Insomnia in palliative care: Information for patients and carers

This information is sourced from the Mental Health Foundation, Fast Asleep and Marie Curie:

Sleep problems are common in people with advanced illness and are important to address. Difficulty sleeping can be caused by a combination of many factors such as pain, needing to go to the toilet too frequently or depression. If physical symptoms are affecting sleep, or if the practical tips on this page do not help, it is important to discuss sleep problems with a doctor.

Each person needs a different amount of sleep. The aim is to feel alert most of the the day time.

Practical tips for good quality sleep

Environment

Try to remove distractions from the bedroom. 

Ideally stop the bright displays of computers, phones and TVs an hour or two before sleep as these suppress melatonin production – the hormone that helps sleep. 

Consider an eye mask or ear plugs.

The temperature of the room is also important as being too cold or too hot can disrupt sleep. 

Anxiety about sleep

Worrying about sleeping can keep people awake. Relaxation techniques can help.

If unable to sleep it is better to get up, try a warm drink (no sugar or caffeine), and go back to bed when feeling sleepier.

If sleep problems persist for more than a month Cognitive Behavioural Therapy (CBT) may help. Please see 'Related Services' on this page for psychological therapy services in your area.

Lifestyle

Napping may be unavoidable but can reduce night time sleep requirements.

Food and drink containing caffeine or sugar can worsen insomnia and should be avoided in the evening.

Alcohol often impairs the quality of sleep.

Medication

Sedative medications for sleep work better if not taken every night.

Melatonin is particularly helpful to reset the body clock (i.e. asleep all day and awake all night).

Some people find various herbal remedies such as lavender helpful- these are always worth a try.

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Resources

Dr Michael Mosley's website Fast Asleep has some great tips, with a book by the same name

Recommended Resources

The mental health foundation: how to sleep better

Published 1st August 2022

Marie Curie - Sleep problems in palliative care

Published 1st March 2022

Fast Asleep

Published 9th June 2024

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