Sleep and mood during hospitalization for high‐dose chemotherapy and hematopoietic rescue in pediatric medulloblastoma

Graef, Danielle M.; Crabtree, Valerie McLaughlin; Srivastava, Deo Kumar; Li, Chenghong; Pritchard, Michele; Hinds, Pamela S.; Mandrell, Belinda N.

doi:10.1002/pon.4737

Cited by 16 publications

(12 citation statements)

References 47 publications

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“…The intervention was implemented between May 2008 and August 2011. Outcomes of nighttime sleep and mood have been published . Methods are described here briefly, with a detailed description in Supporting Information Appendix S1.…”

Section: Methodsmentioning

confidence: 99%

“…Outcomes of nighttime sleep and mood have been published. 11 Methods are described here briefly, with a detailed description in…”

Section: Sleep Interventionmentioning

confidence: 99%

“…Hospitalization for cancer treatment disrupts children's sleep pattern through changes in routines, environmental light and noise, pain, chemotherapy side effects, and awakenings for care provision . High‐dose chemotherapy (HDCT)/stem cell transplantation appear to confer particularly severe sleep problems, in the short‐term during transplant and over the longer‐term in survivors …”

Section: Introductionmentioning

confidence: 99%

“…severe sleep problems, in the short-term during transplant and over the longer-term in survivors. [10][11][12] Sleep disturbances are associated with significant long-term morbidities. Short duration and poor quality sleep are associated with suboptimal neurodevelopmental outcomes in healthy children, 13,14 and with development of cardiovascular and metabolic disease and obesity.…”

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confidence: 99%

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A pilot randomized controlled trial to improve sleep and fatigue in children with central nervous system tumors hospitalized for high‐dose chemotherapy

Rogers

Zhu

Ancoli‐Israel

et al. 2019

Pediatric Blood & Cancer

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Objectives To determine whether a sleep intervention compared with standard of care (SOC) was successful in preserving nighttime sleep in children with central nervous system cancers hospitalized for high‐dose chemotherapy (HDCT) and autologous stem cell rescue, and to explore associations between sleep and fatigue during treatment. Methods An unblinded, randomized, controlled, multicomponent intervention (NCT00666614) including evidence‐based cognitive and behavioral strategies to improve sleep was implemented in 33 children (age 4–12 years) and adolescents (age 13–19 years) during hospitalization. Children wore an actigraph to measure sleep and wake, and reported fatigue scores daily. Parents concurrently kept a sleep diary and reported fatigue scores for their children. Results The mean age was 9.5 ± 3.9 years, 81.8% were white, and 60.6% were male. Sleep in all children was seriously disturbed throughout the study. Children in the intervention group maintained their longest nighttime sleep across the study, while it declined in children receiving SOC (P = 0.009 for interaction). There were few other differences in sleep between groups. Controlling for age and baseline fatigue, higher nighttime activity score, and lower percent sleep were significantly associated with higher next‐day adolescent‐reported fatigue (P < 0.05); longest sleep was significantly positively associated with next‐day child‐reported fatigue (P = 0.018). Conclusion In this sample of children undergoing HDCT, a multicomponent sleep intervention modestly preserved nighttime sleep duration, although overall sleep was poor in both groups. Sleep is an integral component of health, and may influence outcomes of children receiving HDCT. Further investigation into methods of preserving sleep in children undergoing intensive cancer therapy is warranted.

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Section: Methodsmentioning

confidence: 99%

“…Outcomes of nighttime sleep and mood have been published. 11 Methods are described here briefly, with a detailed description in…”

Section: Sleep Interventionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

mentioning

confidence: 99%

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A pilot randomized controlled trial to improve sleep and fatigue in children with central nervous system tumors hospitalized for high‐dose chemotherapy

Rogers

Zhu

Ancoli‐Israel

et al. 2019

Pediatric Blood & Cancer

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“…Inpatient hospitalizations disrupt a child's sleep, due in part to the frequency of nocturnal awakenings for care provision, potentially resulting in delirium, which has not been studied in oncology. Even a comprehensive intervention intended to improve sleep in patients with CNS tumors receiving conditioning chemotherapy before hematopoietic stem cell transplantation could not increase total sleep time compared with controls because of the care required throughout the night . Past studies show that sleep disturbances (including difficulty initiating and maintaining sleep, daytime napping, and variable sleep patterns) are common in ALL patients and can substantially impact their QoL .…”

