Anxiety, Stress and Sleep During Cancer

Many people living with cancer experience anxiety and stress, which can make getting a good night’s sleep more difficult. Worries about treatment, uncertainty about the future, and the emotional toll of living with cancer can all make it harder to fall asleep or stay asleep. Some people find that while they can distract themselves during the day, night-time becomes the moment when their mind starts racing, leading to restless sleep or lying awake for hours.

Common Triggers for Night-Time Worry

• Waiting for results – sometimes called “scanxiety” – can cause intense stress and sleep disruption
• Worries about the future, loved ones, or planning ahead may surface more strongly at night
• At night, with fewer distractions, there may be more time to think, which can make fears feel more overwhelming

Techniques to Manage Stress and Support Sleep

Here are some ideas to help you reduce anxiety and create a more restful mind and body at bedtime:

Exercise

• Gentle, regular activity during the day can reduce stress and improve sleep
• A short walk, stretching, yoga, chair-based exercises or any movement you enjoy can help

Breathing Techniques

Simple breathing exercises can calm the nervous system.  They can especially help if you practise them regularly, as this makes them easier to remember when you feel stressed.

‘Hooking’ them onto something that you do regularly (e.g. going to the toilet or having a cup of tea) can be an easy way to remember to practise. Here are three different types of breathing techniques you could try. Find the one that fits best with you.

Relaxed Or Diaphragmatic Breathing

• Sit or lie comfortably
• Place one hand on your stomach just above your belly button and the other on your chest.
• Inhale slowly through your nose, feeling the belly rise while the chest remains still.
• Exhale gently through your mouth, feeling the tummy soften and fall.

Repeat a few times, practising ideally a few times daily.

Relaxation and Meditation

Relaxation exercises can help release mental and physical tension.

Mindfulness practices help you to develop a non-judgmental, present-moment awareness of thoughts, feelings, and bodily sensations, through gently learning to pay attention.

Both can promote a calm state and even a few minutes of practice during the day or before bed can make a difference.

Brief Guided Meditation (3 minute breathing space)

Find a calm space — sit or lie comfortably with eyes closed or softly focused.

• Begin by noticing your breath, without changing it. Observe your natural breathing pattern, your inhales and exhales.
• Shift attention to the sensations in your body, noticing them without judgement as best you can.
• Focus solely on breathing for one minute, letting thoughts rest and your body settle.

End by gently noticing your surroundings and thoughts, then return to your day or bedtime

Managing Night-Time Thoughts

Use relaxation or mindfulness

• If your thoughts start spiralling at night, pause and try to shift attention to breath, body sensations, or relaxed posture.  Breathing exercises or mindfulness can be effective tools for bringing focus back from worry to the present.

Pause worries through planning

• If you’re struggling with thoughts about the future, consider making a plan during the day. Feeling more prepared can reduce mental clutter at night.
• Remind yourself that it’s OK not to solve everything at once and to allow space for rest.
• Try keeping a notepad by your bed to jot down worries or things to remember – this can help clear your mind.

How to use this idea:

Notice the thought
“I’m thinking that I’ll never fall asleep.”

Name it as a thought, not a fact
“That’s a worry thought, not a certainty.”

Challenge it gently
“I’ve had bad nights before, but I’ve always slept eventually.”

Let it pass like a cloud
Don’t wrestle with the thought. Let it come and go, like watching clouds float across the sky.

Practise ‘Cognitive Shuffling’

Cognitive shuffling works by breaking up persistent, looping thoughts (like worries or plans) and replacing them with a series of random, non-emotional mental images or words. This helps trick the brain into a relaxed, pre-sleep state by mimicking the way the brain behaves naturally as it transitions into sleep.

How to Do It:

• Pick a random word with 5 or more letters. Example: “Garden”.
• Take the first letter (G) and think of as many unrelated, simple objects starting with that letter (e.g. “Goat, Grapes, Gate”).
• Visualise each item briefly in your mind for 5–10 seconds.
• Then move to the next letter (A) and repeat: “Apple, Ant, Apron”…
• Keep going through the letters of the word. If you finish, pick another random word.

Seeking Support

If anxiety or worry is regularly affecting your sleep, consider talking to supportive family or friends about your concerns.  You can also speak to your cancer care team or GP. Many hospital and community services offer access to psychological therapies and support groups specifically for people affected by cancer.

Resources with further information about cancer and emotional wellbeing:

• Cancer Research UK – Mental health and cancer
• Macmillan Cancer Support – Cancer information and support
• Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust – General mental health support in various formats including leaflets, videos in English and BSL