TY - JOUR
T1 - High prevalence of parent-reported sleep problems in pediatric patients with acute lymphoblastic leukemia after induction therapy
AU - Steur, Lindsay M.H.
AU - Grootenhuis, Martha A.
AU - Van Someren, Eus J.W.
AU - Van Eijkelenburg, Natasha K.A.
AU - Van der Sluis, Inge M.
AU - Dors, Natasja
AU - Van den Bos, Cor
AU - Tissing, Wim J.E.
AU - Kaspers, Gertjan J.L.
AU - Van Litsenburg, Raphaële R.L.
PY - 2020/4/1
Y1 - 2020/4/1
N2 - Objective: To assess sleep problems (prevalence and predictors) in pediatric patients with acute lymphoblastic leukemia (ALL) after the most intensive phase of therapy (induction). Methods: Patients (≥2 years) treated according to the Dutch ALL-11 protocol were included. Sleep was measured using parent-reports and self-reports (Children's Sleep Habits Questionnaire; CSHQ) and actigraphy. Parental sleep (Medical Outcome Study Sleep Scale) and distress and parenting problems (Distress Thermometer for Parents) were assessed with questionnaires. Z-scores were calculated for total CSHQ scores using age-appropriate scores of healthy Dutch children. The prevalence of sleep problems (defined as a Z-score > 1) in patients with ALL was compared to healthy children (chi-square tests). Actigraphic sleep estimates were collected in healthy Dutch children (n = 86, 2-18 years) for comparison with patients (linear regression). Determinants of parent-reported child sleep (total CSHQ Z-score) were identified with regression models. Results: Responses were collected for 124 patients (response rate 67%), comprising 123 parent-reports, 34 self-reports, and 69 actigraphy assessments. Parents reported sleep problems in 38.0% of the patients compared to 15.2% in healthy children (P <.001). Patients reported fewer sleep problems themselves: 12.1% compared to 15.8% in healthy children (P =.33). Total time in bed (B (95% CI): 22.89 (9.55-36.22)) and total sleep time (B (95% CI):16.30 (1.40-31.19)), as derived from actigraphy, were significantly longer in patients. More parent-reported child sleep problems were predicted by parenting problems, more parental sleep problems, bedroom sharing, and child's sleep medication use (explained variance: 27.4%). Conclusions: Systematic monitoring of child and parental sleep and implementation of effective interventions may be a gateway to improve quality of survival in pediatric ALL.
AB - Objective: To assess sleep problems (prevalence and predictors) in pediatric patients with acute lymphoblastic leukemia (ALL) after the most intensive phase of therapy (induction). Methods: Patients (≥2 years) treated according to the Dutch ALL-11 protocol were included. Sleep was measured using parent-reports and self-reports (Children's Sleep Habits Questionnaire; CSHQ) and actigraphy. Parental sleep (Medical Outcome Study Sleep Scale) and distress and parenting problems (Distress Thermometer for Parents) were assessed with questionnaires. Z-scores were calculated for total CSHQ scores using age-appropriate scores of healthy Dutch children. The prevalence of sleep problems (defined as a Z-score > 1) in patients with ALL was compared to healthy children (chi-square tests). Actigraphic sleep estimates were collected in healthy Dutch children (n = 86, 2-18 years) for comparison with patients (linear regression). Determinants of parent-reported child sleep (total CSHQ Z-score) were identified with regression models. Results: Responses were collected for 124 patients (response rate 67%), comprising 123 parent-reports, 34 self-reports, and 69 actigraphy assessments. Parents reported sleep problems in 38.0% of the patients compared to 15.2% in healthy children (P <.001). Patients reported fewer sleep problems themselves: 12.1% compared to 15.8% in healthy children (P =.33). Total time in bed (B (95% CI): 22.89 (9.55-36.22)) and total sleep time (B (95% CI):16.30 (1.40-31.19)), as derived from actigraphy, were significantly longer in patients. More parent-reported child sleep problems were predicted by parenting problems, more parental sleep problems, bedroom sharing, and child's sleep medication use (explained variance: 27.4%). Conclusions: Systematic monitoring of child and parental sleep and implementation of effective interventions may be a gateway to improve quality of survival in pediatric ALL.
KW - actigraphy
KW - acute lymphoblastic leukemia
KW - parenting
KW - pediatric
KW - questionnaires
KW - sleep
UR - http://www.scopus.com/inward/record.url?scp=85078312173&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85078312173&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/pbc.28165
DO - https://doi.org/10.1002/pbc.28165
M3 - Article
C2 - 31944548
SN - 1545-5009
VL - 67
SP - 1
EP - 11
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
IS - 4
M1 - e28165
ER -
