If you have hypersomnia you likely feel extremely sleepy during the day (different from standard tiredness or fatigue) and want to sleep longer than is normal at night, generally more than ten hours. You may find that sleeping for long lengths of time during the night does not improve your tiredness during the day, and that your sleepiness makes it hard to work, take care of your home, or enjoy the activities you normally do. Hypersomnia may sound a lot like fatigue, but they are distinct problems. Regular (not chronic or severe) fatigue may respond to increased rest, like a nap during the day. Hypersomnia is unlikely to respond to regular or increased sleep.

Insomnia is a catch-all term that addresses both trouble falling asleep and staying asleep. It can be acute, or only lasting for a few days or weeks, or chronic, where it lasts for three months or longer. Generally, people experiencing insomnia simply don’t get as much sleep as they should. It is advised that adults should get 7 hours, at minimum, of good sleep per night – those facing cancer or other illnesses may find that they need even more sleep. Getting less than this amount can lead to mental, emotional, and physical fatigue, and general difficulty operating throughout the day. If you have already been diagnosed with insomnia before your cancer diagnosis, you are more likely to experience it after your diagnosis as well. It is advisable to bring this up with your care team as soon as possible so you can discuss possible interventions before you lose too much sleep!

Mouth sores, or mucositis, is the inflammation of the mucosa lining the mouth and gastrointestinal tract. Mucositis is commonly caused by cancer treatments and again makes it painful to brush your teeth or otherwise care for your mouth. There are specialty toothpastes and mouthwashes that may help treat the pain and symptoms of mucositis.

Gum irritation and bleeding

Chemotherapy can alter your blood counts, causing your gums to be more likely to swell, bleed, and generally uncomfortable. This can also reduce your willingness to brush your teeth, again leading to enamel erosion and tooth decay.

Vomiting can erode your tooth enamel due to the acidity of your stomach acid, but nausea by itself is also detrimental. If you are feeling nauseous, the simple act of putting a toothbrush in your mouth to brush can make you feel like you’re going to be sick, which might make you forgo regular brushing. While understandable, skipping regular brushings can allow bacteria and plaque to accumulate, leading to increased risk of tooth decay.

Acidic drinks and foods, such as soda and tomatoes, can weaken tooth enamel and lead to tooth decay. An unfortunate side effect of chemotherapy is nausea and vomiting, which is also very acidic and attacks tooth enamel. You may find that you want to brush your teeth immediately after vomiting, but this can actually cause more harm than good. Brushing your teeth while your tooth enamel is soft due to vomiting can increase enamel erosion and damage, leading to increased risk of developing cavities. It is advised that you rinse your mouth thoroughly with water after vomiting to help freshen up and clean your teeth but avoid brushing.

Chemotherapy and radiation therapy can both cause extreme mouth dryness and reduced saliva production. Dry mouth speeds up the tooth decay process caused by bad bacteria in the mouth and can exacerbate the role of sugar in the formation of cavities. There are a variety of products that can help relieve dry mouth.

Eat more dairy. Low fat dairy consumption may be linked to a lower incidence of colorectal cancer.

Sugar is not necessarily something you have to completely avoid, however it's ideal to limit foods with sugar. It's sneaky and is found in foods you wouldn’t expect, such as ketchup and white bread. Look out for high fructose corn syrup and other sweeteners. Consider natural sweeteners like honey or maple syrup over processed, granulated sugar. Try to avoid or limit sugary drinks. Keep in mind that drinks advertised as “healthy,” such as sports drinks, are often loaded with sugar.

Avoid alcohol, as it’s shown to increase cancer risk. If you choose to drink, drink in moderation. Consider swapping in a mocktail instead of a cocktail.