1
|
Michaud AL, Bice B, Miklos E, McCormick K, Medeiros-Nancarrow C, Zhou ES, Recklitis CJ. Sleep Treatment Education Program for Young Adult Cancer Survivors (STEP-YA): Protocol for an Efficacy Trial. JMIR Res Protoc 2023; 12:e52315. [PMID: 38019571 PMCID: PMC10719817 DOI: 10.2196/52315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/10/2023] [Accepted: 10/13/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Young adult cancer survivors (YACS) are at elevated risk for chronic insomnia, even years after completing treatment. In addition to potential health consequences, insomnia can interrupt social, educational, and vocational development just as they are trying to "make up" for time lost to cancer. Cognitive behavioral therapy for insomnia (CBTI) is recommended as first-line treatment for insomnia but remains largely unavailable to YACS due to several barriers (ie, shortage of trained providers, geographic limitations, financial limitations). Traditional CBTI has not been adapted to meet YACS' unique developmental and circadian challenges. To improve availability of effective behavioral insomnia treatment for this population, we developed the Sleep Treatment Education Program for Young Adult Cancer Survivors (STEP-YA), a low-intensity educational intervention delivered virtually online. OBJECTIVE In this phase 2 "proof of concept" trial, primary aims are to test the efficacy of STEP-YA to improve insomnia symptoms and mood in YACS and assess the utility of individualized coaching to improve treatment effects. A secondary aim will explore participant variables associated with clinically significant response to STEP-YA. METHODS This 2-arm randomized prospective trial will enroll 74 off-treatment YACS aged 20 years to 39 years with clinically significant insomnia. Each participant completes the STEP-YA intervention in a 1-on-1 synchronous online session led by a trained interventionist following a structured outline. The 90-minute intervention presents educational information on the development of insomnia after cancer and offers specific suggestions for improving insomnia symptoms. During the session, participants review the suggestions and develop a personalized sleep action plan for implementing them. After the session, participants are randomized to either the coaching condition, in which they receive 2 telephone coaching sessions, or the no-coaching condition, which offers no subsequent coaching. The Insomnia Severity Index (ISI) and the Profile of Mood States: Short Form (POMS-SF) are assessed at baseline and 4 and 8 weeks postintervention. RESULTS Enrollment began in November 2022, with 28 participants currently enrolled. We anticipate recruitment will be completed in 2024. The primary endpoint is a change in ISI score from baseline to 8 weeks postintervention. The secondary endpoint is change in mood symptoms (POMS-SF) from baseline to 8 weeks postintervention. Change scores will be treated as continuous variables. Primary analyses will use ANOVA methods. A within-subjects analysis will examine if the STEP-YA intervention is associated with significant changes in insomnia and mood over time. A 2-way ANOVA will be used to evaluate the utility of coaching sessions to improve treatment effects. CONCLUSIONS Chronic insomnia has significant negative effects on YACS' medical, educational, and psychological functioning. STEP-YA aims to address their needs; study results will determine if the intervention warrants future effectiveness and dissemination studies and if individualized coaching is necessary for adequate treatment response. TRIAL REGISTRATION ClinicalTrials.gov NCT05358951: https://clinicaltrials.gov/study/NCT05358951. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/52315.
