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Do cancer patients sleep a lot?

Many people who are chronically ill feel tired. But cancer-related fatigue goes beyond the usual tiredness. People who experience cancer fatigue often describe it as "paralyzing." Usually, it comes on suddenly and is not the result of activity or exertion. With this type of fatigue, no amount of rest or sleep helps.

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Overview What is fatigue? Fatigue can be confused with tiredness. Everyone gets tired. It's an expected feeling after certain activities or at the end of the day. Usually, we know why we're tired, and a good night's sleep will solve the problem. Fatigue is different. Fatigue is a daily lack of energy — an unusual or excessive whole-body tiredness that is not relieved by sleep. It can be acute (lasting a month or less) or chronic (lasting from one to six months or longer). Fatigue can have a profoundly negative impact on a person's ability to function and quality of life. What is cancer-related fatigue? Cancer-related fatigue (CRF, sometimes simply called "cancer fatigue") is one of the most common side effects of cancer and its treatments. Many people who are chronically ill feel tired. But cancer-related fatigue goes beyond the usual tiredness. People who experience cancer fatigue often describe it as "paralyzing." Usually, it comes on suddenly and is not the result of activity or exertion. With this type of fatigue, no amount of rest or sleep helps. You feel physically, emotionally and mentally exhausted most of the time. Cancer fatigue may last a few weeks (acute) or for months or years (chronic). Chronic cancer fatigue can harm your quality of life. How common is cancer fatigue? Cancer-related fatigue affects 80% to 100% of people with cancer. Who might have cancer fatigue? All types of cancers and cancer treatments can cause fatigue. That’s because your body’s immune system is working hard to fight the disease. Symptoms and Causes What causes cancer fatigue? Cancer treatments, including chemotherapy, radiation therapy, immunotherapy and surgery, can cause fatigue. These treatments can: Change how cells work.

Cause inflammation.

Make you nauseated and dehydrated.

Change hormone levels.

Damage tissues and cells.

Reduce blood counts, leading to anemia.

Stimulate the production of cytokines (toxic cell proteins). The exact reason for cancer fatigue is unknown. Cancer fatigue may be related to both the disease process and treatments, including surgery, chemotherapy, radiation therapy and immunotherapy. Cancer treatments commonly associated with cancer fatigue are: Chemotherapy . Any chemotherapy drug may result in fatigue. This may vary from person to person. Some people say it lasts only a couple of days. Others feel the fatigue persists through and beyond the completion of treatment. Drugs such as vincristine, vinblastine, and cisplatin often cause cancer fatigue. Any chemotherapy drug may result in fatigue. This may vary from person to person. Some people say it lasts only a couple of days. Others feel the fatigue persists through and beyond the completion of treatment. Drugs such as vincristine, vinblastine, and cisplatin often cause cancer fatigue. Radiation therapy . Radiation therapy can cause cumulative fatigue (fatigue that increases over time). This can occur regardless of treatment site. Cancer fatigue usually lasts from 3-4 weeks after treatment stops, but can continue for up to 2-3 months. Radiation therapy can cause cumulative fatigue (fatigue that increases over time). This can occur regardless of treatment site. Cancer fatigue usually lasts from 3-4 weeks after treatment stops, but can continue for up to 2-3 months. Immunotherapy . Immunotherapy stimulates your immune system to fight cancer. The treatment is also sometimes called biological therapy. Immunotherapy stimulates your immune system to fight cancer. The treatment is also sometimes called biological therapy. Bone marrow transplant . This aggressive form of treatment can cause cancer fatigue that lasts up to one year. This aggressive form of treatment can cause cancer fatigue that lasts up to one year. Biologic therapy. Cytokines are natural cell proteins, such as interferons and interleukins, which are normally released by white blood cells in response to infection. These cytokines carry messages that regulate other elements of the immune and endocrine systems. In high amounts, these cytokines can be toxic and lead to persistent fatigue. Cancer and its treatment can also make you prone to these issues that may contribute to cancer fatigue: Anemia . Anemia can result from blood counts that are reduced by treatment. These lowered blood counts reduce the oxygen-carrying ability of the blood (hemoglobin). About 7 in 10 patients experience anemia during chemotherapy. . Anemia can result from blood counts that are reduced by treatment. These lowered blood counts reduce the oxygen-carrying ability of the blood (hemoglobin). About 7 in 10 patients experience anemia during chemotherapy. Combination therapy. People experiencing more than one treatment at the same time or one after the other may experience more cancer fatigue. People experiencing more than one treatment at the same time or one after the other may experience more cancer fatigue. Tumor-induced "hypermetabolic" state. Tumor cells compete for nutrients, often at the expense of the normal cell's growth and metabolism. Weight loss, decreased appetite and fatigue are common results.

