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About Lymphoma

Sleep issues

Many people notice changes in their sleep patterns when they have lymphoma. These changes can be caused by:

  • stress, anxiety, depression or fear
  • medicines such as steroids given as part of your treatment
  • sleeping during the day
  • hormone imbalances
  • night sweats or infections
  • pain
  • changes to routine
  • noisy hospital wards.
On this page:

Why we need sleep?

Sleep is needed to:

  • Help our bodies grow (even as adults our bodies need to make trillions of new cells every day).
  • Repair wounds, damaged cells and replace old cells.
  • Decrease inflammation in our bodies.
  • Control our weight.
  • Consolidate memories and retain new information.
  • Protect our mental and emotional health.
  • Regain energy.
Fatigue is a common symptom of lymphoma, and side-effect of treatments

What our bodies need to sleep

Our bodies need to be mentally and physically tired to sleep. But, we also need to produce hormones to make us sleepy. The 2 main hormones that help us sleep are melatonin and serotonin. 

Melatonin

Our bodies naturally make this hormone when it recognises night-time. It recognises night-time by the cooling of weather and darkness.

  • Higher melatonin levels help you sleep.
  • Lower melatonin levels help you wake up.

How to encourage your body to produce melotonin

Having lots of lights on, watching tv or looking at screens such as phones, computers, tablets or electronic books can stop our body from producing melatonin.

To encourage your body to produce melotonin and improve your sleep try:

  • Turning off the tv and putting away electronic devices for an hour before bedtime. Only use enough light to keep you safe while moving around.
  • Consider buying an alarm clock rather than using your phone in the bedroom, as it can be tempting to look at the phone when you can’t sleep.
  • A cool shower before bed may also help your body prepare for sleep.

Serotonin

Serotonin is a chemical naturally produced in our bodies. It is responsible for regulating sleep, mood and stress levels. Tryptophan is a molecule needed to make the proteins that control serotonin.

Foods to improve tryptophan and serotonin levels and promote sleep

Several foods have tryptophan or serotonin. To help improve your sleep try to include some of the following foods in your diet:  

    • eggs
    • tofu
    • salmon
    • cheese
    • fresh pineapple
    • ripe tomatoes
    • nuts and seeds
    • turkey
    • rice, oatmeal and whole grains.

Develop a new sleep routine

Having a regular routine helps your body learn when it should sleep. Your body needs to get into a new sleep habit. It usually takes at least 3 weeks of regularly doing the same thing to learn a new habit.

Your body and mind need to associate your bedroom with sleep. Do not use your bedroom to study, work or exercise. By doing these activities, your body will associate that room as a place to work, not rest.

Use your bedroom only for sleeping and, if you have a partner or spouse – sex (if you want). Cuddling with someone you feel safe with can also help you sleep better.

Your body may start to recognise bed as a frustrating place to be, if you’re lying awake for hours. 

If you haven’t fallen asleep in 20 minutes, get up. Sit quietly with the lights down low. When you start to feel sleepy again. Go straight back to bed, lay comfortably and close your eyes.

When you get up, don’t do anything that will stimulate your brain too much.

  • You may like to read book – but make sure it is a paper book, not on an electronic device. Have only enough light to see and read.
  • Have a warm drink such as warm milk, decaffeinated coffee or tea.
  • If you notice you have extra energy at this time, prepare meals for the next day or do simple chores. This way you feel like the time has not been a waste, and you will not have as much to do the following day when you may feel tired.

Being able to ‘switch off’ your thoughts and relax will definitely help with sleep. But this is often easier said than done, isn’t it?

Relaxing takes practice!

  • Try listening to music with no words such as instrumentals or meditation music.
  • Use guided imagery where you listen to someone take you through peaceful scenery or thoughts. You can find these online, in apps or CDs.
  • Breathe in deeply and slowly through your nose. Breathe out slowly and think about how it feels as your lungs fill with air.
  • Focus on one thought only. As other thoughts enter your mind acknowledge them and let them go. Come back to the first thought.
  • Exercise such as yoga, tai chi or a gentle stretch. Light massage can also help.

Hear from the experts

Watch the videos below to learn more about sleep, and how you can improve your body’s ability to sleep well.

