Understanding Ovarian Cancer and Insomnia: Practical Tips for Better Sleep

Night after night, you stare at the ceiling. 3 AM comes and goes. Morning arrives, and you feel like you never slept at all. For women diagnosed with ovarian cancer, insomnia isn’t just occasional trouble sleeping — it’s a persistent challenge that often accompanies them from diagnosis through treatment and beyond.

If you’re experiencing this right now, know this: you’re not alone. Sleep disturbances affect up to 70% of cancer patients, much higher than the 9 to 33% seen in the general population. For those with advanced cancer, this number rises to about 71%. 

Let’s explore what’s happening with your sleep, why it matters, and most importantly, what you can do about it.

The Ovarian Cancer and Insomnia Connection: Why It Happens

Sleep problems and ovarian cancer are deeply interconnected. Understanding these connections is your first step toward better nights.

Before Diagnosis: Symptoms That Disrupt Sleep

Even before diagnosis, early symptoms of ovarian cancer can begin affecting sleep quality:

• Abdominal discomfort and bloating makes finding a comfortable sleeping position difficult
• Pelvic pain often intensifies when lying down
• Frequent urination leads to multiple nighttime bathroom trips
• Growing anxiety about unexplained symptoms creates racing thoughts at bedtime

Many women report these disruptive symptoms months before their eventual diagnosis, gradually eroding sleep quality long before treatment begins.

During Treatment: When Sleep Becomes Difficult

Once treatment starts, several factors combine to challenge quality sleep:

Physical factors:

• Pain from surgery and recovery
• Nausea and digestive issues from ovarian cancer chemotherapy
• Hormonal changes after ovarian removal
• Hot flashes and night sweats from surgical menopause
• Medication side effects from steroids, certain antidepressants, blood pressure medications, and other treatments that can interfere with sleep patterns

Psychological factors:

• Scanxiety and worry about prognosis and treatment outcomes
• Depression affecting sleep patterns and duration
• Concerns about finances, family, and the future
• Disrupted daily routines and sleep schedules

One research study examined sleep quality before surgery and throughout the first year post-diagnosis among women with ovarian cancer. The research found that most patients reported disturbed sleep at all assessment points, with those requiring pain medications and sleep aids experiencing more severe underlying sleep disturbances and poorer quality of life outcomes — highlighting how pain and sleep problems compound each other’s effects.

The research found that most patients reported disturbed sleep at all assessment points, with pain medications and sleep aids associated with poorer sleep outcomes.

Why Good Sleep Matters During Your Cancer Journey

Quality sleep isn’t just about feeling rested — it also plays a crucial role in your cancer recovery. Research suggests that poor sleep quality is linked to:

• Compromised immune function when you need it most
• Elevated inflammation, potentially worsening cancer symptoms
• Possibly reduced effectiveness of certain treatments
• Decreased cognitive function, affecting decision-making about your care
• Lower quality of life scores in multiple areas

Recent research indicates a potential link between chronic sleep disruption and cancer outcomes. One study found that insomnia was associated with reduced survival in cases of invasive epithelial ovarian cancer. For patients receiving standard chemotherapy for high-grade serous ovarian cancer, insomnia was associated with a 2.48-fold higher risk of reduced survival.

These findings suggest that addressing sleep problems is a potentially important component of your overall treatment approach.

The Cycle: How Insomnia and Cancer Affect Each Other

What makes ovarian cancer and insomnia particularly challenging is their circular relationship:

• Cancer and treatments disrupt sleep
• Poor sleep reduces your body’s resilience and treatment tolerance
• This increases side effects and cancer-related symptoms
• Which further disrupts sleep

Breaking this cycle requires addressing both the cancer-related factors and the sleep disruption together.

Beyond Treatment: Ongoing Sleep Challenges

Completing treatment doesn’t always resolve sleep issues. Many ovarian cancer survivors face continued sleep difficulties. Research found that almost two-thirds (64.8%) of patients still reported disturbed sleep a full year after diagnosis, with about 19% experiencing what researchers classified as “clinical impairment” levels of sleep disruption.

Why do sleep problems continue after treatment ends?

• Lingering physical effects: Nerve pain, hot flashes, and other symptoms can persist
• Emotional aftermath: The experience of cancer diagnosis and treatment affects sleep
• Recurrence concerns: Worry about cancer returning often increases at night
• Established patterns: Sleep difficulties during treatment can become habitual
• Hormonal changes: Many women experience permanent menopause after ovarian cancer treatment

Practical Solutions for Better Sleep

Let’s focus on solutions. While there’s no single fix for ovarian cancer and insomnia, these evidence-based approaches can help:

Medical Approaches

Discuss sleep concerns with your ovarian cancer doctor and oncology team. They may suggest:

• Managing underlying symptoms: Improving pain control, addressing nausea, or hormone therapy for ovarian cancer.
• Appropriate sleep medications: Used carefully, these can help interrupt persistent insomnia. Trazodone is commonly prescribed because it helps restore healthy sleep patterns and is non-habit forming, though it may have side effects. It’s important to work with your medical team rather than self-medicating with over-the-counter options like Benadryl, which can cause cognitive impairment and other problems with long-term use, especially in older adults. Always inform your oncology team about any sleep medications or supplements you’re considering, as these can potentially interfere with chemotherapy or other treatments.
• Mental health support: Treatment for depression or anxiety may improve sleep.
• Specialized care: Referral to sleep specialists for complex sleep disorders.

Behavioral and Lifestyle Changes

Research shows these approaches are particularly effective for cancer patients:

• Cognitive Behavioral Therapy for Insomnia (CBT-I): Research shows this is particularly effective for cancer-related sleep problems, with benefits that can continue after treatment ends.
• Regular gentle exercise: Even brief daily walks can improve sleep quality.
• Sleep hygiene practices: Good sleep habits can make a significant difference, including: using your bed only for sleep and intimacy, avoiding electronics 1 to 2 hours before bedtime, creating a consistent wind-down routine to signal bedtime, and limiting caffeine after noon and avoiding alcohol before bed.
• Regular sleep schedule: Consistent bedtimes and wake times help regulate your body’s clock.
• Sleep-friendly environment: Keep your bedroom cool, dark, and quiet.
• Mindfulness practices: Simple meditation can calm racing thoughts at bedtime.

During Hospital Stays

If you’re hospitalized:

• Use an eye mask and earplugs to reduce disruptions
• Request consolidated nighttime checks when possible
• Discuss medication timing to minimize sleep interruptions

When to Ask for More Help

While some sleep disruption during cancer treatment is common, certain signs indicate you need additional support:

• Sleep problems that persist despite trying several self-help approaches
• Significant daytime fatigue interfering with daily activities
• Unintentionally falling asleep during the day or while driving
• Sleep disruption causing substantial distress
• Symptoms of sleep disorders like sleep apnea (loud snoring, waking up feeling unrefreshed despite adequate sleep time, dry mouth, and difficulty concentrating)

Ovarian Cancer and Insomnia: You’re Not Alone

Remember that difficulty sleeping isn’t your fault or something you must simply endure. It’s a recognized, treatable aspect of the ovarian cancer experience shared by thousands of women.

At Not These Ovaries, we’re funding research to improve all aspects of ovarian cancer treatment, including better approaches to the sleep problems affecting so many patients. We’re particularly focused on advancing research for low-grade serous ovarian cancer and borderline tumors, which predominantly affect younger women who may face sleep challenges for years after diagnosis.