Managing Insomnia for Caregivers

This information explains what insomnia is and how you can manage it.

About Insomnia and Caregiving

While providing care for a loved one with cancer can be a rewarding experience that brings meaning to your life, it can also be a stressful and challenging one as you balance helping your loved one with your own responsibilities. Being a caregiver comes with many tasks, such as managing medications, cooking, handling paperwork, scheduling appointments, and monitoring symptoms. You may feel like you need to do all these at once, which can be overwhelming. This is why it’s common for caregivers to feel too stressed to sleep. Many caregivers have a hard time creating a peaceful environment where they can sleep, especially those who sleep with the person they are caring for. All of these factors combined contribute to insomnia in caregivers.

Insomnia is when you have trouble falling asleep, staying asleep, waking up too early, or a combination of all of these things, even when you have enough time to sleep. People with insomnia often have trouble going back to sleep after they wake up. It’s recommended that adults get about 7 or more hours of sleep a night but the responsibility that comes with caregiving can make it hard to do so.

Causes of Insomnia for Caregivers

Insomnia can be caused by many things, such as:

• Anxiety or stress caused by taking care of someone else while dealing with your own responsibilities and emotional reactions to your loved one’s illness.
  • For more information on managing anxiety or stress, read the resource Managing Anxiety for Caregivers.
• Changes to your daily routine or environment caused by your role as a caregiver.
• Feeling like you always have to be awake and ready to care for your loved one.
• Unhealthy sleep habits, such as watching TV in bed or using your bed for activities other than sleep or sexual activity.
• Managing many responsibilities.
• A feeling of loss of control over your own life.
• Concerns about your loved one’s well-being.
• Not having enough support from your family, friends, healthcare team, or other people in your life.
• Some medications.
• Medical problems.

Effects of Insomnia on Caregivers

Insomnia affects your ability to do the important work of caregiving because you feel tired and have little energy throughout the day. It can also affect your own physical and mental health. After just 1 night of sleeplessness, you’re more likely to catch a cold, have an accident, feel intense emotions, and lose focus.

After repeatedly getting less than 7 hours of sleep each night, you increase your risk of depression, stroke, heart disease, colorectal and breast cancers, diabetes, and premature death. Not getting enough sleep also kills your brain cells, causing more problems such as memory loss. Insomnia also generally makes it harder for you to take care of your loved one and attend to their needs.

Signs of Insomnia in Caregivers

Insomnia can cause physical symptoms, emotional symptoms, or both. It’s important to recognize the signs of insomnia and ask for help when you need to. The following things can be signs of insomnia:

• Trouble falling asleep
• Waking up often during the night and having trouble getting back to sleep
• Waking up too early in the morning

People with insomnia may feel very tired during the day and have low energy. They may also have trouble concentrating, which can affect the way they work or study.

If you have any of these signs, talk with your healthcare provider.

How to Manage Your Insomnia While You’re a Caregiver

Insomnia not only affects your mood but it can also affect your health and the care you provide to your loved one. This is why it’s important to take care of yourself. If you don’t, you will soon feel like you’re too stressed or tired to do anything. No matter how long you’ve had insomnia, there are treatments that can help. The first step is to tell your healthcare team. They can guide you to the right resources.

Here are a few tips that can help:

