48. Is caregiver sleep related to allogeneic hematopoietic stems cell transplant engraftment?

Abstract

Caregiving for hematopoietic stem cell transplant patients (HSCTp) is burdensome resulting in inadequate self-care, possibly leading to negative patient outcome. This potential Caregiver–HSCTp relationship was examined through assessment of caregiver objective and subjective sleep measures. We hypothesized that better caregiver sleep would be related to shorter time to patient engraftment (TtoE). Dyads ( N = 109) were HSCTp (M (SD) age = 48.2(12.7)) and caregivers (M (SD) age = 52.7(12.6)). Linear regression controlled for clinically relevant patient variables (age, sex, pre-transplant treatment intensity, clinical status). Better caregiver subjective sleep quality (Pittsburgh Sleep Quality Index) and objective sleep efficiency (SE; actigraphy) collected prior to engraftment significantly predicted TtoE (std beta’s = .20 and −.30 respectively; p ’s < .05). Objective SE remained a significant predictor of TtoE after additionally controlling for sleep medications (std beta = −.29; p < .05), explaining an additional 8% of the variance (total R squared = 24%). Further, the timespan of sleep assessment relative to engraftment (M (SD) days = 18.5(12.1)) was controlled for to address the potential bidirectional relationship (e.g., shorter TtoE led to better caregiver sleep), and significant effects of caregiver SE remained (std beta = −.18; p < .05). These data highlight potential influences of caregiver self-care, specifically sleep, on HSCTp outcome. Future research should examine potential mediators of this relationship as well as addressing caregivers’ psychological well-being and sleep disturbance during the process of HSCT. (Supported by NIH grant CA126971 and PCORI contract CE-1304-6208.)