By Adriana Ermter
In our monthly column, senior writer and editor Adriana Ermter shares her personal experiences with breast cancer.
The last time I had a deep, uninterrupted, good night’s sleep was before I was diagnosed with breast cancer. Because since then, it’s like sleep dumped me. Just walked out the door and didn’t come back.
I vividly remember the first night, after I found out I had breast cancer. I was lying in bed, wide awake with my eyes closed, listening to Trixie the cat purring beside me. My body was heavy, but my mind was wild, racing with thoughts of nothing and everything all mashed together. That was the beginning of a new kind of insomnia. Not the kind where you just can’t fall asleep, but the kind where sleep feels like something you used to do in a different lifetime but can’t access any more.
The cancer diagnosis had jolted my body’s nervous system into high alert. My brain’s fight-or-flight response, triggered by fear and uncertainty, was suddenly flooded with stress hormones. Apparently, this is normal. It’s how we’re wired to survive. But when those stress hormones kick in and don’t switch off, it’s exhausting. Ask any woman diagnosed with breast cancer and I bet she’d say the same. A 2023 research article published in Science Direct found that 62 per cent of breast cancer patients sleep poorly and are two to three times more likely than the general population to experience sleep disruption. Still, this initial insomnia was just the beginning.
Surgery Sleeplessness
After surgery, I experienced different sleep issues. There were the obvious things: the sharp, stinging incisions, the tightness across my chest and the dull ache in my armpit and breast that kept me awake. But there was also this sense of unfamiliarity with my own body. I didn’t know where to put my arms when I lay down. I was scared of hurting myself, which I knew wasn’t rational because I wasn’t doing anything except lying horizontally. Even with my extra-long, super soft and squishy Canadian Down & Feather pillow, I couldn't find a comfortable position that lasted all night. I’d fall asleep, only to wake an hour later, throbbing in pain. Post-surgical pain and mobility issues, especially from lymph node removal which I had, are common. Yet somehow, they’re made worse by the emotional undercurrent of feeling physically changed and emotionally vulnerable.
Radiation Restlessness
Radiation brought its own brand of fatigue and not the kind that lulled me to sleep. It was a deep, dragging exhaustion paired with red, tender skin that felt like it was on fire. Week after week I oscillated between wanting to crawl under my desk at work and crash (yes, I made the horrible mistake of working through treatment) or lay, teeth chattering, in a bath filled with ice. The daily radiation treatments compounded my physical symptoms and resulted in a mental toll I could never have predicted. My brain would randomly shut down every single day, often multiple times a day, and always turning me into an idiot. I couldn’t remember anyone’s name. Every thought was elusive—there one second gone the next. I routinely had to stop mid-conversation to ask what we were talking about. I stopped caring about how I looked, I didn’t have the energy to cook, and despite my body begging for rest, when I did sleep it was never enough. The Canadian Cancer Society’s website states that fatigue is one of the most common side effects of radiation therapy, which was comforting to know, but not helpful in the moment.
Tamoxifen Terrors
And then there was the Tamoxifen effect. No one warned me how such a small pill could shake my nights so thoroughly. Within days of taking it, I’d wake up in the middle of the night drenched in sweat, sheets soaked, heart racing—the hot flashes and night sweats were ruthless. I’d kick off the blankets, towel dry, change my pyjamas and sheets and crawl back into bed. Minutes later, I’d be shivering and pulling the duvet over my head, before having a repeat sweat session just hours later. Tamoxifen threw my body into hormonal chaos. Alongside the night sweats, there was joint pain, mood swings, a dry and painful vagina, nausea and…zero sleep. The lack of zzzzs further impacted my ability to think and kept me zombie-like during waking hours.
Nobody tells you any of this or at least not with any detail or specificity before it happens. The pamphlets that get passed around and the doctors’ commentary during weekly appointments all feel somewhat vague.
Cancer Fatigue
Every doctor appointment, every treatment, every side effect, every pill swallowed intensifies over time and then transforms into something called cancer-related fatigue. Not to be confused with all the other ways breast cancer exhausts, this is a persistent, bone-deep exhaustion that no amount of sleep can fix. It first happened to me during treatment, but lots of women experience it months later, sometimes even after they've been declared cancer free. It’s both physical and mental and it makes your body feel like it’s moving through molasses. Your brain forgets simple words. There are days when the effort to brush your teeth feels overwhelming. And it’s complex.
A 2024 article published by the Mayo Clinic links cancer fatigue to inflammation, anemia, hormonal changes and the emotional toll of living in a state of constant uncertainty. It doesn’t always look like what people expect either. Some days you might seem fine, smiling, making dinner, replying to emails, but on the inside, you’re depleted. Other days, you may barely get out of bed. It’s not laziness. It’s not depression. It’s real, and while it may diminish over the years, it may also never fully go away. I still have mine.
Sleep Solutions
There are things that can help with the fatigue and sleeplessness. I try to avoid sugar, as it causes my body to overheat and makes the night sweats and hot flashes more frequent and intense. I still love and use my oversized pillow; it’s my dream saver. Crisp cotton sheets and a cooling drop of peppermint essential oil rubbed across the back of my neck are soothing. Walking and swimming laps a few times a week releases tension. At bedtime, I read a few pages of an actual book (not a Kindle. I don’t want the blue light), to inspire and distract me from my hamster wheel of thoughts. Sometimes, I just lie in bed with my hand on my chest, breathing slowly.
Post-treatment, I need more sleep than I ever did in my pre-cancer life. I’m a napper now and I go to bed early, and I want to. I often turn down social plans because nothing feels better than climbing into bed with my snuggly cats Murphy and Olive (Trixie is in cat heaven now). I like to wake up early too, to ease into my day with coffee and stillness. This slower rhythm feels like a reward for everything my body has been through. While none of this completely fixes my sleep issues, all combined it certainly helps.
Adriana Ermter is a multi award-winning writer and editor. Her work can be read in IN Magazine, Living Luxe, 29Secrets.com, RethinkBreastCancer.ca and AmongMen.com. The former Beauty Director for FASHION and Editor-in-Chief for Salon and Childview magazines lives in Toronto with her two very spoiled rescue cats, Murphy and Olive. You can follow Adriana on Instagram @AdrianaErmter
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