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How Does Lymphoma Cause Sleep Problems?

Updated on March 17, 2022
Medically reviewed by
Mark Levin, M.D.
Article written by
Maureen McNulty


Lymphoma often makes it difficult to sleep. Many people who have lymphoma deal with disrupted sleep schedules, painful symptoms, uncomfortable treatment side effects, or anxious thoughts. Having trouble sleeping can often take a toll and lead to a worse quality of life.

Lymphoma can lead to several different types of sleeping problems. These may include:

  • Struggling to fall or stay asleep (insomnia)
  • Waking up earlier than desired
  • Experiencing nightmares
  • Feeling very tired throughout the day
  • Sleeping too much

Many members of MyLymphomaTeam say they deal with sleeping problems. One member posted, “I have issues with waking up at 2 a.m. or 3 a.m. almost every night. Have a hard time getting back to sleep.” Another commented, “I have not slept a full night in three years. I’m up from 2 to 4 a.m. Fall back asleep on the sofa till 7. Then get a nap during the day. It’s a cancer thing.” One member said her husband still experienced poor sleep after being in remission for 18 months. “Insomnia is a problem the majority of the nights. Rollercoaster fatigue is a problem too,” she said.

How Does Lymphoma Cause Sleep Problems?

There are many reasons why a cancer diagnosis can cause changes in a person’s sleep. Lymphoma can lead to symptoms — like pain, itching, and sweating — that can affect sleep. Many people living with lymphoma also deal with changes in their daily routine as they juggle various treatments or take time off of work. Additionally, many people with lymphoma have increased levels of stress and anxiety. Worries about treatment decisions, finances, loved ones, or the future can certainly keep a person up at night.

Lymphoma treatments can also cause sleep disturbances as a side effect. For example, many MyLymphomaTeam members have reported insomnia after taking corticosteroids. “Round four, second cycle complete. Now the insomnia has kicked in! I’m usually out by 9 p.m., and it’s now 12:23 in the morning,” one member posted.

Pain and Neuropathy

Some people with lymphoma experience pain in their abdomen, chest, or bones. Doctors don’t always know why lymphoma causes this pain. Pain can also be a side effect of some cancer treatments. When lymphoma or its treatments damage a person’s nerves, they have peripheral neuropathy. Neuropathy can lead to feelings of pain, tingling, weakness, numbness, burning, or coldness.

Pain and neuropathy often affect a person’s sleep. “I had very little sleep last night due to the Neulasta shot I had on Wednesday. The pain was so intense, and nothing was helping,” reported one MyLymphomaTeam member. Another commented that their pain was long-lasting. “My neuropathy is killing me,” they said. “I have been in remission since 2016. It seems to get more painful every year. It is hard to fall asleep without sleep medicine.”

Itching

Both of the two main types of lymphoma can cause itching. People with lymphoma may feel itchy in one specific area near a tumor, or they may experience this sensation all over the body. Doctors think that itching may occur when the immune system makes chemicals to try to fight off lymphoma cells. These chemicals may affect nearby nerves, producing an itching feeling.

Itching can get in the way of a good night’s sleep. “Sleepless nights filled with night sweats and itchy skin are the worst,” said one MyLymphomaTeam member.

Sweating

Drenching night sweats are a common symptom of lymphoma. People with lymphoma may also experience hot flashes or sweating during the day. This symptom may be caused by molecules made by blood cancer cells.

Night sweats can often be so extreme that they wake a person up. Many people need to change their sheets or bed clothes after a night sweat. “I now wake up two to three times a night to change because I am drenched and end up shivering for 30 to 40 minutes afterward,” one member commented. Luckily, night sweats are one of the first symptoms that respond to treatment.

Stress, Anxiety, and Depression

Many people living with cancer experience a great deal of stress and go through mental health changes. Anxiety and depression are very common symptoms for people with lymphoma.

“I am in remission, but still have bad anxiety and can’t sleep,” commented one MyLymphomaTeam member. Often, anxiety is connected with their other lymphoma symptoms. One member posted, “I hate it when I wake at night hurting. My mind races away, cataloging where it hurts and what it means.”

Getting Better Sleep

Make sure to tell your health care team about all of the issues you are experiencing. They may be able to help you find new solutions. Addressing sleep problems can help you improve your quality of life and make you feel better throughout the day.