Collapse
Affiliation(s)
- Alexis L Michaud
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
- Department of Psychology, Suffolk University, Boston, MA, United States
| | - Briana Bice
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
| | - Eva Miklos
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
| | - Katherine McCormick
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
| | | | - Eric S Zhou
- Perini Family Survivors' Center, Dana Farber Cancer Institute, Boston, MA, United States
- Harvard Medical School, Boston, MA, United States
| | | |
Collapse
|
2
|
Garland SN, Tulk J, Cotter R, Zhou ES, Daniel LC, Schulte FSM, Bender JL, Chalifour K, Eaton G. Understanding sleep quality in a national cohort of young adult cancer survivors: Results from the YACPRIME study. Sleep Med 2023; 109:293-299. [PMID: 37499465 DOI: 10.1016/j.sleep.2023.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/10/2023] [Accepted: 07/17/2023] [Indexed: 07/29/2023]
Abstract
PURPOSE A cancer diagnosis in young adulthood can negatively impact sleep quality. The present study describes sleep issues in young adults (YAs) and analyzes potential demographic and clinical characteristics related to sleep quality. METHODS Canadian YAs (n = 359) diagnosed with cancer between ages 15-39 participated in the study. Pittsburgh Sleep Quality Index (PSQI) items were examined to identify specific sleep issues that occurred 3+ times per week. Logistic regression was used to examine demographic, clinical, and symptom-related variables associated with poor sleep quality (defined as a PSQI global score >8) and sleep medication use. RESULTS Participants were predominantly female (87.5%) with an average age of 32 years. Of the sample, 52% had poor sleep quality, 55.5% took >30 min to fall asleep, 32.9% slept <7 h, and 54.6% reported a habitual sleep efficiency of <85%. YAs with poor sleep quality were 5.7 times more likely to report severe distress (p=<.001), as well as 1.8 times more likely to report poorer mental (p = .03) and physical functioning (p = .05). Nearly half (44%) of YAs used sleep medication to help them sleep. YAs who reported severe psychological distress were 2.4 times more likely to use sleeping medication (p = .01), whereas those with a household income ≥$100,000/year were half as likely to use medication to help with sleep (p = .04). CONCLUSION Psychological distress is associated with worse sleep quality and sleep medication use in YA cancer survivors. Sleep quality may be a possible target for future research and intervention to promote long-term function and recovery.
Collapse
Affiliation(s)
- Sheila N Garland
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada; Discipline of Oncology, Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada.
| | - Joshua Tulk
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Riley Cotter
- Department of Psychology, Faculty of Science, Memorial University, St. John's, Newfoundland and Labrador, Canada
| | - Eric S Zhou
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Lauren C Daniel
- Department of Psychology and Health Sciences, Rutgers University, Camden, NJ, USA
| | - Fiona S M Schulte
- Department of Oncology, Division of Psychosocial Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jacqueline L Bender
- Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, 585 University Avenue, Toronto, Ontario, Canada
| | - Karine Chalifour
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
| | - Geoff Eaton
- Young Adult Cancer Canada, St. John's, Newfoundland and Labrador, Canada
| |
Collapse
|
3
|
van Litsenburg R, Kamara D, Irestorm E, Partanen M, de Vries R, McLaughlin Crabtree V, Daniel LC. Sleep problems during and after paediatric brain tumours. THE LANCET. CHILD & ADOLESCENT HEALTH 2023; 7:280-287. [PMID: 36950977 DOI: 10.1016/s2352-4642(22)00380-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 11/18/2022] [Accepted: 12/08/2022] [Indexed: 02/16/2023]
Abstract
Brain tumours are among the most common cancer diagnoses in paediatrics. Children with brain tumours are at risk of developing sleep problems because of direct and indirect effects of the tumour and its treatment, in addition to psychosocial and environmental factors. Sleep has an important role in physical and psychological wellbeing, and sleep problems are associated with many adverse outcomes. In this Review, we describe the state of the evidence regarding sleep in people with paediatric brain tumours, prevalence and types of sleep problems, risk factors, and effectiveness of interventions. Evidence shows that sleep problems, particularly excessive daytime sleepiness, are common in people with paediatric brain tumours, with high BMI emerging as a consistent predictor of sleep disruption. Further intervention studies are needed, and clinical evaluation of sleep is warranted for people with paediatric brain tumours.
