Healthy sleep supports the immune system’s battle against illness and the side effects of leukemia treatments, making sleep especially important for people with leukemia. However, getting a good night’s sleep is often more easily said than done. Insomnia — the inability to fall asleep, stay asleep, or get back to sleep after waking up too early — is a common issue for many people living with leukemia. “I haven’t had a night’s sleep in over two months. Some days, I feel like a zombie,” one MyLeukemiaTeam member said.

Insomnia may be acute or chronic. Acute insomnia lasts for several days or weeks, while chronic insomnia can last for months or longer.

Luckily, there are some ways to fight this symptom and get more high-quality sleep.

How To Get a Better Night’s Sleep With Leukemia

Discussing insomnia with your oncologist and other members of your health care team can help you pinpoint its causes and your best treatment options. Your oncologist may refer you to a sleep specialist, who may also be able to diagnose the cause of your insomnia.

Manage Your Pain

Pain is a frequent and upsetting cause of insomnia for people with leukemia. As one member shared, “I am tossing back and forth with backaches and neuropathy. I can’t imagine trying to work because of the sleep problems right now.”

“I’ve been struggling with intense pain in my back and my sides for over a week now,” wrote another member. “It’s been so intense that I have been awakened from a deep sleep in the middle of the night.”

Insomnia can also increase sensitivity to pain, which can, in turn, worsen insomnia.

If pain is getting in the way of a good night’s sleep, talk to your doctor about a referral to a pain specialist. The specialist can help you manage pain related to your leukemia or your treatment. Be sure to take any over-the-counter or prescription pain medications that your doctor has recommended, especially at night. Trying physical therapy might also be helpful in managing pain that’s causing insomnia.

Your doctor might prescribe sleep aids for a fixed period of time to get sleep patterns back on track. Other pain management techniques include acupuncture, massage therapy, biofeedback, and hypnosis.

One MyLeukemiaTeam member suggested these tips for managing pain: “I rubbed my legs with CBD oil, which helped. I took Tylenol (acetaminophen) and made myself go for walks. All of this helped me. I hope your oncologist finds relief for you.”

Practice Good Sleep Hygiene

It is important to follow a set sleep routine to fight insomnia. Following a sleep hygiene protocol may help improve the quality and amount of sleep, no matter the cause of insomnia. Sleep protocols suggested by the Leukemia & Lymphoma Society to fight insomnia include:

• Relax before bed — Take a shower or warm bath, meditate, or put on calming music or sounds.
• Restrict bed use to sleep and sex only.
• Keep the room quiet, cool, and dark.
• Stick to a rigid bedtime and wake time whenever possible.
• Avoid stimulation before bedtime, especially screens.
• Limit caffeine and alcohol consumption.
• Try some complementary therapies, such as deep breathing, guided imagery, and muscle relaxation exercises.
• Try not to nap during the day.

Taking naps can disrupt your established sleep patterns and throw off your circadian rhythm — the natural internal clock that helps you fall asleep. Not sleeping at night from insomnia can further increase daytime fatigue, which can force a person to nap — which, in turn, can worsen insomnia.

The Sleep Foundation suggests keeping a sleep diary. Recording your sleep symptoms alongside your leukemia symptoms or treatment side effects can help you and your health care team uncover patterns to your insomnia.

Use a CPAP Machine

Sleep apnea is a common comorbidity (co-occurring condition) of leukemia. This sleep disorder causes breathing to start and stop throughout the night. People with leukemia who develop obstructive sleep apnea are much more likely to experience insomnia.

If sleep apnea is a factor in your insomnia, using a continuous positive airway pressure (CPAP) machine may help. These machines work by delivering positive air pressure while you sleep to help keep the airways open.

Try a Sleep Study

Participating in a sleep study could help to identify issues causing your insomnia. These studies can help uncover issues like sleep apnea or an inability to reach rapid eye movement sleep.

Try Natural Sleep Aids

With their doctor’s approval, some people fight insomnia with products like natural herbs and supplements. Melatonin, for example, is a hormone found naturally in the body — and a common insomnia remedy. Melatonin production increases with darkness and decreases with daylight. Rising melatonin levels put the body into a state that promotes sleep. Taking melatonin as a supplement can boost or add to your body’s melatonin production to get your sleep back on track.

Some members also swear by medical marijuana for insomnia. “I am now on medical marijuana,” said one member, “and I have been getting at least four hours of sleep now, compared to two hours maximum before.”

Another member suggested valerian root. “I take three valerian root capsules when I have trouble falling asleep. It is a natural supplement,” they said.

Another member found a different supplement helpful: “A doctor suggested magnesium to help with sleep. For the first time in many, many years, I am getting four to six hours of sleep without waking up.”

For others, sleep aids may be less effective. As one member shared, “I have a horrible time trying to get to sleep, and then to stay asleep. Sleep aids don’t really help most nights. I still toss and turn for hours. After a few weeks, my body is so tired that the sleep aids will help a bit.”

Stay Active

Getting regular physical activity that you enjoy can help fight off insomnia and fatigue. “The fatigue is the absolute worst part of this, in my opinion. If you can do any exercise at all, it does help a bit,” one member reported.

Treat Mental Health Proactively

There is a strong correlation between mental health conditions and cancer, and anxiety and depression are notorious causes of poor sleep. Likewise, insomnia can cause or worsen mental health issues.

Speak to your health care team and to mental health professionals about any mental health symptoms you may have. Cognitive behavioral therapy (CBT) is often recommended when leukemia-related anxiety is acute. CBT is an effective treatment used to treat anxiety disorders, as well as insomnia itself.

One member achieved better sleep despite anxiety by combining traditional and alternative treatments: “I’ve been taking anxiety medication and a CBD candy, and I have been able to sleep better.”

Talk to Your Doctor About Side Effects

Leukemia treatments can often cause insomnia as a side effect. Studies have shown that approximately half of people undergoing cancer treatments experience sleep difficulties. Chemotherapy medications can cause fatigue and insomnia. As one member shared, “I’m home on medical leave because my sleep from chemo is awful.”

Night sweats can occur as a symptom of leukemia or as a side effect of cancer medications. Night sweats and temperature fluctuations are other possible causes of sleep disturbances and poor sleep quality. “I cannot get comfortable in bed,” one member described. “I sweat on and off all night, even with a fan.”

Talk to your doctor about any side effects you may be experiencing. Your doctor may be able to adjust your treatment, prescribe other medication, or offer other approaches that can help.

Get Support

Reach out to caregivers, family members, or any loved one you trust for support when dealing with sleep issues related to leukemia. Communicate openly with your cancer care team about how much insomnia is impacting your quality of life.

You can also find support on MyLeukemiaTeam, the social network for people with leukemia and their loved ones. More than 11,000 members come together to ask questions, give advice, and share their experiences with others who understand life with leukemia.

Do you have trouble sleeping? Have you found techniques to get a good night’s rest? Share your insights in the comments below or by posting on MyLeukemiaTeam.