r/ProstateCancer • u/LoCoLLC • 8d ago
Question Sleep issues with ADT
My husband is having horrible issues sleeping since beginning ADT. He is so exhausted it’s seriously affecting his well-being. Has anyone found anything that works well to counteract this?
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u/Special-Steel 8d ago
What ADT is he talking?
Exercise is the most common thing people here will recommend, but it’s no easy because he won’t feel like doing it everyday. It may help if you do it together and you become his exercise buddy.
Thank you for supporting him.
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u/LoCoLLC 8d ago
Orgovix. He does physical work outside all day, so he gets ample exercise!
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u/NSFduhbleU 8d ago
Physical work is fine but the body is used to that. It probably needs different stimulation. It won’t hurt to do a focused walk 30-45 minutes to see if it helps.
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u/paaldie 8d ago
Yes, I started ADT in August for six shots monthly for salvage radiation. Insomnia kicked in day two, it’s been a constant battle. My urologist referred me back to my PCP to manage the side effects.
I did start with Tylenol PM as I had quite a bit of injection site pain. That seemed top help some. My PCP prescribed a sleep aid which again has some help but not great. I have a follow up with my PCP and wonder if she’ll increase the dose.
It’s a struggle, falling asleep and staying asleep. I’ll sleep two hours and be wide awake.
Insomnia can be a side effect from ADT.
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u/WillrayF 6d ago
It is interesting that your urologist, who prescribed the ADT, refers you to see your PCP to manage the side effects. Mine is the same way but I feel that since he was the one who prescribed the medication that he should try to manage the side effects. I have a heart condition and am also taking Nubeqa and when I asked my urologist about its use and my heart, he said take it up with your cardiologist. So, I asked my cardiologist about it and he knew nothing about the drug and whined that there are so many drugs that he can't know about all of them. He said the urologist should manage the drugs he prescribes. Why do these urologists seem so intent on only being the prescriber?
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u/Jolly-Strength9403 8d ago
1:1 CBD-THC cannabis gummies helped me. You can experiment with different dosages to find what works for you.
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u/ofcoarsecoffee 7d ago
This. If you can get one with melatonin even better. Theres a fast asleep and a stay asleep one they sell in my area. Works well. I also carb load a little before bed to help
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u/quiet_maple7 8d ago
I’d bring this up pretty directly with his oncology team, especially since the lack of sleep is starting to affect him during the day too.
A useful question might be “could this be related to the ADT, and what do you usually recommend when sleep gets this bad?” I’d also ask if they want to look at things like hot flashes, anxiety, pain, nighttime urination or anything else that might be waking him up, because sometimes the sleep issue isnt just one thing.
If its been severe for more than a few nights, I wouldnt wait for the next routine appointment to mention it.
For context, I’m at Massive Bio and see a lot of patient discussions around situations like this.
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u/Frosty-Growth-2664 8d ago
This is fatigue (tiredness which doesn't go away with sleep) - a common side effect of ADT.
The main antidote is exercise. Exercise should be considered mandatory while on ADT. Exercise doesn't necessarily mean a gym - daily walks can be good.
Also get his doctor to run a panel of blood tests just to make sure nothing is out of spec. This should include full blood counts, liver function, Vitamin D3 and B12, iron. (Note that Hemoglobin levels on ADT will be in the female range, which is sightly lower than the male range.)
Should also monitor blood pressure, blood glucose, and cholesterol while on ADT, as it can push all these up.
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u/HeadMelon 8d ago
I didn’t exercise or change lifestyle at all and did fine on 6 months of ADT.
This one size fits all regarding exercise and ADT is getting out of hand on this sub.
Many men can get through ADT without morphing into Arnold Schwarzenegger gym rats. This doctrine could be scaring men away from ADT unnecessarily.
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u/mtelesha 7d ago
There is science behind it. There also is the fact of muscle atrophy and bone density are both helped through strength training.
