Sleep disruption

Difficulty sleeping (insomnia) may be caused by a number of things.

1. Stress and anxiety – you may have concerns about the future or worries about relationships with friends and family and their expectations of you. Feeling anxious can stop you from getting to sleep, or cause you to wake in the night or wake up early
2. Changes to your sleep pattern – your sleep pattern may have changed while you were having chemotherapy. For example, you may be used to having naps during the day
3. Changes to your daily routine – being diagnosed with breast cancer may have affected what you do each day. For example, you might have stopped working during treatment and started getting up later, or you may have less energy and be doing less exercise
4. Side effects of treatment – some treatments have side effects that can interfere with your sleep. For example, hormone (endocrine) therapies can cause menopausal symptoms, which can mean sleep is disrupted by night sweats or hot flushes

When your treatment has ended you might continue to feel tired during the day. You may feel frustrated that your sleep pattern has not returned to normal immediately, or guilty that you can’t get straight back to the things you want to do. This is not unusual and it may take some time before your sleep pattern returns to normal.

1. Try and get some regular moderate exercise during the day, but don’t exercise late in the evening as this can disrupt your sleep
2. Try not to have drinks containing caffeine after mid-afternoon. These include tea, coffee and many fizzy drinks
3. Limit the amount of alcohol you drink. Alcohol may help you get to sleep but it can also cause disrupted sleep
4. Limit the number of daytime naps you have and keep them to less than half an hour at a time. Avoid late afternoon naps
5. Try to go to bed and get up at the same time each day. Some people think if they have a bad night’s sleep they should go to bed early the next night, but this can make the problem worse. Most people require 6 to 8 hours of sleep
6. Think about how much sleep you get on average each night and go to bed at a time that allows you to get the sleep you need. For example, if you are sleeping for 6 hours a night and you get up at 6am, you should try to go to bed before midnight
7. Do something relaxing before bedtime. For example, listen to some quiet music or an audiobook, have a warm bath or practise a relaxation technique
8. Avoid using screens (for example, watching TV or using your mobile) before bed
9. Make sure your bedroom is quiet, dark and a comfortable temperature
10. Try not to use your bedroom for other activities such as working, using your computer or watching TV
11. If you can’t get to sleep or you wake up in the night and can’t get back to sleep, get up for a bit rather than lying in bed. Read or listen to the radio until you start to feel tired, then go back to bed again

Talking therapies such as counselling or cognitive behavioural therapy (CBT) can be useful and might help you change your patterns of thinking and behaviour. If you think counselling or CBT could help, talk to your GP or treatment team.

Some people find complementary therapies such as yoga, meditation and relaxation techniques help them to relax and sleep better. You can find more information about complementary therapies on our website.

Some people may be recommended a short course of sleeping tablets to help them sleep. You can talk to your GP or treatment team about this.

You may find it helpful to listen to a short audio guide on sleeping problems from the NHS choices website.

Find out more about sleep disruption and helpful tips on you can manage it in the How To Sleep guide. 

You may also want to join our online forum and talk to people who are in the same situation. You can also call our free helpline below, to talk through your concerns.