Cancer causes tremendous physical and mental stress to patients, resulting in varying degrees of sleep disorders. Some foreign studies have shown that the prevalence of spontaneously reported sleep disorders in the cancer population is 30%-50%, and as high as 37%-38% in breast and lung cancer patients. A domestic study showed that the prevalence of sleep disorders was 26.54% in patients with cancer including various types and stages. Despite the high incidence of insomnia in cancer patients, many patients are not diagnosed and treated. They are afraid of psychotropic drug addiction and worry that they cannot stop taking it, so they prefer to suffer from insomnia. 1. Cancer-related sleep disorder mainly manifests as insomnia Insomnia usually refers to a subjective experience that patients are not satisfied with the time and quality of sleep and affects their social functions during the day. The common clinical forms of insomnia include: obvious difficulty in falling asleep, prolonged sleep latency, difficulty in maintaining sleep, increased number of awakenings (>2) and prolonged duration of awakenings, decreased sleep quality, shallow sleep and dreaminess, shortened total sleep time, usually less than 6 hours, increased early awakening and daytime sleepiness, etc. 2.Treatment of cancer-related insomnia The first step is to develop different measures for different causes in order to achieve the treatment goals of relieving symptoms, maintaining normal sleep structure, restoring social function and improving quality of life. Anxiety and depression are common predisposing factors for insomnia. Pain, chemotherapy, radiotherapy and surgery are often predisposing factors for insomnia in cancer patients, while poor sleep hygiene habits and misunderstandings in insomnia treatment often lead to chronic progression of insomnia. Acute insomnia (within 1 week) should be treated with early medication. Subacute insomnia can be treated with medication combined with cognitive behavioral therapy. For patients with chronic insomnia (more than 3 weeks), it is recommended to consult with the relevant specialist in the sleep clinic. The duration of drug treatment is still controversial, and the recommended course of treatment is generally several weeks. 3.Medication (1) Sedative-hypnotic drugs Non-benzodiazepines should be chosen as the first-line drugs for insomnia. The first few weeks of drug treatment for insomnia are generally used as continuous treatment, and intermittent treatment is used at appropriate times during the follow-up process according to the patient’s sleep improvement status. When patients feel that they are able to control their sleep, they can consider gradually discontinuing the medication, which should be slow and take several weeks to months. Sleep apnea is often present in elderly cancer patients and should be used with caution to avoid inhibiting breathing. Anxiety is a common symptom in cancer patients and can easily affect sleep. Benzodiazepines are also commonly used, such as lorazepam, oxazepam, clonazepam, etc. Non-benzodiazepines these drugs only have hypnotic and no sedative, muscle relaxation and anticonvulsant effects. These drugs have a short half-life, can be quickly absorbed, do not produce accumulation, relatively few sequelae, and have a weak effect on the daytime, and basically do not change the normal physiological sleep structure, and can improve the sleep structure of patients, not easy to produce tolerance, dependence, generally do not produce insomnia rebound and withdrawal syndrome. (2) Antidepressants For insomnia patients with depression, we often use antidepressants with sedative-hypnotic effects, such as mirtazapine, trazodone, amitriptyline, etc. Mirtazapine is more effective for patients with major depression with anxiety or insomnia, and is more suitable for cancer patients, especially those with gastrointestinal tumors or those undergoing radiotherapy, because it has no gastrointestinal side effects. Trazodone has mild anxiolytic and antidepressant effects and strong hypnotic effects, which can treat insomnia and can also be used to treat insomnia rebound after discontinuation of hypnotic drugs. If the patient has anxiety and depression, the effect of using sedative-hypnotic drugs alone is not good, and antidepressant drugs should be given. 4.Non-pharmacological treatment (1) Sleep hygiene education Insomnia is often related to poor sleep hygiene habits, such as reading in bed, watching TV, or drinking alcohol, coffee and tea at night. Poor sleep hygiene can disrupt the normal rhythm of sleep and lead to disruption of sleep patterns, causing insomnia. Sleep hygiene education can enable patients to learn to control and correct various behaviors that affect sleep, improve their sleep quality by creating a comfortable sleep environment, maintaining a regular waking time, minimizing the time spent in bed, paying attention to dietary regulation, eating easily digestible food before bedtime, avoiding overly exciting recreational activities, and quitting smoking and alcohol. (2) Psychotherapy If patients have anxiety and depression, psychotherapy should be given along with medication. It is necessary to establish a good doctor-patient relationship, encourage cancer patients to overcome their fears, provide them with emotional support, build up their confidence to overcome the disease, and set appropriate treatment goals. Many studies have shown that cognitive behavioral therapy is effective for insomnia. Patients with insomnia often have biased perceptions of sleep. It is important to help patients establish a correct cognitive approach to insomnia, and on this basis, establish a set of behavioral approaches that can promote good sleep, which will eventually lead to improvement of patients’ sleep. Behavioral treatments include meditation, relaxation training, biofeedback therapy, stimulus control therapy and sleep restriction therapy.