Parental sleep after induction therapy for childhood acute lymphoblastic leukemia

Abstract

Abstract Background: Parents of pediatric patients with acute lymphoblastic leukemia are at risk for developing sleep problems. This study aimed to assess the prevalence of parental sleep problems after induction, the most intensive treatment phase, and identify predictors of poor sleep—as substantiated by a proposed conceptual model. Methods: Parents completed the Medical Outcomes Study Sleep Scale, Distress Thermometer for Parents, and a sociodemographic questionnaire approximately 4 months after their child's diagnosis. Clinically relevant sleep problems were defined as a sum score >1 SD above the reference's mean, and severe problems as >2 SD. Clinical distress was defined according to the pre-established cut-off of ≥4. Pediatric patients wore an actigraph for 7 days to assess sleep efficiency, total sleep time, sleep onset latency, and wake after sleep onset. Predictive determinants of parental sleep (sociodemographic, psychosocial, actigraphic estimates of child sleep) were assessed with multiple linear regression. Results: Questionnaires were available from 123 parents (77% mothers). Their children (n = 120, median age 5.5 years, 60% boys) were on average 4.7 ± 1.3 months from diagnosis. The prevalence of parental sleep problems was 51%; half of this group reported severe problems. Identified predictors were clinical distress (bèta .35, P = .002), insufficient social support (bèta .26, P = .020), more “wake after sleep onset” of the child (bèta .22, P = .042), and chronic illness in the parent (bèta .18, P = .097). Explained variance was 39%. Conclusions: Parents of pediatric patients with acute lymphoblastic leukemia commonly report sleep problems after their child's induction treatment. Enhancing parental well-being benefits the whole family. Hence, early attention to sleep is warranted.