Paediatric cancer patients and sleep
Children and adolescents who are diagnosed with paediatric cancers are at risk for experiencing disturbed sleep due to a number of factors. Sleep difficulties, such as difficulty falling asleep, problems maintaining sleep, early awakening, and excessive daytime sleepiness, are the most frequent side effects experience by patients with cancer.
Approximately 30-45 per cent of children with cancer report disrupted sleep. Cancer can have either direct effects on sleep (i.e., the physical presence of a tumour which causes brain injury), or indirectly (i.e., steroids, stress, chemotherapy treatment etc.). Cancer can affect sleep by disrupting the normal circadian rhythm of the sleep-wake cycle. Sleep can also be impacted by night-time interruptions while staying in hospital.
Why sleep is important?
Sleep is an important part of our lives and is necessary for the development and maintenance of physical and psychological health. Sleep is important for general physical health, restoring energy, repairing injuries or illness, growth, concentration, memory, work performance, psychological wellbeing, mood, and getting along with others. Along with eating and exercise, sleep is one of the three pillars on which a healthy and happy life is based.
How much sleep is enough?
Generally, people usually take less than 30 minutes to fall asleep at the beginning of the night, and will wake up once or twice during the night. It is unrealistic to expect to fall asleep immediately in bed or to never wake up at all during the night.
|Newborn (0 – 3 months)
|Infant (4 – 11 months)
|Toddler (1 – 2 years)
|Pre-School (3 – 5 years)
|School Age (6 – 13 years)
|Teen (14 – 17 years)
Effects of sleep deprivation
When deprived of sleep, we function less effectively. We may also experience the following:
- tiredness and irritability
- poor attention, concentration and memory
- irritability and other mood disturbances
- impaired judgment and reaction time
- poor physical coordination
- higher risk of depression and anxiety.
What can impact on sleep during cancer treatment?
- environmental stimuli (inpatient hospital admission)
- bright lights (affects melatonin levels)
- extraneous noise
- staff conversations
- treatment and nursing care (Procedures performed at night)
- fatigue, nausea and vomiting, and being physically unwell during the night
- side effects of treatment
- loss of control
- separation from parents
- unfamiliar environment
- loss of normal routine.
Tips for getting a good night’s sleep
- Stick to a sleep schedule. Go to bed and wake up at the same time each day.
- Avoid daytime napping. It is best to avoid naps during the day, to make sure that you are tired at bedtime.
- Avoid caffeine and sugary drinks.
- Avoid using a device with a bright screen in the hour before bedtime (e.g., smart phone, laptop).
- Relax before bed. Take time to unwind. A relaxing activity, such as reading or listening to music.
- Have a good sleeping environment. Attempt to minimise anything in your room that might distract you from sleep (bright lights, TV).
- No clock-watching. Frequent checking of clocks during the night can reinforce negative thoughts such as ‘Oh no, look how late it is, I’ll never get to slee’p or ’it’s so early, I have only slept for a few hours, this is terrible’, which can lead to further difficulties in getting back to sleep.
- Relaxation exercises. Engage in relaxed breathing exercises or progressive muscle relaxation.
- Set conditions for sleep. Make sure the room is completely dark, ensure your pillow is comfortable and you have comfortable layers of blankets.
- Make sure that your child prepares for bed in a way that helps them relax and feel ready for sleep. Think about what should and should not be in the room. You want it to be a relaxing place.
- Bring your child’s own pillow or blanket if possible.
- Use a sleep mask or ear plugs (noise cancelling headphones) if comfortable.
- Wear comfortable clothes.
- Try not to watch the clock.
- Try to use the toilet before you settle down for the night, and if you are in any pain ask nursing staff for assistance.
- Read for a while, listen to some relaxing music, or try some relaxation exercises.
Where to get help?
The first step is talking to your treating doctors & nursing team. The doctors and nursing team may:
- refer you to clinical services (including Psychology) for support
- prescribe medications for sleep
- refer you to private sleep units (e.g. Mater Children’s Private Brisbane Sleep Unit).
Find out more information about children’s sleep at: www.raisingchildren.net.au
Oncology Services Group
Level 12B, Queensland Children’s Hospital
501 Stanley Street
South Brisbane 4101
t 07 3068 5456
If it’s not an emergency but you have any concerns, contact 13 Health (13 43 2584). Qualified staff will give you advice on who to talk to and how quickly you should do it. You can phone 24 hours a day, seven days a week.