Medication

Doctors may be able to prescribe sleeping aids or recommend other drugs to help with your sleep. Many MyLymphomaTeam members have found that certain medications or natural supplements have helped them get a better night’s sleep:

  • “Take melatonin a half hour before you go to sleep. It works for me.”
  • “I use gummy bears with melatonin, chamomile tea, and lemon balm from Costco (Kirkland Signature brand), and 1 milligram of Xanax.”
  • “Thinking about asking a doctor about medical marijuana. I am in remission but still have bad anxiety and can’t sleep.”

Talk to your doctor before taking any new sleep aids, including over-the-counter drugs and natural or herbal supplements. Sometimes, drugs, supplements, and herbs can change the way your cancer medications work.

Create New Sleep Habits

Changing your sleeping environment or bedtime routine may help you get more shut-eye. Some tips to try for better sleep quality include:

  • Follow a regular sleep schedule — Go to bed at the same time each night, and set an alarm for the same time each morning.
  • Get a lot of bright, natural light — Spend some time outside during the day.
  • Be physically active — Short stints in the morning or afternoon are helpful.
  • Avoid the interrupters — Skip alcohol, caffeine, and nicotine late in the day.
  • Lessen your nightly food and beverage intake — Eat a lighter dinner, and avoid eating or drinking anything within a few hours of going to bed.
  • Wind down — Take a warm bath, read a book, or try relaxation exercises.
  • Avoid blue light — Shut down phones, computers, and TVs or use a blue light filter when it is close to bedtime.
  • Darken your bedroom — Use blackout curtains or a sleep mask to get as close to total darkness as possible.
  • Cool your bedroom — Maintain a cool environment with air conditioning or a fan.

Some members of MyLymphomaTeam have achieved a better night’s sleep using these suggestions. One member shared: “Best not to watch TV or go out sometimes in the evening. Pay for it by not falling asleep.”

See a Cognitive Behavior Therapist

Therapy with a therapist skilled in insomnia treatment can also be very helpful. When you are living with lymphoma, it is important to get enough rest, which may mean napping during the day. However, napping too long may make it harder to sleep at night. You may need to try out a few different sleeping and napping schedules before you find something that works for you. “I woke up very early so I’m catching up on the local news. I will do some light housework then rest,” commented one MyLymphomaTeam member. “Then I’ll walk my dog, fix a little lunch, then nap. With neuropathy, extreme fatigue, and insomnia, I get tired easily and rest often.”

Address Underlying Issues

If you think that your sleeping problems may be tied to a certain lymphoma symptom or treatment side effect, attending to that issue may help improve your sleep.

Your doctor may be able to help you find an effective strategy to relieve pain, itching, or sweating. One member said that addressing their neuropathy helped reduce insomnia. “I have been taking anxiety meds, now gabapentin for nerve damage at the biopsy site on my face. The nerve medication helps me sleep.” Another member found an over-the-counter solution for their treatment-related pain: “I take Aleve Back & Muscle Pain pills, it’s the only thing that solves the Neulasta shot pain.”

Treating anxiety or depression may also lead to a better night’s sleep. In some cases, medication works well. One member of MyLymphomaTeam said that they initially struggled with anxiety. “I was prescribed anti-anxiety meds, which helped with sleep,” they wrote. “Gradually it got better, but it was a slow process.”

Visiting a psychiatrist, psychologist, therapist, or counselor may also help. These mental health professionals can help you build coping skills and learn how to manage negative thoughts and worries. Additionally, complementary and alternative medicine practices may help calm your thoughts and improve sleep. Deep breathing exercises, meditation, hypnosis, and yoga can all help you relax.

Ongoing fatigue can also be caused by other underlying medical conditions, such as anemia (low levels of red blood cells), an infection, or thyroid problems. If you are dealing with constant tiredness, your doctor may be able to run tests to determine whether you have another health condition. Additionally, researchers are running clinical trials to try to find new treatments for cancer-related fatigue. You may be able to find an effective treatment by participating in a trial.

Talk With Others Who Understand

On MyLymphomaTeam, the social network for people with lymphoma and their loved ones, more than 12,000 members come together to ask questions, give advice, and share their stories with others who understand life with lymphoma.

Are you experiencing sleep problems while living with lymphoma? Share your experiences in the comments below, or start a conversation by posting on MyLymphomaTeam.

All updates must be accompanied by text or a picture.
Mark Levin, M.D. is a hematology and oncology specialist with over 37 years of experience in internal medicine. Review provided by VeriMed Healthcare Network. Learn more about him here.
Maureen McNulty studied molecular genetics and English at Ohio State University. Learn more about her here.

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