What can I take for insomnia while on letrozole?

Sleep challenges are a common concern for those taking letrozole, and many community members have found various approaches that work for them. Speaking with a healthcare provider about sleep aids or strategies specifically safe to use alongside letrozole would be the best first step, as they can recommend options that won't interfere with the medication. Many in this community have shared helpful experiences with sleep hygiene techniques and other supportive measures that might be worth exploring together.

I was hoping for some advice. Melatonin 10 mg is not doing the trick. This is not top on the list of issues for healthcare providers. I see my GP in December.

I don’t know what state you live in, but medical marijuana gummies are a huge help for me. I get some for sleep that have melatonin in them in addition to CBN +5 mg of THC. It does the trick every night. I’m on anastrozole and had the same problem.

I am in Jersey and there is a dispensary nearby. I will definitely give this a try. Thank you for the suggestion!

I am on Letrozole fir 4 years; my psychiatrist prescribed Lorazepam, Davigo; they work well, but sometimes night time I still get up because of pain

Thanks for this information. I am on a journey so I don’t fall asleep at 4 pm when I am trying to work.

Sandra, I tried melatonin as well, and it did nothing. (Also, 10 mg is way too much. You should not take more than 3 mg, max.) I resorted to reducing my endocrine therapy by half. It is the only thing that has helped with the absolutely horrible insomnia.

Good to know. I will need to consider that option. BTW my oncologist suggested 10 mg of Melatonin!

Thank you ladies for sharing! I was prescribed gabapentin but does not sit well with me. I started taking cbd and it helps a bit. Unfortunately hot flashes hit me aswell and wakes me up. I’ll have to role with the punches for now.

I tried melatonin. It was useless. I am on anastrazole. Originally sleeplessness was an issue,but only periodically now. When I do have trouble, I take trazodone, that my oncologist has approved.

Does the trazedone help? I tried it but it did nothing for me. How many mgs do you take? Do you take it right before bed?

My trazodone is 50 mg. And yes, it definitely works for me.

I take an over the counter sleep aid Unisom , Doxylamine Succinate , 1/2 tablet works well

@sandra: your oncologist made a super common mistake. (I am a neurologist specializing in older adults with cognitive decline and dementia.) As a crude generalization, with sleep aids, lower doses are almost always better. 1 mg of melatonin, and never more than 3. Also, try taking it **several hours** before bedtime. Benzodiazepines (I'm looking at you lorazepam) are ALWAYS best avoided. They produce sedation more than restorative sleep. Plus, they have a huge downside that includes increased risk for falls and cognitive impairment. Suvorexant is a relatively newer FDA-approved sleep aid with a primary sleep mechanism (most other so-called sleep aids capitalize on side effects, but suvorxant has a primary sleep mechanism). It would almost certainly require prior authorization by your onc, but I think you'd have a reasonably good case for approval, given that insomnia interferes with what coukd be life-saving cancer treatment.

Thank you Amy; Is good to know, and unfortunately they never told me about the downsides you specified; Few months ago I had an episode of TGA( transient global amnesia); lucky me I was in the house; The MRI that time showed 2 millimetres spots symmetrical in hippocampus; I still suspect could be a side effect of Letrozole Does anybody on Letrozole had TGA during tratment with Letrozole? Thank you

How do you all feel when taking gabapentin? Is there anything to be concerned while taking this drug?

Some people, especially older adults, worry about dizziness and cognitive clouding. When gabaP was first approved by the FDA, it was as an adjunctive (add on) anti-seizure medication. It is virtually never used for that indication any longer. It IS frequently used for nerve pain, eg carpal tunnel and a bad back in my case. It can cause fatigue/ sleepiness, which gives it some utility about insomnia. A word about dosing. The maximum daily dose is 3600 mg. Many people get startled on 100 mg, then get frustrated because "it didn't work." I typically start people at 300 mg at night. It is a 3-times daily medication, but often given in a single bedtime dose. Me, I take 900 an hour or two before bedtime. This is just generic information; I am not prescribing anything for anyone.

Hi Griselda, over the last 4 years I have been taking Gabapentin for different side effects of the treatment; usually 300 evening time, as it gives me light dizziness. The problem with this one is that the effectiveness of it comes after you take it for a while; other than that no issues.

Wow. Thank you Amy. I have an appointment this week with my GP. I copied comments to discuss. I like her and she listens. Will keep you all posted.

Very helpful comments, Amy. Thanks.

I’m taking 100 mg of trazadone. I’m not having insomnia issues but only been taking lertrozole & kisqali for two weeks

I made a personal choice to stop taking all estrogen degrades/blockers. I know it raises my risk of recurrence/metastasis.But you know what else does? Consistently not getting enough sleep. Lack of sleep elevates cancer recurrence and metastasis risk through mechanisms like circadian disruption, reduced melatonin, inflammation, and weakened immunity, with studies showing risks up to 69% higher for those sleeping under 7 hours nightly.[frontiersin +1] I’m choosing to stay on Lynparza, which goes directly at my gene mutation (PALB2, similar to the BRCA gene mutation) and staying in ketosis, which starves glucose-dependent tumor cells, reducing insulin and IGF-1 levels that fuel growth, and enhances therapies like PI3K inhibitors relevant to PIK3CA mutations.[healthline +1] Ketosis also boosts chemotherapy and radiation efficacy, lowers inflammation via reduced cytokines and NF-κB, and decreases matrix metalloproteinases (MMPs) that enable invasion, potentially extending survival when combined with standard treatments. It also elevates ketones that may trigger ferroptosis in cancer cells, though cachexia risks exist without monitoring.[cshl +2] It seems to me that this method will greatly improve my quality of life, while lowering my chance of recurrence. Dr. Thomas Seyfried speaks extensively about the metabolic diet being key to avoidance of all of our worst diseases, including heart disease, Alzheimers, diabetes, and yes, cancer. He has many podcasts and YouTube videos explaining exactly how it works. I would love to hear anyone else’s thoughts on this.

Mariana, I just happened to run across this: Observational studies link lorazepam use during cancer therapy to worse progression-free survival and overall survival in breast cancer patients, with hazard ratios indicating up to 35% increased risk.[aacr +1] Lorazepam may not be safe for you.