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Tumor cells compete for nutrients, often at the expense of the normal cell's growth and metabolism. Weight loss, decreased appetite and fatigue are common results. Decreased nutrition from the side effects of treatments (such as nausea, vomiting, mouth sores, taste changes, heartburn and diarrhea). from the side effects of treatments (such as nausea, vomiting, mouth sores, taste changes, heartburn and diarrhea). Hypothyroidism . If the thyroid gland is underactive, your metabolism may slow so that your body doesn't burn food fast enough to provide adequate energy. This is a common condition in general but may happen after radiation therapy to the lymph nodes in your neck. If the thyroid gland is underactive, your metabolism may slow so that your body doesn't burn food fast enough to provide adequate energy. This is a common condition in general but may happen after radiation therapy to the lymph nodes in your neck. Medications used to treat side effects such as nausea, dehydration, pain, depression, anxiety and seizures can contribute to cancer fatigue. used to treat side effects such as nausea, dehydration, pain, depression, anxiety and seizures can contribute to cancer fatigue. Pain. Research shows that chronic, severe pain increases fatigue. Research shows that chronic, severe pain increases fatigue. Daily routine. Many people try to maintain their normal daily routine and activities during treatments. You may need to modify your routine to conserve energy. Many people try to maintain their normal daily routine and activities during treatments. You may need to modify your routine to conserve energy. Stress can worsen feelings of fatigue. This can include any type of stress, from dealing with the disease and the unknowns to worrying about daily accomplishments or worrying about not meeting the expectations of others. can worsen feelings of fatigue. This can include any type of stress, from dealing with the disease and the unknowns to worrying about daily accomplishments or worrying about not meeting the expectations of others. Depression and fatigue often go hand in hand. It may not be clear which started first. One way to help sort this out is to try to understand how your feelings of depression. Are you depressed all the time? Were you depressed before your cancer diagnosis? Are you preoccupied with feeling worthless and useless? If the answers to these questions are yes, you may need treatment for depression. and fatigue often go hand in hand. It may not be clear which started first. One way to help sort this out is to try to understand how your feelings of depression. Are you depressed all the time? Were you depressed before your cancer diagnosis? Are you preoccupied with feeling worthless and useless? If the answers to these questions are yes, you may need treatment for depression. Insomnia. Inability to sleep eight hours a night will cause both mental and physical fatigue. Diagnosis and Tests How can I tell if I have cancer fatigue? Think of your personal energy stores as a "bank." Deposits and withdrawals have to be made over the course of the day or the week to ensure a balance between energy conservation, restoration and expenditure. Keep a diary for one week to identify the time of day when you are either most fatigued or have the most energy. Note what you think may be contributing factors. Be alert to the warning signs of impending cancer fatigue — tired eyes, tired legs, whole-body tiredness, stiff shoulders, decreased energy or a lack of energy, inability to concentrate, weakness or malaise, boredom or lack of motivation, sleepiness, increased irritability, nervousness, anxiety or impatience. How is cancer fatigue diagnosed? Your healthcare provider will assess your symptoms. You may be asked to complete a questionnaire or rate your fatigue level. Your provider may ask you to keep a journal to track your level of fatigue and factors that might contribute to fatigue. Blood tests can check for anemia, signs of infection or other problems that cause fatigue. Management and Treatment How can I combat cancer fatigue? The best way to combat fatigue is to treat the underlying cause. Unfortunately, the exact cause may be unknown, or there may be multiple causes. There are treatments to reduce certain causes of cancer fatigue, such as anemia or hypothyroidism. Other causes must be managed on an individual basis. The following are tips you can use to combat cancer fatigue: Conserve energy.

