or a cancer survivor might be struggling with. They range from things such as insomnia disorder,
to sleep apnea, to a number of other circadian issues that may come up as well.
The most common issue that we typically run into tends to be insomnia disorder. And this is
describing an individual who struggles with falling asleep. And or with staying asleep. People
often develop behaviors, or coping strategies that are maladaptive in the long run
when it comes to their insomnia. For example, somebody who struggles with being able to sleep
through the night during their treatment may then take extended daytime naps. And this becomes the
reason why months and years after they've survived cancer, they continue to experience
and suffer from insomnia. Sleep is essential. If you chronically aren't getting enough sleep,
it's associated with a host of different physical, emotional and psychological outcomes. These can
range from impacting your body's immune system, to be more likely to experience a depressive episode,
you may be more irritable, you may have trouble remembering things, you just won't be you.
We can do something to improve sleep. An approach called cognitive behavioral therapy for insomnia
should be the first line the gold standard treatment that all patients receive. Cognitive
behavioral therapy for insomnia is not the same beast as cognitive behavioral therapy for say,
depression, PTSD - these are different approaches. If we want to distill some of the
core elements of what makes CBTI or cognitive behavioral therapy for insomnia so effective,
I'll provide a few suggestions. The first of which, and this is something that I wish I could
tell every patient is to understand that more sleep is not necessarily better. Not all adults
require a 8, 9, 10 hours of sleep. In fact, there is a range of typical and perfectly healthy sleep
hours for somebody. And so one of the elements of the work that I do with patients is to help them
essentially experiment to figure out what is the right sleep dosage, if you will. A second
thing that I would advise individuals to consider is waking at the same time, seven days a week.
And the reason that's important as opposed to going to bed at the same time
is because waking at the same time prevents individuals from falling into a pretty
common pattern that we see among patients with insomnia, which is they often get two or three
bad nights of sleep. And as a result of going to bed and not falling asleep or staying up at night.
They haven't gotten enough sleep. And so what happens three or four nights later is
they go to bed and they pass out and they sleep a lot. However, what that
does is it creates the consequence if they oversleep, that it makes it harder for them to
fall asleep at the right time the next night. And so they begin that cycle again. Sleep issues
among cancer patients and survivors are incredibly common. Sometimes we feel so grateful that we've
survived cancer that we don't feel like burdening our clinical staff with what we consider to be
these minor details. Sleep is not a minor detail. So rather than getting used to it, and by that,
I mean just getting used to really bad sleep for months and months for years and years.
This is something that I strongly encourage that you bring up the
earlier that you intervene. The earlier that we understand and know what to do with your sleep,
the less of an opportunity, that sleep issue will have to be able to negatively impact your life.