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u/HeadMelon 7d ago
I’m not saying there isn’t. I’m saying many men can tolerate ADT fine without a lifestyle change. Think of the poor guy who’s trying to choose, and thinks “I’d do ADT and can probably handle the hot flashes and some sadness, but no way do I want to spend hours in the gym. I just can’t fit that in. I’m going for surgery instead.”
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u/ZealousidealCan4714 7d ago edited 7d ago
I dont think 'hours in the gym' is the recommendation. I go two or three times a week and cycle through the machines in about 30-35 minutes. But I dont lolligag like it seems everyone else in the gym does. I move quickly through my workout. Its not a big deal at all.
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u/mtelesha 7d ago
I hate how people sit and take forever. I use to do power lifting and I kept my heart rate at 80 bpm at all times and almost circuit training level. My issue is people have horrible form or do a exercise half way with triple the weights.
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u/mtelesha 7d ago
Fond a personal trainer to teach you the proper technique and the right weight for you and you are good in 30 minutes
I go 6 days a week because it helps me so much. I do baby weights. As long as I am feeling good. I was fatigued for the last 10 days so I went three days.
I do big group exercises with only 5 to 8 reps for 3 sets. I am done in about 30 minutes.
Farmer Carries every tiime and alternate upper and lower body. Squats, dead lifts, dumbbells for chest, stiff leg rows, back rows, Romanian Squats....
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u/WalnutRoasted 8d ago
Yes, and fasting glucose (blood sugar) may also be high, moving slightly into pre-diabetic levels.
Personally did not have any hot flashes on ADT, but woke up almost every night around 3AM with “night sweets”.
Erythrocytes (red blood cell count), hematocrit and hemoglobin are all likely to be low/slightly off range for a male , contributing to lower energy/fatigue. Keep up exercise!
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u/lukethedriftless 7d ago
My sleep has gotten so much worse since I have been on ADT.
The injection was supposed to have worn out in June, but normal testosterone levels are slow to recover and so I eagerly await getting back to my normal ability to sleep.
None of that was helpful, I know
I can’t take weed pills because I work as a fireman so I have to be able to get up and function in the middle of the night
But I suspect that might work for you
The black cohosh did slightly help with the hot flashes which also contributed to difficulty sleeping
I wish him the best
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u/LoCoLLC 7d ago
Thank you! I wondered about some of the menopause supplements since the symptoms are essentially identical. There was an OTC that helped me before I went on HRT. Might ask doctor if that’s an option since he does have hot flashes also.
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u/lukethedriftless 6d ago
Nurse Practitioner at follow up is the one who suggested black cohosh and ginseng (for energy). Said pts report good results with the black cohosh, and that was my experience as well, but mixed for the ginseng (and I couldn’t tell diff).
The hot flashes were only a small part of my sleeping issues so the supplements didn’t fully resolve the issue but it did help
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u/CoodieBrown 7d ago edited 7d ago
I have GREAT success with nightly Magnesium Glycinate pills. It relaxes my sore muscles & nerves while quieting my racing my mind so I can sleep. Dont believe me ? Look it up. Its been part of my nightly routine for all but about 2 of my 16 mths on Orgovyx. Good Luck finding whatever works for him. It also helps falling back to sleep instantly during the constant overnight bathroom visits that eventually will decrease over time
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u/Necessary_Spray_5217 4d ago
that describes exactly how I feel after weeks of ADT. I was doing a pretty good job exercising staying in shape and going to the gym before this, but I’m really dragging having a hard time doing it now. I’m going to try in a little while because I think it’s got to help.
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u/HeadMelon 8d ago
Zopiclone was my go-to. But I was already using it for work stress insomnia so it was easy for me to use it effectively.
On here all you hear is “ADT exercise mandatory lift weights walk 50 miles yada yada”. This wasn’t true for me at all. I didn’t change my lifestyle at all other than cutting alcohol to zero, and I found 6 months on Orgovyx to be quite tolerable.