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The Science of Sleep and Cancer—Plus 19 Insomnia Solutions

A cancer diagnosis is stressful.

Stress often leads to a constant, underlying state of worry and anxiety about the future. Anxiety often leads to insomnia, or short sleep.

Short sleep is defined as getting less than 7 hours of sleep in a 24-hour period (although some people do this intentionally). On the other hand, insomnia is defined as trying to get enough sleep, but having difficulty falling, or staying, asleep.

Since adequate sleep is one of the many lifestyle components vital for a healthy immune system, both short sleep and insomnia contribute to poor health—and may play a significant role in the onset of cancer.

More than half of my coaching clients over the years have complained of anxiety-induced insomnia and lack of consistent, deep REM sleep. This article shares what the medical literature tells us about the impact of sleep on cancer, and offers 19 solutions to improving the quality of your daily slumber to strengthen your immune system and boost your health.

Sleep, Immunity, and Cancer

Sleep is vital for immune health, as evidenced by studies showing that many health risks increase as sleep decreases. For example, hypertension, diabetes, obesity, depression, heart attack, and stroke.[1]

Evidence suggests that for middle-aged people with certain health conditions, cancer and premature death may also be a consequence of short sleep.[2] In addition, sleep deprivation increases the risk of colorectal cancer by a whopping 36 percent.[3]

Even though scientists don’t fully understand sleep, they have discovered one of the benefits of sleep on the brain. During sleep, the brain shrinks, allowing a type of cleansing fluid to circulate through it freely. This fluid is similar to the lymphatic fluid in the body, whose purpose is to “take out the trash” of the body’s normal cellular functioning. During sleep, the glymphatic[4] system (cerebrospinal fluid) serves the same purpose: It gathers toxic cellular debris (beta-amyloid[5]) from the brain and shuttles it away to be eliminated. 

Melatonin, Cortisol, and Circadian Rhythms

Experts estimate that from 20-70 million Americans have sleep problems.

Many factors can contribute to sleeplessness besides worry, stress, and anxiety. (Although if “stress” resonates with you, here are my best stress-reduction techniques for cancer survivors.)

A new form of stress, electricity and digital devices, available 24/7, dysregulate the modern population’s circadian rhythms.

Digital screens emit blue light, which signals the brain’s pineal gland that it’s time to wake up. That “wake up” signal causes melatonin (the sleep hormone) to decrease and keeps cortisol (a stress hormone) levels high. To prepare for sleep, the exact opposite is supposed to happen. High quality, blue-light blocking amber glasses can help.[6], [7]

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Shift workers notoriously have disrupted sleep patterns almost as a job requirement. Some research suggests that disrupted circadian rhythms due to shift work increase the risk of cancer.[8], [9] However, this study[10] and this 2020 meta-analysis[11] suggest that it doesn’t. Although there are no “absolutes,” this study concludes that caution is wise, especially when shift work is long-term.[12]

Circadian rhythms are now being studied for novel approaches to the best time to administer cancer medications to enhance effectiveness and decrease unwanted side effects.[13], [14], [15] This emerging field is called chronopharmacology.

Other Factors of Sleeplessness

Unhealthy food choices (including caffeine), stress eating, and eating late can all contribute to poor quality sleep.

Then, there are factors like restless leg syndrome, chronic pain, or hormonal imbalances and hot flashes. Nutritional imbalances can also cause leg cramps (magnesium often helps).

Sometimes, sleep apnea prevents restful sleep. Sleep apnea is a serious medical condition that causes repeated awakenings (even when the person is unaware of it), making normal restorative sleep impossible. It also tends to be worse with obesity and nighttime alcohol use, which may overly relax the tongue and throat muscles.

Many turn to antidepressants and sleeping pills for relief. These drugs carry risks of serious negative side effects. I urge you to try every possible sensible lifestyle and natural product solution before considering pharmaceutical options.

And if you are already taking medications for sleep, safely experimenting with non-pharma options may allow you—with guidance from your physician—to reduce or even eliminate dependence on prescription drugs to consistently induce restorative sleep.

