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A sleeping woman floats in the darkness, surrounded by various blobs that resemble inflamed skin due to topical chemotherapy treatment.

Efudex: Sleep, Wherefore Art Thou?

Sleep is a beautiful thing when you can get it. The coveted forty winks can be hard to come by even in the most ideal of circumstances. If you are one of those already caught in a vicious cycle of eat-work-fight for sleep-repeat, you won’t want to hear that Efudex may only serve to exacerbate your sleep dilemma.

Why can't I sleep when using Efudex?

Sleeplessness is one side effect reported by many fellow users with whom I have talked over the last few years, and it is a frustrating side effect indeed. It is difficult for me to say exactly what it is about Efudex that causes sleeplessness, but as a frequent user, I have some theories and some tips to get you through this trying time.

Anxiety and stress

Firstly, I assume sheer anxiety brings about some of my sleeplessness during the first week or so of applying the topical chemotherapy cream. Once I have been ordered to use Efudex each year, I am always hit with a certain amount of stress about the outcome. Even though I have treated my chest, face, lips, and spot-treated several times, I can’t help but worry that the cream won’t take away the precancerous cells. I am a born worrier, so this reaction is par for the course for me. Cue the tossing and turning.

Itching and burning

As treatment ensues, the constant itching and burning only adds to my sleeplessness. With the sensation growing from tingling to itching and then burning in the later weeks, it is difficult to find a comfortable position in which to fall asleep. I am a stomach sleeper, so treating my chest or face always presents a special kind of challenge. I believe the increased sensitivity in the treated area is a major factor in most users’ reports of insomnia.

Irriation from any and all fabrics

Last but not least is the struggle of wills between the treated skin and fabric. As if the itchiness weren’t enough, you will likely find yourself battling with the fabric of your nightclothes and the very sheets themselves. Late during treatment and especially during healing, the treated skin may develop sores that seep clear fluid. These patches of skin tend to stick to the sheets and pajamas and make turning over and changing positions during sleep without waking a thing of the past.

Tips for sleeping with Efudex

Though getting the suggested amount of sleep each night may be difficult while using Efudex, it is not impossible. I have a few things I do before bed to better prepare myself for the nighttime fight.

  • I apply the cream at least an hour before bed to allow plenty of time for the cream to fully absorb.
  • About 30 minutes before bed, I take Benadryl to help with both the itching and to help me sleep. *Always check with your prescribing physician before adding other medications to your routine while treating.
  • Propping my arms on pillows at my side helps me stay on my back. I can’t prevent myself from rolling over through the night, but pillows keep me on my back for the most part.
  • In the hardest of times at the end of treatment on my chest and during healing, I place a sheet of plastic wrap over my chest and apply an ice pack on top of the plastic wrap. I’ve found this to be a great way to numb the itching for a little while just before bed.

I know it seems unending, and I know that sleepless nights make the time pass infinitely more slowly. You’re tired. You’re hurting. You just want to feel like you again. All of us know what you are going through, and we can tell you that that day is coming whether you believe it or not right now. Hold on and keep believing. You will get your nights, and your life, back soon.

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