Sleep problems
Many people with cancer have trouble falling asleep, staying asleep, or waking too early. Poor sleep can make fatigue, mood, and pain worse.
Why it happens
Steroids like dexamethasone, hormone therapy, pain, hot flashes, worry, and nighttime trips to the bathroom can all disrupt sleep. Hospital stays and changes in routine also play a role.
What helps
- Go to bed and wake up at the same time every day.
- Keep your bedroom cool, dark, and quiet.
- Limit screens, caffeine, and alcohol in the evening.
- If you take steroids, ask whether you can take them in the morning.
- Try relaxation, gentle stretching, or a warm shower before bed.
- Ask about cognitive behavioral therapy for insomnia (CBT-I), which works well for many people.
Call your care team right away if you have
- You cannot sleep for several nights in a row.
- You feel very sad, hopeless, or anxious at night.
- You snore loudly or stop breathing during sleep, as someone else might notice.
Questions to ask
- Could any of my medicines be affecting my sleep?
- Would CBT-I or a sleep specialist help me?
- Is a sleep medicine safe for me, and for how long?
Medicines that can cause this
- Allopurinol
- Dexamethasone
- Exemestane
- Ifosfamide
- Loperamide
- Lorlatinib
- Niraparib
- Olanzapine (for nausea)
- Ondansetron
- Prednisone
- Prochlorperazine
- Thalidomide
- Trastuzumab
Sources
Quick answers
- What is sleep problems during cancer treatment?
- Many people with cancer have trouble falling asleep, staying asleep, or waking too early. Poor sleep can make fatigue, mood, and pain worse.
- Why does sleep problems happen?
- Steroids like dexamethasone, hormone therapy, pain, hot flashes, worry, and nighttime trips to the bathroom can all disrupt sleep. Hospital stays and changes in routine also play a role.
- What helps with sleep problems?
- Go to bed and wake up at the same time every day; Keep your bedroom cool, dark, and quiet; Limit screens, caffeine, and alcohol in the evening; If you take steroids, ask whether you can take them in the morning; Try relaxation, gentle stretching, or a warm shower before bed; Ask about cognitive behavioral therapy for insomnia (CBT-I), which works well for many people.
- When should I call my care team about sleep problems?
- You cannot sleep for several nights in a row; You feel very sad, hopeless, or anxious at night; You snore loudly or stop breathing during sleep, as someone else might notice.
Last updated: 2026-10-27. Medically reviewed by Veli Bakalov, MD, medical oncologist (October 2026). General education from Step by Step, the patient portal of HemeOncBuddy.