Sleep Hygiene Solutions

The word “hygiene” is usually associated with physical cleanliness. However, health also depends on a clean inner environment. Proper sleep hygiene encompasses not only our physical surroundings, but also what we take in mentally and emotionally.

  • Physical Sleep Hygiene: For at least two hours (three is better) before bed, avoid all screens emitting blue light (cell phones, iPads, computers). Keep room lighting as low as possible at night. Clear bedroom of EMF interferences. Is a smart meter on other side of the wall? (Move bed away.) Digital clock display? (High EMF output; replace with battery-operated device or move it 6 feet from bed.) Ban Wi-Fi from bedroom. If you use your smartphone as an alarm clock, put it on Airplane mode. Consider blackout curtains or a room-darkening shade, an eye mask, and ear plugs. Keep your bedroom temperature cool (and consider a fan for white noise).
  • Emotional Sleep Hygiene: sleep must be a priority. Limit late night engagements and meetings. No news before bed. Read a book, listen to relaxing music, journal.

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Treating the Body and Mind

Finally, scientists are beginning to recognize that health imbalances must be considered from the mind-body perspective, the physical, mental, and emotional. Certain holistic health practices that would have been dismissed 30 years ago as unworthy of medical consideration, are now being researched, and many natural practices are being scientifically validated.

For example, in a meta-analysis, yoga was found to increase sleep and mental and physical well-being in breast cancer patients.[16]

As we age, melatonin production typically drops, contributing to poor sleep. Interestingly, melatonin, taken orally, exhibits anti-tumor effects in ovarian cancer.[17]

Aromatherapy[18] with light Thai massage[19] improved outcomes for colorectal cancer patients undergoing chemotherapy. (Lavender, for example, is one popular relaxing aromatherapy essential oil, but look for an organic product and be wary of the word “fragrance.”[20])

Massage improved mental and physical well-being in breast cancer patients, with measurable differences in lymphocytes and beneficial immune system natural killer cells.[21]

Massage also reduced pain, a common complaint with cancer patients,[22] yet, amazingly, foot reflexology (acupressure), which anyone can perform on their own feet, outperformed both body massage and aromatherapy massage. Foot reflexology maps show which areas of your feet are connected by meridian flows to specific internal organs. Use a gentle touch. What a simple self-empowerment tool!

Tart cherry juice increases sleep time by naturally boosting the availability of tryptophan (which promotes relaxation) and decreasing inflammation.[23] Look for an organic product.

Fitness is vital. Move more, and early in the day—ideally 8 A.M. to 10 A.M. It expends adrenaline and cortisol in a healthy way. Being outside early in the day helps reset your circadian clock. Take a brisk morning walk and get some sunshine, too. Low vitamin D levels are associated with poor health.

Humans weren’t designed to be constantly indoors and inactive. If you must be inside, periodically play some music and dance. You can fit fitness into your life dozens of ways every day. Believe me, it will make you feel and sleep better, as your body adjusts.

[To underscore why moving more will make you feel better, read my related content, The Impact of Exercise on Cancer, for inspiration.]

Everyone is biologically unique. We are each an n of 1. Become a health detective and discover what strategies work for you, physically, mentally, and emotionally.

Here are some strategies to try. 