Collapse
Affiliation(s)
| | - Dana Kamara
- Department of Psychology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Elin Irestorm
- Department of Paediatrics, Faculty of Medicine, Lund University, Lund, Sweden
| | - Marita Partanen
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit, Amsterdam, Netherlands
| | | | - Lauren C Daniel
- Department of Psychology, Rutgers University Camden, Camden, NJ, USA
| |
Collapse
|
4
|
Chahin S, Morse M, Qaddoumi I, Phipps S, Crabtree VM, Brennan RC, Wilson MW, Rodriguez-Galindo C, Russell KM, Parris K, Goode K, Willard VW. An exploratory study of sleep habits in school-aged survivors of retinoblastoma. Sleep Med 2023; 103:123-130. [PMID: 36780752 PMCID: PMC10006349 DOI: 10.1016/j.sleep.2023.01.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 01/18/2023] [Accepted: 01/29/2023] [Indexed: 02/04/2023]
Abstract
OBJECTIVE/BACKGROUND Retinoblastoma is an ocular cancer diagnosed in early childhood. Previous research has indicated the impact of cancer treatment on sleep, but little is known about how sleep is impacted among survivors of retinoblastoma. The current study aimed to describe sleep habits of school-age survivors of retinoblastoma, to examine associations between sleep and quality of life, and to examine concordance between parent and child reports of sleep habits. PATIENTS/METHODS Sixty-nine survivors of retinoblastoma (Mage = 10.89, SD = 1.07, 50.7% female; 56.5% unilateral disease) and their caregivers participated, providing information on both self- and parent-reported sleep habits, quality of life, and demographic data. RESULTS Greater sleep concerns than national norms were reported by parents (bedtime resistance (t(58) = 2.69, p = .009), greater sleep onset delay (t(66) = 2.46, p = .017), shorter sleep duration (t(57) = 2.12, p = .038), increased daytime sleepiness (t(53) = 6.45, p= <.001)) and children (sleep location (t(61) = 2.39, p = .02), restless legs syndrome (t(62) = -2.21, p = .03), parasomnias (t(64) = 19.19, p=<.001)) . Both children and parents of children who received enucleation endorsed greater sleep concerns across several domains (e.g., electronic use before bed, sleep-disordered breathing). Child- and parent-reported sleep concerns were generally associated with decreased quality of life. Finally, child- and parent-report of sleep habits appeared generally consistent. CONCLUSIONS Survivors of retinoblastoma experience sleep difficulties. As such, assessment and targeted intervention is important to mitigate any effects on quality of life. Future research should examine sleep habits of survivors of retinoblastoma across cultures and developmental periods.
Collapse
Affiliation(s)
- Summer Chahin
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melanie Morse
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Ibrahim Qaddoumi
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Global Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Sean Phipps
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | | | - Rachel C Brennan
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Matthew W Wilson
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA; Department of Ophthalmology, University of Tennessee, Memphis, TN, USA
| | | | - Kathryn M Russell
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kendra Parris
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kristin Goode
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Victoria W Willard
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, TN, USA.
| |
Collapse
|
5
|
Hong HC, Min A, Kim YM. A systematic review and pooled prevalence of symptoms among childhood and adolescent and young adult cancer survivors. J Clin Nurs 2022; 32:1768-1794. [PMID: 35014094 DOI: 10.1111/jocn.16201] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 11/24/2021] [Accepted: 12/20/2021] [Indexed: 01/15/2023]
Abstract
AIMS AND OBJECTIVES To systematically review the existing literature reporting symptoms in childhood and adolescent and young adult cancer survivors and to meta-analyse the pooled prevalence of symptoms. BACKGROUND Cancer survivors experience various symptoms caused by cancer treatments and their late effects. These symptoms are associated with adverse health outcomes. However, estimates of symptom prevalence vary largely, and no comprehensive review of symptoms has been conducted for childhood and adolescent and young adult cancer survivors. DESIGN A systematic review. METHODS This systematic review is registered in PROSPERO registry and was performed following the PRISMA guidelines. PubMed, EMBASE, Cochrane Library, Web of Science, Scopus and CINAHL were searched up to July 2021. Three investigators assessed the eligibility of studies, extracted data and performed quality assessment. The pooled prevalence of symptoms was calculated using a random-effect model. Subgroup analysis was conducted to identify heterogeneity. RESULTS Sixty-one studies were used to synthesise symptom prevalence, involving 114,184 participants. There were 24 physical symptoms and 10 psychological symptoms reported in two or more studies. The most studied physical symptoms were fatigue and sleep disturbance, and the most studied psychological symptoms were anxiety and depression. Among physical symptoms, drowsiness had the highest prevalence, followed by dry mouth and fatigue. Among psychological symptoms, worry and nervousness had the highest prevalence, followed by difficulty concentrating. CONCLUSIONS Physical and psychological symptoms are common in the target population. This review provides an up-to-date overview of symptom prevalence, identifying areas for future research. RELEVANCE TO CLINICAL PRACTICE Education about possible symptoms related to cancer and its treatment should be given while in treatment. Symptoms should also be monitored throughout the survivorship period. Nurses have a critical role in identifying and making referrals for psychological symptoms as well as promoting preventative strategies that enhance well-being.