Section: Introductionmentioning

confidence: 99%

A call to action for expanded sleep research in pediatric oncology: A position paper on behalf of the International Psycho‐Oncology Society Pediatrics Special Interest Group

et al. 2019

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Sleep and circadian rhythms are closely related to physical and psychosocial well‐being. However, sleep and circadian rhythm disruptions are often overlooked in children with cancer, as they are frequently considered temporary side effects of therapy that resolve when treatment ends. Yet, evidence from adult oncology suggests a bidirectional relationship wherein cancer and its treatment disrupt sleep and circadian rhythms, which are associated with negative health outcomes such as poor immune functioning and lower survival rates. A growing body of research demonstrates that sleep problems are prevalent among children with cancer and can persist into survivorship. However, medical and psychosocial outcomes of poor sleep and circadian rhythmicity have not been explored in this context. It is essential to increase our understanding because sleep and circadian rhythms are vital components of health and quality of life. In children without cancer, sleep and circadian disturbances respond well to intervention, suggesting that they may also be modifiable in children with cancer. We present this paper as a call to (a) incorporate sleep or circadian rhythm assessment into pediatric cancer clinical trials, (b) address gaps in understanding the bidirectional relationship between sleep or circadian rhythms and health throughout the cancer trajectory, and (c) integrate sleep and circadian science into oncologic treatment.

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Sleep disturbances in hospitalized children: a wake-up call

Burger,

Steur,

Polderman

et al. 2024

Eur J Pediatr

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Although sleep is essential for (recovery of) health, it is adversely affected by hospitalization, due to disease discomfort, environmental noise, and care routines, causing reduced sleep and increased disturbances. This study evaluates factors affecting sleep quality and quantity in hospitalized children and compares inpatient sleep with sleep at home. Using an observational, prospective study design, we assessed sleep in hospitalized children aged 1–12 years, admitted to a tertiary center, and compared this with home 6–8 weeks after discharge. We measured total sleep time (TST), sleep onset latency (SOL), wake after sleep onset (WASO), sleep efficiency, awakenings, and subjective sleep quality, using actigraphy, sleep diaries, and PROMIS questionnaires. We explored an array of sleep-disturbing factors. Regression analyses identified key determinants affecting sleep patterns, while mixed linear models compared sleep in hospital to sleep at home. Out of 621 eligible patients, 467 were invited, and 272 (58%) consented to participate. Key determinants of sleep included pain, number of previous admissions, (underlying) chronic illness, and environment-, staff-, and disease-related factors. Parents reported lower perceived sleep quality in the hospital compared to at home, 97-min (SE 9) lower TST, 100-min (5) longer WASO, more difficulties with falling asleep, lower sleep satisfaction, and more awakenings. Actigraphy outcomes revealed shorter TST (20 min (6)), but better sleep efficiency and fewer awakenings in the hospital. Conclusion: Sleep in hospital was compromised in comparison to sleep at home, primarily due to disturbances related to treatment, environment, and staff. These findings underscore the necessity and potential of relative simple interventions to improve sleep quality and minimize sleep disturbances in hospitalized children.

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Sleep and mood during hospitalization for high‐dose chemotherapy and hematopoietic rescue in pediatric medulloblastoma

Abstract: Patients with medulloblastoma are vulnerable to disturbed sleep during hospitalization, and mood may be an important correlate to consider. Sleep and mood are modifiable factors that may be targeted to maximize daytime functioning.

Cited by 16 publications

References 47 publications

A pilot randomized controlled trial to improve sleep and fatigue in children with central nervous system tumors hospitalized for high‐dose chemotherapy

A pilot randomized controlled trial to improve sleep and fatigue in children with central nervous system tumors hospitalized for high‐dose chemotherapy

A call to action for expanded sleep research in pediatric oncology: A position paper on behalf of the International Psycho‐Oncology Society Pediatrics Special Interest Group

Sleep disturbances in hospitalized children: a wake-up call

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