Physical  

  • Epsom salt bath; magnesium relaxes
  • Foot reflexology massage
  • To reduce frequent nighttime urination, stop drinking liquid 3 hours before bedtime. Make your last evening drink tart cherry juice.
  • Eliminate all forms of caffeine for a week to see if that’s a factor.
  • Eat a well-balanced, low-glycemic dinner 2-3 hours before bed.
  • Fix sleep apnea (no alcohol before bed; if obese, losing weight helps apnea and lowers overall inflammation).
  • Turn the temperature down before you go to bed.
  • Supplements:
    • Herbal: chamomile[24], [25], passion flower,[26] hops, holy basil, valerian, ashwagandha,[27], [28] John’s Wort, cannabidiol[29] (CBD). Ashwagandha root[30] is an herb from India with an impressive track record of relaxation, as well as helping brain cancer, ovarian cancer, obesity, and depression. (Ashwagandha may be especially helpful for list-making, Type-A people.) Valerian root (unrelated to the drug Valium) helps reduce restless leg syndrome.[31]
    • Nutritional: amino acid tryptophan (necessary for the production of serotonin and melatonin), magnesium (vital mineral for heart and muscle health), vitamin B6,[32] vitamin D[33]
    • Hormonal: melatonin levels, as well as estrogen, progesterone, and other hormones should be checked. Results may vary with melatonin,[34], [35] and prolonged-release melatonin[36] may be more effective.
    • Always use high-quality and tested products from reliable companies, not just “anything” from the drugstore, online, or big-box store.
    • Always check with your doctor or pharmacist if you are taking other medications to avoid contraindications. In general, natural therapies are similar to food, with a low risk of contraindications. But do your research. Then, print and take it to your doctor, who may be unfamiliar with the product (and who may dismiss it automatically rather than admit that he or she hasn’t studied the science behind it). You can help educate as you explore healthy options.

Mental

  • Consider cognitive behavioral therapy (CBT[37]), which can even be done online. Researchers are excited to see this non-pharmacological approach outperforming other treatments for a variety of disorders, and for all ages. Many conclude it should be recommended as a first-line treatment for insomnia.[38], [39] Plus, CBT outperformed antidepressants in relieving depression.[40] There’s no shame in seeing a counselor or therapist. These are stressful times. A cancer diagnosis is an additional layer on that.
  • Meditate, pray, visualize, and read (or listen to) inspirational messages.
  • Protect yourself from negative people and news. Set a short time limit for exposing yourself to that during the day, if you must. There’s a time and a place for dealing with unpleasantness, but the evening is not it.
  • If you worry a lot, assign a set amount of time to devote to it early in the day. Make a list of everything you want to worry about during your “worry appointment.” But when the timer goes off, your worry time is over for that day. If it starts up again, just stop and tell those thoughts, “Sorry, you’ll have to wait for tomorrow’s worry session. I’ve done my worrying for today.” Then do something joyful instead.

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Emotional

  • Try “gratitude journaling” before bed; what are you grateful for?
  • Drink relaxing herbal tea—chamomile and lavender are amazing—at night (see Supplements/Herbal above).
  • Play relaxing music[41] in your home, especially near bedtime. Classical, jazz, harps, New Age, ambient, meditative, nature sounds … your preference.
  • Make time for adequate winding down: sitting next to your partner, touching sides, holding hands, and listening to quiet, meditative music. Never underestimate the power of connection: Loving touch, even with a pet, is profoundly calming to the blood pressure and nervous system.

Bad News, Good News

As the immune system drops due to stress (from poor sleep or anything else), the likelihood of cancer (and every other disease) goes up.

But also vice versa. That’s the good, empowering news.

We now know that cancer is a “wake-up” alarm, telling us that something is out of balance in our lives. We can take control and do everything possible to make and keep our immune system strong. Sleep is an essential part of that strong foundation.

When you minimize or eliminate all the factors that drag your immune system down (including poor sleep), and you nourish your body well (mentally, emotionally, and physically), your body does all it can to heal.

