Problems with sleeping

Hormone therapy for prostate cancer can change the levels of sex hormones in your body. This can cause different side effects including difficulty sleeping (insomnia). 

What is insomnia?

Insomnia is when you have difficulty falling asleep or staying asleep at night.

Does hormone therapy for prostate cancer cause insomnia?

Hormone therapy can cause side effects such as hot flushes and anxiety. This can make it difficult to sleep.

What are the best treatments for insomnia?

Relaxation techniques such as meditation can help. Your doctor might also suggest medicines if you’re finding it very difficult to sleep.

Difficulty sleeping and hormone therapy

Hormonal treatments for prostate cancer can lower the levels of sex hormones in the body. Sex hormones are oestrogen and progesterone in women and testosterone in men.

Low levels of sex hormones can cause hot flushes or anxiety, making sleep difficult. Coping with other symptoms can feel harder if you are not sleeping well.

Most adults sleep for 8 hours a day but this varies from person to person.

Sleeplessness (insomnia)

Insomnia is when you have difficulty falling asleep or staying asleep at night.

An occasional night without sleep will make you tired the following day. It won't affect your health, but it can make concentrating and decision making more difficult. Coping with other symptoms may feel harder if you are not sleeping well. 

Understanding why you are finding it difficult to sleep will help you to find possible solutions. 

Sleeplessness can be:

  • difficulty falling asleep
  • difficulty staying asleep
  • waking up often or too early in the morning
  • feeling tired when you wake up (poor quality sleep)

Tips to help with sleep:

  • Go to bed and get up at the same time each day and reduce naps.
  • Do some light exercise each day to tire yourself.
  • Make sure the room is not too hot or too cold.
  • Relax before bedtime, by taking a bath or listening to music.
  • Avoid alcohol, caffeine and smoking for about 6 hours before going to bed.
  • Don't go to bed hungry. Sometimes a light snack before going to bed can help.
  • Turn off mobile phones, tablets and TV at least 2 hours before going to bed.
  • Meditate, practice mindfulness or try deep breathing at bedtime.
  • Minimise noise and light in the bedroom.
  • Try putting a few drops of lavender oil on your pillow or use a lavender cushion.

Talk to your doctor or nurse if you have tried these tips and they haven’t helped.

Treatments for sleeplessness (insomnia)

There are treatments and therapies that might help improve your sleep.

Relaxation techniques

Relaxation techniques such as mindfulness, meditation and breathing exercises can help. They can help you feel calmer and cope with worries and anxieties. This in turn could help you to relax and sleep. 

You can read about meditation in our complementary therapies section. 

Tablets to help you sleep

Your doctor might suggest taking tablets to help you sleep. You usually only take these for a short amount of time. This is because sleeping tablets can have side effects.

Some people are not keen on taking sleeping tablets. But a short course may help you to get back into a healthy sleeping pattern again. 

There are many types of medication available. They include:

  • benzodiazepines such as lorazepam or temazepam
  • non benzodiazepine hypnotics such as zopiclone or zaleplon
  • melatonin (if you are over 55) 

Complementary therapies for sleeplessness

Many people want to try alternative therapies including acupuncture and aromatherapy. There is limited evidence about how well they work. 


Counselling can help if your thoughts and emotions are affecting your sleep. There are different types of counselling including cognitive behavioural therapy (CBT). This type of counselling helps you change how you respond to situations or emotions. 

  • Sleep and daily functioning during androgen deprivation therapy for prostate cancer 
    L Hanisch and others 
    European Journal of cancer care, 2011. Vol 20, Issue 4. Pages 549-554

  • British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update
    S Wilson and others
    Journal of Psychopharmacology, 201p. Vol 24, Pages 1577-1600

  • Chronic Insomnia
    C Morin
    The Lancet, 2010. Vol 379, Pages 1129-1141

  • Cognitive Behavioral Therapy for Chronic Insomnia: A Systematic Review and Meta-analysis
    J Trauer and others
    Annals of Internal Medicine, 2015. Vol 163, Pages 191-204

  • Insomnia- Clinical Knowledge Summary
    National Institute for Health and Care Excellence (NICE), Last revised 2022

  • Associations between sex hormones, sleep problems and depression: A systematic review

    M Morssinkhof and others

    Neuroscience & Biobehavioral Reviews, 2020. Vol 118. Pages 669-680

Last reviewed: 
10 Oct 2022
Next review due: 
10 Oct 2025

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