Collapse
Affiliation(s)
- Hye Chong Hong
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Ari Min
- Department of Nursing, Chung-Ang University, Seoul, Korea
| | - Young Man Kim
- College of Nursing ∙ Research Institute of Nursing Science, Jeonbuk National University, Jeonju-si, Korea
| |
Collapse
|
6
|
Zhang D, Wang J, Gu X, Gu Z, Li L, Dong C, Zhao R, Zhang X. Prevalence, correlates, and impact of sleep disturbance in Chinese meningioma patients. Support Care Cancer 2021; 30:1231-1241. [PMID: 34458943 DOI: 10.1007/s00520-021-06504-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 08/09/2021] [Indexed: 11/30/2022]
Abstract
PURPOSE Sleep disturbance is common in meningioma patients and may lead to disease aggravation and decreases health-related quality of life (HRQoL). However, the sleep quality of meningioma patients newly diagnosed and ready for surgery has not been well clarified in China. This study aims to evaluate the prevalence, correlates, and impact of sleep disturbance among Chinese meningioma patients. METHODS In this cross-sectional study, meningioma patients were recruited from the Affiliated Hospital of Nantong University from January 2020 to November 2020. A series of questionnaires were applied: the 0-10 Numerical Rating Scale (NRS), the Hospital Anxiety and Depression Scale (HADS), the Multidimensional Fatigue Inventory (MFI-20), the Epworth Sleepiness Scale (ESS), the Short-Form 36 (SF-36), the Pittsburgh Sleep Quality Index (PSQI). Independent samples t test, Mann-Whitney U test, chi-square analysis, Pearson/Spearman correlation, and binary logistic regression were used to analyze the data. RESULTS One hundred meningioma patients completed the questionnaires. Sleep disturbance affected 43% of the meningioma patients and was linked to many concomitant symptoms, such as headache, fatigue, anxiety, and depression. Binary logistic regression indicated that fatigue and headache were independently associated with sleep disturbance of meningioma patients. Meanwhile, severe sleep disturbance led to lower quality of life. CONCLUSIONS These findings demonstrated that a considerable number of meningioma patients newly diagnosed and ready for surgery suffered from sleep disturbance, potentially contributing to impair HRQoL. Medical personnel should pay more attention to meningioma patients with sleep disturbance and take effective measures to improve sleep quality, with the ultimate goal to improve their HRQoL.
Collapse
Affiliation(s)
- Dandan Zhang
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong University, 20th Xisi Road, Nantong, 226001, China
- Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Jing Wang
- Department of Medical Image, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Xixi Gu
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Zhifeng Gu
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Liren Li
- Department of Gastroenterology, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Chen Dong
- Department of Nursing, Affiliated Hospital of Nantong University, Nantong University, 20th Xisi Road, Nantong, 226001, China
- Department of Rheumatology, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China
| | - Rui Zhao
- Research Center of Clinical Medicine, Affiliated Hospital of Nantong University, 20th Xisi Road, Nantong, 226001, China.
| | - Xiaomei Zhang
- Department of Neurosurgery, Affiliated Hospital of Nantong University, Nantong University, 20th Xisi Road, Nantong, 226001, China.