And that’s the best news of all.

~~~~~

19 Sleep Strategies to Try 

We are all unique. No “one-size-fits-all” insomnia solution exists. Explore these 19 options. With diligence, you will find healthy strategies that work for you.

  1. Move more during the day
  2. Foot reflexology
  3. Massage
  4. Aromatherapy
  5. Sleep “hygiene” (physical and emotional)
  6. Epsom salts bath (1 cup per tub)
  7. Relaxing music at night
  8. Supplements: well-timed vitamins, herbs, melatonin, tryptophan, L-theanine, magnesium, vitamin D
  9. Tart cherry juice
  10. Loving touch, partner/pet
  11. Low-glycemic dinner
  12. CBT (cognitive behavioral therapy), counseling, if needed
  13. Apnea help, if needed
  14. Limit negativity exposure
  15. Set “worry appointments”
  16. Eliminate caffeine for a week
  17. Avoid alcohol
  18. Meditate, pray, visualize, read inspirational messages
  19. Start a “Gratitude Journal”
  20. BONUS: Address hormone levels, if needed

Photo credit: bigstockphoto.com/netrun78

References

[1] https://pubmed.ncbi.nlm.nih.gov/20669438/

[2] https://www.ahajournals.org/doi/10.1161/JAHA.119.013043

[3] https://www.hopkinsmedicine.org/health/wellness-and-prevention/the-effects-of-sleep-deprivation

[4] https://pubmed.ncbi.nlm.nih.gov/25947369/

[5] https://www.nih.gov/news-events/news-releases/brain-may-flush-out-toxins-during-sleep

[6] https://pubmed.ncbi.nlm.nih.gov/29101797/

[7] https://pubmed.ncbi.nlm.nih.gov/31752544/

[8] https://pubmed.ncbi.nlm.nih.gov/30523327/

[9] https://pubmed.ncbi.nlm.nih.gov/28721811/

[10] https://pubmed.ncbi.nlm.nih.gov/27758828/

[11] https://pubmed.ncbi.nlm.nih.gov/32656086/

[12] https://pubmed.ncbi.nlm.nih.gov/29978466/

[13] https://pubmed.ncbi.nlm.nih.gov/31249491/

[14] https://pubmed.ncbi.nlm.nih.gov/31173839/

[15] https://pubmed.ncbi.nlm.nih.gov/31421905/

[16] https://pubmed.ncbi.nlm.nih.gov/33452652/

[17] https://pubmed.ncbi.nlm.nih.gov/26840297/

[18] https://pubmed.ncbi.nlm.nih.gov/32308715/

[19] http://koreascience.or.kr/article/JAKO201332479511627.page

[20] The word “fragrance” on a label does not mean natural. That word may hide hundreds of synthetic and potentially toxic chemicals. Essential oils are natural and have healing properties; “fragrance” is not natural.

[21] https://pubmed.ncbi.nlm.nih.gov/15809216/

[22] https://pubmed.ncbi.nlm.nih.gov/25784669/

[23] https://pubmed.ncbi.nlm.nih.gov/28901958/

[24] Chamomile syrup seems to reduce chemotherapy-induced neutropenia in pediatric acute lymphoblastic leukemia (ALL) patients, improving their white blood cells and immunity. https://pubmed.ncbi.nlm.nih.gov/31921608/

[25] Drinking herbal teas, especially chamomile, offers protection (almost 80%) against thyroid cancer and other thyroid diseases. https://pubmed.ncbi.nlm.nih.gov/25842380/

[26] https://pubmed.ncbi.nlm.nih.gov/29410738/

[27] https://pubmed.ncbi.nlm.nih.gov/32818573/

[28] https://pubmed.ncbi.nlm.nih.gov/32540634/

[29] https://pubmed.ncbi.nlm.nih.gov/29063814/

[30] https://pubmed.ncbi.nlm.nih.gov/31728244/

[31] Cueller, N., Ratcliffe, S., 2009. Does valerian improve sleepiness and symptom severity in restless leg syndrome, Alternative Ther. Health and Medicine, Mar/April (15)2: 22-28.

[32] https://pubmed.ncbi.nlm.nih.gov/31331545/

[33] https://pubmed.ncbi.nlm.nih.gov/30275418/

[34] https://pubmed.ncbi.nlm.nih.gov/28460563/

[35] https://pubmed.ncbi.nlm.nih.gov/31907900/

[36] https://pubmed.ncbi.nlm.nih.gov/30132686/

[37] https://www.psychologytoday.com/us/basics/cognitive-behavioral-therapy

[38] https://pubmed.ncbi.nlm.nih.gov/29165623/

[39] https://pubmed.ncbi.nlm.nih.gov/31730011/

[40] https://pubmed.ncbi.nlm.nih.gov/28199710/

[41] https://pubmed.ncbi.nlm.nih.gov/31221932/