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Insomnia is a sleep disorder in which a person has trouble falling asleep or staying asleep. Chronic insomnia is a common problem in patients and survivors of childhood cancer. Insomnia is considered chronic if it happens 3 or more nights per week for at least 3 months.
Symptoms of insomnia include:
Insomnia in children with cancer can occur for different reasons. Often, insomnia is learned through changes in sleep habits (behavioral insomnia).
Insomnia can develop through changes in sleep behaviors and routines during the cancer experience. When a child has cancer, families often change their normal habits and “rules” about bedtime and sleep. Nighttime caretaking may increase with fever checks or other medical care during the night. Parents might also co-sleep in a child’s room to make care easier.
Over time, children develop new habits. They may resist going to bed. They may rely on having parents nearby during sleep and not want to sleep independently. Other factors such as stress, discomfort, and noise can make it hard to fall asleep or stay asleep. Sleep problems can then lead to anxiety about sleep, further contributing to poor sleep.
Symptoms of behavioral insomnia include resistance to going to bed at night, problems falling asleep, waking up during the night, and trouble going back to sleep after waking up in the night.
In cancer patients and survivors, it is important to know if insomnia is a result of the cancer, side effect of medication, or other physical cause.
Assessment of insomnia may include:
Behavioral and environmental changes are the first steps in managing insomnia in children. Families can take steps to encourage healthy sleep habits and improve specific sleep behaviors:
Doctors may sometimes prescribe medicine to help with sleep. However, no medicine is currently approved specifically for insomnia in children under age 16. Families should talk to their doctor before taking any medicine or supplement, including those available without a prescription.
Reviewed: June 2019