Insomnia and cancer: what to do when you can't sleep

Sleep problems can happen for different reasons. These include:

• side effects of treatment (e.g. chemotherapy, radiotherapy)
• cancer symptoms
• anxiety about your diagnosis or treatment.

Worry and poor sleep can become a cycle. The more you worry about not sleeping, the harder it can feel to fall asleep./p>

What you can do when you can't sleep

If your sleep problems may be linked to treatment or symptoms, speak to your GP or cancer care team. They can suggest treatments or support.

There are also things you can try yourself to help reduce stress and feel more relaxed.

Even if you do not fall asleep, resting and relaxing can help your energy levels the next day.

Mindfulness involves focusing on the present moment, such as your breathing or body sensations. It can help calm your thoughts and reduce anxiety.

Even if you can't fall asleep, managing to relax while lying down can have a significant impact on your energy levels the next day.

1: Breathing exercises

Breathing slowly can help to relax your body.

• Deep breathing:

Get comfortable and breathe in slowly and deeply through your nose. You should feel your stomach rise. Breathe out slowly through your nose or mouth.

• Box breathing

Inhale through the nose for 4, hold the breath for 4, exhale through the mouth for 4, and hold the breath for 4 before you inhale again. You can try different variations of these exercises, such as breathing in for 4, holding for 7, and exhaling for 8

Explore more breathing techniques at Headspace.

2: Meditation

Meditation often involves focusing your attention or using imagery.

• Body scans

Focus on how each part of your body is feeling. Start by focusing your attention on your toes and repeat the practice all the way up the body, allowing 20-30 seconds to focus on each body part. As you do this, breathe slowly.

You can also try:

• Silently repeating a calming word to yourself
• Imagining relaxation flowing through your body.

If your mind wanders, gently bring your attention back.

Try to focus on relaxing, not on falling asleep. This can make sleep come more naturally.

Read more about mind-body therapy techniques.

3: Try a relaxation app

Mindfulness or meditation apps can be very helpful in guiding you through these techniques. They can make it easier to focus if your thoughts are feeling overwhelming.

• There are apps that offer customisable sleep sounds that can be relaxing to listen to while you are awake at night. Many of these are free, with paid ads within the app
• Other apps you may have to pay a subscription for, such as Headspace.

See also:

• Ways to establish a helpful sleep routine
• Staying active to help boost energy
• Mind - guide to mindfulness for sleep 

You cannot always control your thoughts, but you can respond to them differently.

Try keeping a notebook by your bed. Write down worries when they come up. This can help clear your mind and reduce stress.

Try to make yourself as comfortable as you can, even if you can't sleep. This will give your body a chance to rest and recover as much energy as it can for the next day. 

If you are in pain, there are home remedies you can try to help feel more comfortable. These include:

• applying heated wheat bags or hot water bottles to ease inflammation and aches
• using ice packs to relieve pain

You can alternate between hot and cold for additional relief.

For severe or persistent pain, you should talk to your cancer care team. 

If you are experiencing long term sleep deprivation, there are things you can do to help cope during the day. For example, you may decide to delegate or prioritise different tasks or activities.

We have information on ways to cope with long term fatigue.

Your rights at work

If you are working, you might be struggling to cope with work because of feeling fatigued.

Under the Equality Act 2010, employers must look at ways to adjust the work environment to support employees with disabilities or other needs.

This includes things like:

• Adapting your working hours, e.g. allowing for a later start time in the morning
• Flexible working, such as working from home

We have information on work and cancer.

This information has been written, revised and edited by Macmillan's Digital Content Editor team. Learn more about our Digital Content Editors and how we produce our cancer information. 

Accurate information helps you make informed choices. Look for trustworthy, reliable sources such as Macmillan Cancer Support, the NHS and your own healthcare team. 

We have more information on how to find reliable health information online and understanding cancer misinformation.