Abstract
BackgroundWith the increase of pediatric cancer survival rates, late effects and quality of life (QoL) have received more attention. Disturbed sleep in pediatric cancer is a common clinical observation, but research on this subject is sparse. In general, sleep problems can lead to significant morbidity and are associated with impaired QoL. Information on sleep is essential to develop interventions to improve QoL.MethodsChildren (2-18 years) with acute lymphoblastic leukemia (ALL) were eligible for this multi-center study. The Children's Sleep Habits Questionnaire (CSHQ), Child Health Questionnaire (CHQ) and Pediatric Quality of Life Inventory 3.0™ Acute Cancer Version (PedsQL) were used to assess sleep and QoL halfway through maintenance therapy. Sleep and QoL were measured during and after dexamethasone treatment (on-dex and off-dex).ResultsSeventeen children participated (age 6.7 ± 3.3 years, 44% boys). Children with ALL had more sleep problems and a lower QoL compared to the norm. There were no differences on-dex and off-dex. Pain (r = -0.6; p = 0.029) and worry (r = -0.5; p = 0.034) showed a moderate negative association with sleep. Reduced overall QoL was moderately associated with impaired overall sleep (r = -0.6; p = 0.014) and more problems with sleep anxiety (r = -0.8; p = 0.003), sleep onset delay (r = -0.5; p = 0.037), daytime sleepiness (r = -0.5; p = 0.044) and night wakenings (r = -0.6; p = 0.017).ConclusionQoL is impaired in children during cancer treatment. The results of this study suggest that impaired sleep may be a contributing determinant. Consequently, enhanced counseling and treatment of sleep problems might improve QoL. It is important to conduct more extensive studies to confirm these findings and provide more detailed information on the relationship between sleep and QoL, and on factors affecting sleep in pediatric ALL and in children with cancer in general.
Highlights
With the increase of pediatric cancer survival rates, late effects and quality of life (QoL) have received more attention
Sleep There appeared to be more sleep problems in children with acute lymphoblastic leukemia (ALL) compared to healthy children
In the middle age group children with ALL scored significantly higher for bedtime resistance (p = 0.025)
Summary
With the increase of pediatric cancer survival rates, late effects and quality of life (QoL) have received more attention. The improved survival rates have led to more attention to other outcomes, such as quality of life (QoL), fatigue and to a lesser extent, sleep. Children with sleep difficulties experience higher rates of behavioral problems, depression, anxiety in adulthood, and impaired cognitive function and emotional development [6,7,8,9,10,11]. During dexamethasone treatment duration of sleep was increased and there was an increase in nighttime awakenings, restless sleep and nap time
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