| |
Collapse
|
7
|
Oswald KA, Richard A, Hodges E, Heinrich KP. Sleep and neurobehavioral functioning in survivors of pediatric cancer. Sleep Med 2020; 78:153-159. [PMID: 33444972 DOI: 10.1016/j.sleep.2020.12.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 12/21/2020] [Accepted: 12/22/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVES Sleep problems are a common late effect in survivors of pediatric cancer. Growing literature suggests deficits in sleep functioning may be related to more impairing neurobehavioral outcomes. The purpose of the present study was to evaluate the prevalence of parent reported sleep concerns in survivors of pediatric cancer, as well as evaluate the relationship between sleep and neurobehavioral functioning utilizing both parent and teacher input. METHODS The study included parent-teacher dyads of 75 survivors of pediatric cancer between the ages of six and 17 who completed a clinical neuropsychological evaluation with embedded measures of neurobehavioral functioning and sleep, including excessive daytime sleepiness and snoring. Bivariate correlations and multiple linear regressions were conducted to evaluate the relationship between sleep and neurobehavioral functioning. RESULTS No significant difference in parent reported sleep concerns was found with regard to demographic, diagnostic, or treatment variables. Daytime sleepiness was significantly elevated for 28% of the sample; snoring was not identified as a significant concern. Daytime sleepiness was significantly associated with worse neurobehavioral outcomes as reported by parents and teachers, including inattention, hyperactivity/impulsivity, peer difficulties, anxiety, depression, somatic complaints, and aggressive behaviors. Daytime sleepiness was not significantly related to report of learning problems. CONCLUSIONS Results further support that daytime sleepiness, as reported by parents, impacts approximately one third of survivors of pediatric cancer and is associated with worse neurobehavioral outcomes across home and school environments. As a result, it is vital that sleep functioning is a target of assessment in annual survivorship care. Future longitudinal studies are needed to further delineate the directionality of the sleep-neurobehavioral relationship in survivors.
Collapse
Affiliation(s)
| | | | - Elise Hodges
- University of Michigan, Department of Psychiatry, USA
| | | |
Collapse
|
8
|
Botchway EN, Godfrey C, Ryan NP, Hearps S, Nicholas CL, Anderson VA, Catroppa C. Sleep Disturbances in Young Adults with Childhood Traumatic Brain Injury: Relationship with Fatigue, Depression, and Quality of Life. Brain Inj 2020; 34:1579-1589. [PMID: 33054410 DOI: 10.1080/02699052.2020.1832704] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE This study assessed the consequences of childhood traumatic brain injury (TBI) on sleep, fatigue, depression, and quality of life (QoL) outcomes and explored the relationships between these variables at 20 years following childhood TBI. PARTICIPANTS We followed up 54 young adults with mild, moderate, and severe TBI, and 13 typically developing control (TDC) participants, recruited at the time of TBI. METHODS Sleep was assessed with the Pittsburgh Sleep Quality Index and actigraphy. RESULTS At 20 years postinjury, results showed no significant difference between whole TBI group and TDC participants on subjective sleep quality; however, the moderate TBI group reported significantly poorer subjective sleep quality compared to those with severe TBI. Poorer subjective sleep was associated with increased symptoms of fatigue, depression, and poorer perceptions of General Health in the TBI group. Actigraphic sleep efficiency, fatigue, depression, and QoL outcomes were not significantly different between TBI and TDC or among TBI severity groups. CONCLUSIONS These preliminary findings underscore associations between subjective sleep disturbance, fatigue, depression, and QoL in this TBI sample, and mostly comparable outcomes in sleep, fatigue, depression, and QoL between the TBI and TDC groups. Further research is required to clarify these findings.
Collapse
Affiliation(s)
- Edith N Botchway
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia
| | - Celia Godfrey
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia
| | - Nicholas P Ryan
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia.,Cognitive Neuroscience Unit, Deakin University , Geelong, Victoria, Australia
| | - Stephen Hearps
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia
| | - Christian L Nicholas
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Melbourne School of Psychological Sciences, University of Melbourne , Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health , Heidelberg, Victoria, Australia
| | - Vicki A Anderson
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne , Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne , Melbourne, Australia
| | - Cathy Catroppa
- Clinical Science, Murdoch Children's Research Institute , Parkville, Victoria, Australsia.,Department of Psychology, Royal Children's Hospital , Parkville, Victoria, Australia.,Melbourne School of Psychological Sciences, University of Melbourne , Melbourne, Australia
| |
Collapse
|
9
|
Zhou ES, Recklitis CJ. Internet-delivered insomnia intervention improves sleep and quality of life for adolescent and young adult cancer survivors. Pediatr Blood Cancer 2020; 67:e28506. [PMID: 32568460 DOI: 10.1002/pbc.28506] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 05/13/2020] [Accepted: 05/31/2020] [Indexed: 12/20/2022]
