Fatigue and Insomnia

Fatigue and insomnia (sleeping problems) are common during breast cancer treatment. Some treatments may cause fatigue and insomnia. Or you may have fatigue and insomnia because of the many emotions you feel as part of being diagnosed with cancer.

Although these side effects usually go away once treatment ends, some people may have fatigue and insomnia for a longer period of time [288-289].

If you feel overly tired or are having trouble sleeping, talk with your health care provider. Together, you can find ways to reduce fatigue and insomnia that will work best for you.

Some ways to relieve fatigue and insomnia are discussed below.

Fatigue

Fatigue is common during breast cancer treatment and can continue after treatment ends [13,288-289]. You may feel like you don’t have any energy and may be tired all the time. Resting may not help.

Fatigue can cause distress and impact quality of life [13,289].

After treatment, fatigue can make it difficult to get back to a normal routine.

Exercise and sleep

Regular physical activity (even walking every day) can help reduce fatigue in people with breast cancer, during and after treatment [13-16,290-292]. Although it can be hard, try to do some physical activity every day.

Aerobic exercises (such as walking or cycling) appear to be best for reducing fatigue, but exercises such as yoga can also help [290,293-295]. You may want to ask someone to be your exercise partner. Family and friends often want to help, but don’t know how. This may be a way for them to be there for you.

Getting a good night’s sleep is also important.

Other methods

Some findings show these methods may help reduce fatigue in breast cancer survivors [296-301]:

• Acupuncture
• Going to bed and getting up at the same time every day (including weekends)
• Avoiding naps during the day
• Exercising regularly during the day, but avoiding exercise in the evening
• Avoiding spicy foods, caffeine, alcohol and nicotine in the late afternoon and evening
• Having a dark, quiet and cool place to sleep
• Cognitive behavioral therapy (a special type of mental health counseling that may combine techniques such as relaxation exercises) plus hypnosis
• Mindfulness meditation (mindfulness stress reduction)

Insomnia

Although medications are often used to treat insomnia in people without breast cancer, only a few studies show they reduce insomnia related to breast cancer treatment [297].

These tips may help improve sleep and reduce insomnia [13,297]:

• Reduce stress with meditation or other relaxation techniques
• Turn off your TV, computer, phone or tablet one hour before bedtime

Some findings show these methods may also improve sleep for cancer survivors [13,301-309]:

• Acupuncture
• Cognitive behavioral therapy (a special type of mental health counseling that may combine techniques such as relaxation exercises)
• Mindfulness meditation (mindfulness stress reduction)
• Tai chi
• Yoga

Some of these methods, such as cognitive behavioral therapy, can be done remotely. Others, such as mindfulness meditation and yoga, can also be done at home. For example, you can find yoga classes online.

Updated 04/09/24