In today’s 24/7 world, countless things can interfere with a good night’s sleep. Erratic schedules, work and family responsibilities, noisy neighborhoods, a million digital temptations, stress, worry, pain, illness and medication side effects can all get in the way of getting sufficient sleep.
The Simms/Mann-UCLA Center for Integrative Onocology recently offered a virtual workshop — “Improving Sleep: From A to Zzzz” — to help people with cancer and their family members in their quest for rest.
But their tips can be useful to anyone looking to improve their snooze.
“It is counterproductive to try and force sleep,” said Elizabeth Cleary, PhD, a clinical psychologist with the Simms/Mann Center. “However, relaxation is a prerequisite for sleep. So any strategies we can engage in to promote relaxation will get us one significant step closer to actually falling asleep.”
Insomnia — disrupted sleep several nights a week — affects 30% to 40% of American adults, said Shiori Lange, LCSW, a Simms/Mann Center social worker who co-led the sleep workshop.
“Insomnia is a very normal reaction to stress,” she said, including the stress of a cancer diagnosis and associated pain and treatment side effects.
Fatigue is also a common side effect of cancer treatment, Lange said, and it can be hard to distinguish from sleepiness due to inadequate sleep. Many of the strategies that can help improve sleep can also help reduce fatigue.
Among the sleep-boosting strategies shared during the workshop, which is next scheduled for Nov. 15, noon to 1:30 p.m.:
- Maintain a consistent sleep schedule: Going to bed and waking up at the same time each day and getting exposure to natural sunlight in the morning can help regulate circadian rhythms and the secretion of hormones related to alertness, Dr. Cleary said. Similarly, it’s important to reduce exposure to artificial light sources as bedtime nears to help promote sleepiness and the secretion of sleep hormones.
- Develop a nighttime routine: Along with dimming the lights, performing a series of behaviors as part of a regular nighttime routine helps cue the body that it’s time for rest and can make it easier to fall asleep. The routine doesn’t have to be fancy — washing your face, brushing your teeth and putting on pajamas counts.
- Avoid screens before bed: Ninety percent of Americans use some type of electronics within an hour of going to bed, Dr. Cleary said, and this blue-light exposure is interfering with sleep. She cited a study that found that people who used an iPad before bed produced 55% less melatonin (a hormone that plays a role in the sleep-wake cycle), took an extra 10 minutes to fall asleep and felt sleepier the next morning than people who didn’t use electronics before bed.
- Get some exercise: Regular exercisers sleep better and experience less insomnia and fatigue than people who don’t move their bodies regularly, studies show. “The more vigorously you exercise, the more powerful the sleep benefits are,” Dr. Cleary said. “But even light exercise — such as walking for 10 minutes a day, engaging in other activities like gardening, cooking, being on your feet — can improve and contribute to better sleep quality.”
- Be mindful of caffeine and alcohol: It takes about six hours, on average, for the body to metabolize half the caffeine we consume, and for older adults, it can take even longer. Dr. Cleary suggests limiting caffeine intake after 2 p.m. to avoid interfering with sleep. Alcohol also disrupts sleep. People who drink alcohol before bed may feel drowsy and fall asleep quickly, but as the alcohol is metabolized overnight, sleep quality suffers, she said.
- Be careful with naps: Dr. Cleary acknowledged that she considers naps “one of life’s greatest pleasures,” but timing and duration matter. Shorter naps before 3 p.m. may be less likely to interfere with nighttime sleep, she said. “If you are someone post-surgery, post-radiation, post-chemotherapy, naps can be really helpful for healing the body and recovering,” she said. “But we want most of our sleep to be at night, so thinking strategically and experimenting with the duration of naps and daytime sleep can be really helpful.”
- Watch your thoughts: Many of us experience negative automatic thoughts at bedtime or when we wake up during the night: Did I return that phone call? How am I going to handle all these upcoming appointments? Is that pain something I should be worried about? “These are not the sorts of thoughts that are particularly relaxing,” Dr. Cleary said. “We want to be moving in the direction of having more calming, reassuring, relaxing thoughts, as opposed to thoughts that are activating, agitating and frustrating.”
Dr. Cleary suggested keeping a pad of paper by the bed to write down any worrisome thoughts. Positive self-coaching is another valuable strategy, Lange added. Notice if your thoughts are leading to possible solutions. If not, allow yourself to set them aside to revisit in the morning. “Most of our thoughts can wait unless it’s an emergency,” she said. Mindful breathing can be a helpful way to disengage from unproductive worry by focusing instead on the in-breath and out-breath.