• Set a regular sleep schedule. Having a regular schedule with a set sleep and wake time can help you fall asleep and wake up rested.
• Do some light physical activity. Light physical activity can be going for a walk or a short bike ride. Getting out into the fresh air and sunshine can help your body get ready for sleep at night.
• Create an ideal sleep environment. Make sure that the room you sleep in is cool, dark, and quiet. Your bed, pillow, and sheets should be comfortable for you. If you have a pet that’s active at night, try not to let them sleep in your bed with you. Take them out of your bedroom or put them on the floor in their own bed. This will help keep them from disturbing you while you sleep.  
• Relax and calm down before bed. Avoid bright lights and stimulating activities before bedtime, such as vigorous exercise or stressful tasks for work. Try and create a calm and relaxing bedtime routine. You can do this by taking a hot shower or bath before bed, writing in a journal, reading, or doing gentle stretching exercises or yoga.
• Ask for help and accept it. Ask your friends and family members for help with household chores or with preparing meals. When people offer their help, accept it. Feeling guilty about accepting help is normal, but needing support isn’t a sign of weakness or failure. The less overwhelmed you feel, the better you’ll sleep and the better you’ll be able to take care of your loved one and yourself.
• Try relaxation techniques. Relaxation techniques, such as deep breathing, meditation, and acupressure (putting pressure on parts of your body to help you relax), can help you manage your anxiety and improve sleep. You can also listen to free guided meditations by visiting www.mskcc.org/meditation.
• Avoid electronic devices with blue light 2 to 3 hours before bedtime. Blue light is the light that comes from electronic devices, such as your cellphone and LED light bulbs. Many electronic devices have a blue light filter that you can set for nighttime. You can also buy a pair of blue light blocking glasses to wear when using an electronic device.
• Talk with your healthcare provider about other treatments for insomnia. Many integrative medicine therapies offered at Memorial Sloan Kettering (MSK) can help treat or manage insomnia. Examples include cognitive behavioral therapy for insomnia (CBT-I) and acupuncture.
  • CBT-I is a type of talk therapy that helps people change their sleeping habits without using medication.
  • Acupuncture is a form of treatment in traditional Chinese medicine. It’s done by applying very thin needles to certain points on your body. Research shows that acupuncture may help treat insomnia. To learn more about acupuncture, read the resource About Acupuncture.
  • For more information about other integrative medicine therapies that can help you manage your insomnia, call 646-608-8550 or go to www.mskcc.org/cancer-care/integrative-medicine.

Resources at MSK

If insomnia is affecting your life in any way, talk with your healthcare provider. You can also contact any of the resources in this section for help. We can help you find the right treatment for you.

Social Work
212-639-7020
www.mskcc.org/experience/patient-support/counseling/individual-family-counseling/social-work-experts
Our social workers provide emotional support and guidance to patients and their families, friends, and caregivers. Social work offers programs, including both in-person and online support groups. They can also help with practical issues such as transportation to and from medical appointments, temporary housing, and financial concerns. Social workers are available at every MSK location. To talk with a social worker, ask your doctor or nurse, or call 212-639-7020.

Counseling Center
646-888-0200
www.mskcc.org/experience/patient-support/counseling
Many people find that counseling helps them manage their emotions during caregiving. MSK’s counselors provide counseling for individuals, couples, families, caregivers, and groups. They can also prescribe medications to help with anxiety, depression, and other mental health problems. For more information, ask your doctor or nurse, or call 646-888-0200.

The Caregivers Clinic
The Caregivers Clinic provides support specifically for caregivers who are having trouble coping with the demands of being a caregiver. For more information, call 646-888-0200 or go to www.mskcc.org/cancer-care/doctor/allison-applebaum.

Location
MSK’s Counseling Center
641 Lexington Avenue (on 54^th Street between Lexington and Third Avenues)
7^th floor
New York, NY 10022

Integrative Medicine Program
646-608-8550
www.mskcc.org/integrativemedicine
Our Integrative Medicine Service offers many therapies to complement (go along with) traditional medical care. Some of the services offered include music therapy, mind and body therapies, dance and movement therapy, yoga, and touch therapy. Services are available to patients, their families and caregivers, and to the general public. For more information, or to make an appointment, call 646-608-8550.

Hours
Monday through Friday from 9:00 a.m. to 8:00 p.m.
Saturdays from 9:00 a.m. to 5:00 p.m.

Location
Bendheim Integrative Medicine Center
205 East 64^th Street (on 64^th Street between Second and Third Avenue)
New York, NY 10065

Patient and Caregiver Education
www.mskcc.org/pe
Visit the Patient and Caregiver Education website to search our virtual library. There, you can find written educational resources, videos, and online programs.

Virtual Programs
www.mskcc.org/vp
MSK’s Virtual Programs offer online education and support for patients and caregivers, even when you can’t come to MSK in person. Through live, interactive sessions, you can learn about your loved one’s diagnosis, what to expect during treatment, and how to prepare for the various stages of cancer care. Sessions are confidential, free, and led by expert clinical staff. If you’re interested in joining a Virtual Program, visit www.mskcc.org/vp for more information.