Beating bowel cancer together

Sleep and fatigue

The worry and uncertainty of living with a cancer diagnosis can affect your sleep. The cancer and its treatment can also cause extreme tiredness (fatigue).


Sleep problems can last for many months after treatment finishes. Stress and anxiety can make it difficult to get to sleep, or cause you to wake up during the night. 


The worry that you aren't getting enough sleep can itself be a problem. If you find yourself awake in the night, tell yourself that relaxing can be as refreshing as sleep. Lie quietly and don’t keep looking at the clock. Allow your thoughts to drift away and focus on things that make you feel happy. A relaxation or meditation CD or podcast can be a way to take your mind off the fact that you are not sleeping and you may actually drift off. 


Good sleep habits

Here are some tips on how to get into good sleep habits: 

  • Avoid caffeinated drinks (coffee, tea, cola) for at least four hours before bedtime – try a cup of herbal tea instead
  • Avoid smoking or drinking alcohol close to bedtime (or give up completely)
  • Keep the same bedtime routine each night
  • Only go to bed when you feel sleepy
  • Don’t eat or watch TV in bed, use it only for relaxing or sleeping
  • Take any prescribed painkillers just before going to sleep if you find that you tend to wake in the night with pain

If you continue to have problems sleeping, talk to your GP about self-help strategies or complementary therapies. If necessary, they can refer you to a counsellor or mental health professional, or prescribe medication. If your sleep is disturbed by needing to empty your bowels during the night your GP may give you medicine, such as diarrhoea medicine, to slow your digestion.

The NHS Better Health: Every mind matters page has more information on coping with sleep problems.

Managing fatigue

Extreme tiredness (fatigue) is one of the most common effects of cancer and its treatment. It can feel completely draining and can affect all areas of your life. It’s not unusual for fatigue to last for many months after treatment is over. In some people, it may last for a year or two.

Fatigue can affect your mood and your relationships. You may feel impatient, upset or tearful over small things, or you may avoid spending time with friends or family. You may be spending longer in bed in the morning, but still have problems sleeping. You may have difficulty completing small tasks and find that you’re short of breath doing even light activities. Poor concentration or memory loss might also be a problem. You might find that you have lost all interest in sex, even though you have recovered physically from your surgery.

Fatigue can get worse if you’re feeling stressed or low in mood. If you think this is the case, ask your healthcare team for help.

The following things can help you cope with fatigue:

  • Making a plan of what you want to do each day
  • Doing the most important things first
  • Pacing yourself by taking regular rest breaks, even when you’re having a good day. This can help you feel better in the long-term
  • Trying to keep physically active, even if you don’t feel like it

Our booklet, Living well, has more tips for coping with fatigue.

Diet and fatigue

Preparing meals can be challenging when you have cancer-related fatigue. The tips below may help you:

  • Try to eat and drink a wide variety of fresh food and fluids to make sure you get all the nutrients you need
  • Have some of your favourite foods and drinks. It’s important to enjoy mealtimes and look after your wellbeing
  • Try choosing healthier ready meals or prepared salads
  • Keep portion sizes small and eat five or six smaller meals or snacks a day. This will help to keep your energy levels steady and stop you feeling hungry
  • Ask friends or family to help you prepare food. You could also ask someone to help you with food shopping or order your groceries online
  • When you feel able to, cook large dishes and then freeze them in meal-size portions. Making several portions of soups and other meals means you can put some in the fridge or freezer for when you don’t feel like cooking
  • Boost your iron intake. Good sources of iron include dried apricots, green vegetables, beans and breakfast cereals with added iron and wholegrains. Red meat also contains iron, but you should limit how much you eat
  • Eat a light snack and have a caffeine-free milky or herbal drink before bed to avoid waking up hungry or thirsty in the night

 Download our Living well booklet

Updated February 2024

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