Abstract
BACKGROUND Insomnia is common among adolescent and young adult (AYA) cancer survivors. Cognitive-behavioral therapy for insomnia (CBT-I) is considered the gold standard treatment. Standard CBT-I was designed for adults and not adapted to the unique medical, psychosocial, and developmental needs of AYA cancer survivors, which can exacerbate their insomnia. Further, the vast majority of cancer centers do not have a behavioral sleep medicine expert on staff. Our study objective was to examine the efficacy of an Internet-delivered CBT-I program that was tailored for AYA cancer survivors (NCT03279055). PROCEDURE Twenty-two AYA cancer survivors (mean age 20.4; range 14-25) with insomnia enrolled in an automated CBT-I program modified for AYA cancer survivors following stakeholder feedback. Participants were blood cancer (54.5%) and solid tumor (45.5%) survivors, an average of 9.7 years postdiagnosis. Sleep health, fatigue, and quality of life were assessed at baseline and at two follow up timepoints (8 and 16 weeks postbaseline). RESULTS Significant improvements in insomnia severity, daytime sleepiness, fatigue, and quality of life were reported at both follow up timepoints. However, most participants (72.7%) did not complete all of the six study sessions, with a mean completion rate of 3.2 sessions. Participants who completed at least two sessions reported better sleep (insomnia severity index total score) than those who did not. CONCLUSIONS An Internet-delivered insomnia intervention adapted for AYA cancer survivors was efficacious. This has important implications for access to evidence-based clinical care for this growing population. Future efforts should study stepped care models of care and ways to improve treatment adherence.
Collapse
Affiliation(s)
- Eric S Zhou
- Department of Psychosocial Oncology and Palliative Care, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts, USA.,Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | | |
Collapse
|
10
|
Russell KB, Merz EL, Reynolds K, Schulte F, Tomfohr-Madsen L. Sleep Disturbances in Survivors of Pediatric Acute Lymphoblastic Leukemia and Their Siblings. J Pediatr Psychol 2020; 45:707-716. [PMID: 32548611 DOI: 10.1093/jpepsy/jsaa043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 05/05/2020] [Accepted: 05/21/2020] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Sleep disturbances have been identified by patients with cancer as common and distressing; however, conflicting evidence about the prevalence of these outcomes exists for survivors of childhood cancers. Additionally, little is known about how the experience of cancer might impact survivor siblings' sleep. The current study compared the sleep of survivors of acute lymphoblastic leukemia who were 2-7 years off therapy and their siblings to healthy control/sibling dyads. METHODS Participants (survivors, n = 45; survivor siblings, n = 27; controls, n = 45; control siblings, n = 41; 58% male) aged 8-18 (m = 11.64) completed a 7-day sleep diary and seven consecutive days of actigraphy. Parents (n = 90) completed the Children's Sleep Habits Questionnaire for each of their children. RESULTS No between-group differences were found on measures of sleep diaries or actigraphy. Parents reported that survivor siblings had significantly poorer sleep habits than survivors or controls. For survivors, greater time off treatment and younger age at diagnosis were associated with less total sleep time, more wake after sleep onset, and decreased sleep efficiency via actigraphy. CONCLUSION Sleep across all groups was consistent and below national guidelines. Although the survivor group did not have poorer sleep compared to their siblings or matched controls, within the survivor group, those who were diagnosed at an earlier age and those who were further off treatment had more disrupted sleep. Parent reports suggested that survivor siblings may be at risk for sleep problems.
Collapse
Affiliation(s)
| | - Erin L Merz
- Department of Psychology, California State University, Dominguez Hills
| | - Kathleen Reynolds
- Long Term Survivor's Clinic, Alberta Children's Hospital.,Department of Family Medicine, University of Calgary
| | - Fiona Schulte
- Hematology, Oncology, Transplant Program, Alberta Children's Hospital.,Division of Psychosocial Oncology, Department of Oncology, Cumming School of Medicine, University of Calgary
| | | |
Collapse
|
11
|
Kim H, Zhou ES, Chevalier L, Lun P, Davidson RD, Pariseau EM, Long KA. Parental Behaviors, Emotions at Bedtime, and Sleep Disturbances in Children with Cancer. J Pediatr Psychol 2020; 45:550-560. [DOI: 10.1093/jpepsy/jsaa018] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 03/03/2020] [Accepted: 03/12/2020] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Poor sleep is common for children during cancer treatment, but there is limited understanding of the nature of children’s sleep throughout the treatment trajectory. The current exploratory study used an explanatory sequential mixed method approach to examine quantitative associations among sleep problems in children with cancer, parental behavior, and children’s sleep hygiene, with follow-up qualitative characterizations of children’s sleep across cancer treatment stages.
