Sleep and cancer

[waterdreamer]

We all know how important sleep is, and very often the pain of bone mets and other aches and pains make that hard. I take 3 - 6mg of melatonin before I go to bed to try and ensure I get a good nights sleep.
This article is very interesting:
http://www.huffingtonpost.com/2014/0...tml?ref=topbar

[Andrea Barnett Budin]

I've read numerous studies that show that a good nights sleep helps repair and regenerate our bodies. T cells dip, indicating depressed immune systems and depression... I have felt for many years that it is my duty to get a good night's sleep, in order to heal. That's our job, right?

Thank you for posting this for all to see, Waterdreamer...

[BonnieR]

Ah, elusive sleep! You ladies are so right about its importance. And when newly diagnosed and in treatment it can be hard to come by. I have come to rely upon Ativan nightly. Would rather not, but enough sleepless nights have convinced me that it's necessary and does the trick without any morning after effects
Keep the faith

[tricia keegan]

I don't sleep well since my cancer treatments and have thought about taking Melatonin and think this post has made up my mind and hope it helps!

[KsGal]

I haven't tried melatonin yet. I'm glad to hear it is working so well for you! Like Andi, I believe that when you are sleeping is when your body is healing, recharging and repairing itself. My doctor also told me that when you are tired your pain tolerance is lower i.e. you hurt more. I was dead set against using any narcotics or anything similar when I was diagnosed. I don't know why considering I was taking chemotherapy, which is far more damaging to your body. But at any rate, over the last couple years I have changed my tune. I refuse to suffer any more than I have to. So like Bonnie I take Ativan and get a good nights sleep without dragging in the morning. And if I am in pain, I take a vicodin. But since you are having such good results, I might just give that melatonin a try and see how it does for me.
Jody

[Aussie Girl]

Sleeping is a big problem for me. I've had problems for many years, but the cancer therapy and the onset of menopause with hot flushes are driving me to distraction.

Mostly I get 4 hours sleep a night and I consider anything more than that a real blessing. Lately it has been less than that and I am not coping very well.

I've tried to set up a good sleeping place (away from my husband's snoring). Coal trains go down our valley hourly (squealing brakes and low vibrations for 10 to 15 minutes each time). I'm sleeping in the most insulated room, but I still hear them. The rest of the family don't even notice them. D@#% the coal seam gas boom in our region!

The worst though is the hot flashes. Variable but often 4 per hour at night, each lasting about 3 to 5 minutes. They occur during the day, but don't disturb me so much.

I am severely lactose intolerant and all of the benzodiazepine drugs (eg. Ativan) contain lactose. I take a Temazepam (mild hypnotic) with lacteeze tablets once a week but still get diarrhea from this - often in the middle of the night. Melatonin tablets usually have lactose and I believe are usually bought online from overseas by Australia customers because the only type available here on prescription is very expensive. I feel like I can't win on this problem.

I've been trying deep meditative breathing etc. I helps me to get me to sleep for the first few hours, but not when I wake with the flashes. I have tried a herbal supplement, without much effect (other than heartburn). Exercising during the day makes me feel better, but without much impact on the sleep.

I am going to my general practitioner next week. She has suggested, in the past, taking a low dose antidepressant (eg. citalopram or mirtazapine) to help with sleep and possibly the flashes. I am trying to track down lactose free versions (oral solutions and orodispersable tablets are theoretically available from my research.)

I wondered if any of you have tried an antidepressant for sleep/ hot flashes. I am a bit reluctant to meddle with my brain chemistry, but I need to sleep to manage going back to work in my laboratory.

In the past, I could work 12 hours a day, while sleeping 4 to 6 hours a night. I could work even if I had no sleep for a night. Now I don't that capability anymore.

Wish me sweet dreams tonight!

Aussie Girl

[Pamelamary]

I have definitely heard of some use of an anti-depressant for hot flushes, so worth following up. I also have sleep problems and to some extent, have just given up and take zopiclone every second or third night.
Listening to music is too engrossing, but my digital radio is a boon. As an Aussie, you would appreciate that ABC overnight talkback can bore you to sleep. It effectively stops the mind going in circles, which certainly screws up my nights.
Sweet dreams indeed..... Pam

[Bellaokc]

Aussie Girl, have you looked into Effexor? It helped some with my hotflashes. I still have to take either Temazepam or Ativan to get to sleep right now, but I am healing from surgery and HAVE to sleep.
The Temazepam got me through chemo nights when the Decadron steroid would not let me rest.

I too was on NO meds before starting the chemo and finally gave in when I realized how much I was suffering by not taking something for the anxiety and insomnia.

[Kkmom]

I have been using effexor xr for the past 6 years. It was prescribed to me by my GYN after going to him for severe insomia and hot flashes. It was a godsend. Prior to using effexor, I would wake up every night at 3:30 on the dot and not go back to sleep - it was a vicious cycle, which made it hard to function. The effexor changed everything.

[Aussie Girl]

I've been talking with my sister who is a doctor and she's suggested Mirtazapine wafers which are lactose free and have a hypnotic effect as well as being an antidepressant. They are available from my local pharmacy.

My main aim is to be able to sleep through the flashes. There is one lactose free brand of venlafaxine XR (same as effexor xr) and I will try to get that if the mirtazapine isn't enough to help me cope. I want to have the least amount I need. Zopiclone has lactose unfortunately.

Venlafaxine is supposed to reduce flashes in about 50% of women. Estrogen helps 85% or more women.

Thanks for your help

Aussie Girl

[Bellaokc]

Kkmom,
Can you tell me the dosage of your Effexor? I am on 37.5 mg and am thinking maybe it needs to be raised so I can drop the other meds.