Eat a healthy diet.

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Exercise.

Manage your stress. What are the complications of cancer fatigue? Persistent fatigue can interfere with your ability to participate in life’s activities. You may miss out on time with family and friends. It can affect your ability to concentrate and think clearly. Some people are too exhausted to continue working. As many as 1 in 4 people with cancer develop depression. Sometimes, it’s hard to determine if fatigue leads to depression or vice versa. How is cancer fatigue managed or treated? The first step in treating fatigue is knowing the problem exists. Many people don't bother to mention fatigue to their doctors because they believe it is normal. It's vital that you discuss this and all symptoms or side effects with your healthcare provider. Then, efforts can be directed at determining the cause of the problem and prescribing appropriate treatment. Your particular cancer treatment regimen, with its known side effects, may provide clues for your doctor or health care professional. A simple blood test, for example, can determine if you are anemic. There is no single medication available to treat fatigue. However, there are medications available that can treat some of the underlying causes. When you’re struggling, you may want to see a palliative care specialist. These experts help people with cancer manage symptoms like pain, nausea and depression. Your provider or palliative care team may recommend these actions to ease fatigue: Move more: As surprising as it might sound, studies show that staying active is one of the best ways to fight fatigue. Going for a walk outdoors while breathing fresh air can be especially invigorating. Physical activity, including gentle exercises like yoga and tai chi, may also help you sleep better. As surprising as it might sound, studies show that staying active is one of the best ways to fight fatigue. Going for a walk outdoors while breathing fresh air can be especially invigorating. Physical activity, including gentle exercises like yoga and tai chi, may also help you sleep better. Seek mental health support: Cognitive behavioral therapy (CBT) can help you cope with the range of emotions you may feel. Therapy can help you manage stress and may even improve sleep. In-person and online support groups can also provide help. Cognitive behavioral therapy (CBT) can help you cope with the range of emotions you may feel. Therapy can help you manage stress and may even improve sleep. In-person and online support groups can also provide help. Talk to a dietitian: A nutrition specialist can recommend dietary changes, vitamins and electrolyte supplements to raise your energy. You can also find foods that won’t aggravate cancer treatment-related side effects like nausea, mouth sores and diarrhea. A nutrition specialist can recommend dietary changes, vitamins and electrolyte supplements to raise your energy. You can also find foods that won’t aggravate cancer treatment-related side effects like nausea, mouth sores and diarrhea. Use mind-body strategies: Research suggests that mindfulness practices, such as yoga and acupuncture, lessen cancer fatigue. You may also see improvements with massage therapy, meditation and relaxing martial arts like qigong and tai chi. Outlook / Prognosis How long does cancer fatigue last? Everyone’s experience with cancer fatigue is unique. For some people, fatigue lasts a few weeks. Others may feel exhausted for years. You may feel better when your cancer treatments stop, but often fatigue lingers. Bone marrow transplants can cause prolonged fatigue that lasts up to a year. can cause prolonged fatigue that lasts up to a year. Radiation therapy fatigue often gets worse as treatments progress. Fatigue should lessen a few months after you stop treatment. fatigue often gets worse as treatments progress. Fatigue should lessen a few months after you stop treatment. Surgery tends to cause temporary fatigue that goes away after you recover. tends to cause temporary fatigue that goes away after you recover. Systemic treatments (medications that circulate in blood) can cause fatigue that comes and goes. These treatments include chemotherapy, immunotherapy and targeted therapy. You may be exhausted while taking the medications and feel better during the recovery phase (no medication). When treatment resumes, you feel exhausted again. You should have more energy when you finish the treatment.

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