  • Sleep and Lymphoma – Jake Garvey, Registered Psychologist Peter McCallum Cancer Centre
  • Getting a better nights sleep –  Justine Diggens, Clinical Psychologist Peter McCallum Cancer Centre

Talk to your doctor

If you notice your sleep is getting worse, and the above tips don’t work, talk to your doctor. They will want to work out the cause of your sleep issues and treat those causes. For example, if you can’t sleep because of pain, they will look at ways to better control your pain.

Medicine to help you sleep

If you have pain or nausea, or often get these symptoms during the night, take pain (analgesics) or anti-sickness (antiemetics) medicine 30-60 minutes before bed.

Over the counter medicine

There are different types of medicine that can help you sleep. These should only be used short-term while your body learns new sleep patterns. Some medications can be bought over the counter at your pharmacy. Talk to your pharmacist about which ones may be safe for you to take with the treatments you are having.

Prescription medicines

Some medicines to help with sleep can only be bought with a prescription from your doctor. Talk to your doctor about what medicine they recommend to help with your sleep.

Other tips to improve sleep

  • Avoid food and drinks with caffeine (such as coffee and energy drinks) after 2pm.
  • Limit alcohol in the hours before sleep.
  • Use earplugs or an eye mask to limit distractions.
  • Encourage other members of your household to adopt similar habits.
  • If you need to take steroids as part of your treatment, take them early in the morning instead of the afternoon or night.
  • Have a regular bedtime routine and ensure bedding and clothing suitable for the weather.
  • Use lavender in your bath, or hang on your bed, or use lavender essential oils on your pillow.

Help your body wake up in the mornings

As we mentioned above, our bodies need to increase our levels of melatonin to help us sleep. But we also need to decrease our levels of melatonin to properly wake up effectively. Waking up properly will help to improve any fatigue you have, and give you the energy to do more things during this day. This will then help you sleep better the following night.

Tips to help your body decrease melatonin

  • Open your curtains when you get up to let natural sunlight in.
  • Go for a gentle walk early in the morning as the sun rises. Let the sun on your face. Don’t do this in the heat of the day, and take care not to get sunburnt. Some treatments can make your skin more sensitive to sun, so early morning is best. Why not get a group together to help with morale?
  • If walking isn’t your thing, try a bike ride, or rowing, yoga or pilates.
  • Sit outside in the sunlight for a little while (at least 10 minutes) first thing in the morning.
  • Have a stretching routine or gentle exercise in the morning. This will help to raise your internal body temperature slightly and get your blood flowing which will help decrease melatonin.

 

Sleeping takes practice

It may seem strange, but sleeping takes practice. Think about a young child who needs to be sleep trained to go to sleep at the right time at night. It doesn’t happen overnight, but with a regular routine their bodies can learn when to sleep and wake up.

Most of us learn to sleep effectively as children. However, the stressors of everyday life can get us out of our routine, or change our thinking about sleep. After some time, your body can forget how to sleep. You need to retrain your body.

New habits take about 3 weeks to develop. So don’t be discouraged if it takes time. Talk to your doctor or a psychologist to help you as you learn new sleep habits.

Other resources

For more info see
Managing fatigue

Calm app

Calm is a free smartphone app which contains over 100 guided meditations for anxiety, stress and sleep management. From beginners to advanced listeners. Visit: www.calm.com

Sleep Health Foundation

This is an Australian charity dedicated to creating awareness about sleep problems, and providing education on sleeping issues and solutions. Many relevant resources on different sleep problems/disorders and strategies. Visit: www.sleephealthfoundation.org.au

Summary

  • Sleeping changes are common in people with lymphoma but can be improved.
  • There are many possible causes of sleep changes, and managing the underlying cause such as anxiety, pain or nausea can be effective at improving sleep.
  • Our bodies need to produce hormones such as melatonin and serotonin for effective sleep. Simple changes in your routine can help improve melatonin production. Adding foods high in tryptophan and serotonin can improve serotonin production.
  • Good sleeping needs to be relearned. It can take 3 weeks for your body to adjust to your new sleep routine.
  • Over the counter and prescription medications can help. Talk to your pharmacist or doctor.

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