Aussie Girl...let us know how the Mirtazapine wafers work.

thanks!

[Andrea Barnett Budin]

For me the Effexor had no effect on my constant clammy wetness, feeling that I was trapped inside something. And it made me feel weird.

So, slowly, slowly, after begging to be taken off, I weaned off.

Evening Primrose helped during the day. Ativan helped during the night. Actually Ativan was excellent for hot flashes but can't take it by day.

My fav onc since 1995 told me way back, when I resisted taking pills as I never even took aspirin -- YOU SHOULDN'T HAVE TO SUFFER. THAT'S WHY WE HAVE THESE PILLS. TO HELP YOU. AT THE FIRST SIGN OF PAIN, NAUSEA, WHATEVER -- TAKE A PILL. He's basically very conservative, though aggressive when necessary, always reasoned and caring. I offer that advice to all of you.

I find watching a movie, the more boring the better, I start to fall asleep.

I do add Theanine (natural supplement, calmative) to help stop the non-stop thoughts pounding inside my skull. And melatonin.

I would be walking the hallways in my house till 5 AM if not for help. And that is not good, for my body (it needs to regenerate and rejuvenate). I read a study on nurses who worked the night shift. Their T cells were way lower than the other nurses'. Their immune system was compromised. That's the last thing any of us wants, right?!

[Deltadiva]

I agree wholeheartedly, we need to be willing to help our poor bodies heal, maybe in ways we would never do otherwise. While I've long played stupid games on my tablet to get sleepy, I've had to add a Xanax (alprazolam) on some nights. It's nominally for anxiety (which I wouldn't normally admit to) it slows my overactive mind when it's late and I can't sleep.

[Andrea Barnett Budin]

Right on, Delta! I do not feel anxious, as you say, per se. I just have a
hyperactive brainstorm going on in my head at every waking moment.

I have learned even if it is a matter of thinking what I will wear tomorrow or how I could give new life to a room in the house -- DO NOT GO THERE. Stirring creative juices is verbotin!

So, I like to think I talk calmatives, to slowdown the battering ideas banging around in my head.

I meditate every day. Have since '95. But at night, I cannot get that going. Stray thoughts keep popping up. By day, I can zone out and go to my favorite fantasy spot (once actually visited and found to be totally awesome). I recall the sights, sounds, feelings that I experienced (over 50 years ago!) and come back feeling refreshed, joyful and serene.

Just can't seem to master that at night. So, I admit it, I need help. Or I wouldn't have slept a single night since 1998...

[LeahM]

After diagnosis and during treatment and until the end of Herceptin in June 2013 I relied heavily on Ativan. When I didn't have any refills left I weaned myself off and switched to Tyl PM to help me sleep. Aware that too much Tyl isn't good for my liver, especially since I like an alcoholic beverage or two I picked up a bottle of Melatonin 5mg and have been sleeping soundly and waking refreshed ever since. And according to the below link I am doing the right thing! Thanks Europa for sharing this on FB!
http://www.sibley.org/news/default.aspx?ArticleId=414

[Andrea Barnett Budin]

Thanks for that, Leah! Very interesting!

[Aussie Girl]

Update on mirtazapine orodispersable tablets for sleep....

They taste like lemon sherbet dissolving on your tongue (definitely need to be hidden from little kids). Very potent. The med is available in 15mg and 30mg tablets. I take 7.5mg (1/2 of 15mg tablets) and it sends me to sleep in less than 15 minutes. I wake up sometimes in the night, but still drowsy and calm and fall back to sleep.

Hard to get up a 6 in the morning, and there is a certain calmness through the day. After effects are reducing on subsequent days. A quarter tablet didn't quite work. I'm trying to cut the rather crumbly tablets in to thirds which may be the ideal dose for me.

Overall, seems to be a good choice as supposed not to be as addictive as a benzodiazepine (like lorazepam). Good if you don't have to be up early and would be good if you also had some anxiety symptoms. I felt a little flat, but peaceful rather than depressed. I just didn't feel as hyperactive as I usually do, which might be a good thing.

Aussie Girl

[Andrea Barnett Budin]

Aussie, Does it increase your appetite??? I've been reading.

Also, if you stop, you should wean slowly...

Avoid alcohol...

Good luck. Sleep well.

[Aussie Girl]

I haven't noticed an increase in appetite, but I've only had it a few days so far.

I drink very little alcohol and probably have only had two small sips of alcohol since I was diagnosed. I am what in Australia is referred to as a Cadbury's drinker - a glass and a half and I'll be under the table. That will be cryptic for the Americans but I'll leave you to work it out.

Because I'm taking such a low dose, I don't have to worry about withdrawal effects and can take the drug intermittently. I'd have to be careful if the dose was higher.

I remember when my mother-in-law had to slowly withdraw from one antidepressant before starting another one over a six week period. It was six weeks of hell because she became so depressed and not like her usual beautiful self. She has had severe pain from arthritis for years and is my role model for living with grace despite adversity.

Aussie Girl

[linzi]

Hi, ladies:
It looks like the "sleepless club" :-) and I belong here too :-( I've always had some sleeping problem here and there and need to take some herbs or tylenol PM sometimes. The menopause about a year ago made so much worse and now with the chemo/steroid, I have to take Avitan, but worries about its long term use. In addition to that, my left ear also "hears" a wooshing heartbeat sound, especially at night, very annoying and it makes it even harder to go to sleep. Anyone has tips to deal with it? Thanks. Wish everyone sweet dreams at night.