Sleep Hygiene and a Cancer Patient's Insomnia

On a recent visit to my oncologist, we got to talking about some of the issues I was currently dealing with. The treatment I had been on was particularly low on side-effects, which I certainly wasn't complaining about. But after nearly four years of various chemicals being dripped into my veins, there were a few issues that lingered. At the top of the list was the matter of still not getting enough sleep.

My unshakable insomnia

Sleep issues have come and gone for me, but lately, it seemed like insomnia had moved in for good. I could see where it cleared its own space in my dresser, making itself right at home even though I could not for the life of me recall asking it to move in. No matter how I rearranged the room, it managed to have things in the order it liked. Turns out, at least according to my oncologist, I may have been sabotaging myself by inadvertently asking insomnia to stay.

What is sleep hygiene?

My oncologist asked me whether I was familiar with the term,"sleep hygiene." It refers to the idea of having a "clean" place for sleep, devoid of distractions and protected from the outside world. There are a few basic steps to achieve this sort of clean space in the bedroom, beginning with delineating what the room is for.

For many people, sleep may never be an issue that requires taking these actions. Some folks (and I used to be one of them) can fall asleep quite easily and rest deeply even after watching television from the bed or reading a good book under the covers. But when sleep becomes problematic, sometimes relegating stimulating mental activity to specific areas -- and, more importantly, removing it from the place designated for rest -- is a necessary step.

Eliminating distractions

One of the key components of insomnia is an active mind. Having a tablet or phone next to the bed will stimulate the brain just by its presence, and the temptation to turn that screen on for amusement or distraction will only lead to more mental activity. And subconsciously, our brains develop associations that might continue to flip mental switches even when the object might not be around.

To get past this requires a little habit training. My oncologist recommended that, even in the middle of the night, if I was thinking too much to sleep and had a craving to read or watch television, then I needed to move myself to a different room and break the association of these activities with bedtime.

Sleep hygiene basic rules

It makes a lot of sense. Whether I want to or not, I cannot deny that just lying down in bed triggers an urge to check my social media accounts. And I have seen plenty of journal articles urging parents to keep screens out of their children's bedrooms. But I will admit that I was surprised to get the advice that I should not even read a good, old-fashioned book in bed. But the basic rules were clear.

• Keep the room dark.
• Keep the room quiet.
• Keep the room distraction-free.

My oncologist added a few tricks to optimize falling asleep easily. After dinner, take some time to exercise. Follow the exercise with a bath, which lowers the core temperature of the body, thus making sleep more conducive. And, of course, avoid the use of caffeine or any other stimulants in the afternoon hours.

Changing my sleep routine

Simple and clean, but not as easy as it sounds. I know I am going to feel those urges to get on my tablet or flip on the TV when I don't nod off right away. And if I wake in the night (as I usually do), my brain often thinks it has gotten a lot more rest than it actually did. So I will either have to leave the bedroom to occupy my brain or figure out some new way to lull it back to sleep.

Maybe with some strict training, I'll get it down. And hopefully quickly, because I've tried ignoring it and that only led to insomnia bringing in more baggage.

Editor’s Note: We are extremely saddened to say that on October 21, 2018, Jeffrey Poehlmann passed away. Jeffrey’s advocacy efforts and writing continue to reach many. He will be deeply missed.