Procedure
Eighty parents of children with cancer (aged 2–10 years; in active treatment, maintenance treatment, or off treatment) completed an online survey querying the child’s sleep quality (Sleep Disturbance Scale for Children—Disorders of Initiating and Maintaining Sleep subscale) and behaviors (Child Sleep Hygiene Scale) and sleep-related parenting behaviors (Parental Sleep Strategies). A subsample (n = 17 parents) participated in qualitative interviews to better characterize the processes of children’s sleep and parents’ sleep-related behaviors.
Results
Children’s sleep quality, sleep hygiene, or parental sleep strategies were not significantly different by cancer treatment groups. Greater sleep disturbance in children was associated with their parents’ tendency to accommodate the child’s bedtime requests. Qualitatively, cancer treatment-related anxiety in both children and parents influence the onset of these disruptive sleep behaviors.
Conclusion
Parents’ sleep-related behaviors affect children’s sleep during cancer treatment. Parents’ accommodation may start during active treatment to alleviate cancer-related challenges, and these behaviors may continue into maintenance therapy and off treatment to reinforce sleep disturbance. Behavioral interventions targeting unhelpful parental behaviors may improve sleep in children with cancer during and after cancer treatment.
Collapse
Affiliation(s)
- Hyun Kim
- Department of Psychological and Brain Sciences, Boston University
| | - Eric S Zhou
- Perini Family Survivors’ Center, Department of Pediatric Oncology, Dana-Farber Cancer Institute
- Division of Sleep Medicine, Harvard Medical School
| | - Lydia Chevalier
- Department of Psychological and Brain Sciences, Boston University
| | - Phyllis Lun
- School of Public Health, LKS Faculty of Medicine, The University of Hong Kong
| | - Ryan D Davidson
- Department of Gastroenterology and Nutrition, Boston Children’s Hospital
| | - Emily M Pariseau
- Department of Psychological and Brain Sciences, Boston University
| | - Kristin A Long
- Department of Psychological and Brain Sciences, Boston University
| |
Collapse
|
12
|
Recklitis CJ, Liptak C, Footer D, Fine E, Chordas C, Manley P. Prevalence and Correlates of Pain in Adolescent and Young Adult Survivors of Pediatric Brain Tumors. J Adolesc Young Adult Oncol 2019; 8:641-648. [DOI: 10.1089/jayao.2019.0029] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Christopher J. Recklitis
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Cori Liptak
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Dana Footer
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Elizabeth Fine
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Christine Chordas
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Peter Manley
- Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
- Department of Pediatric Neuro-oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| |
Collapse
|
13
|
van Kooten JAMC, Maurice-Stam H, Schouten AYN, van Vuurden DG, Granzen B, Gidding C, de Ruiter MA, van Litsenburg RRL, Grootenhuis MA. High occurrence of sleep problems in survivors of a childhood brain tumor with neurocognitive complaints: The association with psychosocial and behavioral executive functioning. Pediatr Blood Cancer 2019; 66:e27947. [PMID: 31418996 DOI: 10.1002/pbc.27947] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 07/09/2019] [Accepted: 07/10/2019] [Indexed: 02/01/2023]
Abstract
BACKGROUND Survivors of childhood brain tumors are prone to sleep and neurocognitive problems. Effective interventions to improve neurocognitive functioning are largely lacking. In general, sleep problems are negatively related to neurocognitive functioning, but this relationship is unclear in survivors of childhood brain tumors. Therefore, the occurrence of sleep problems, potential risk factors, and the relation between sleep and executive functioning were evaluated. PROCEDURE Baseline data of a randomized controlled trial on the effectiveness of neurofeedback were used. Childhood brain tumor survivors 8-18 years of age with parent-reported neurocognitive complaints ≥2 years after treatment were eligible. Parents completed the Sleep Disturbance Scale for Children. Executive functioning was assessed by parents and teachers (Behavior Rating Inventory of Executive Functioning). Multiple linear regression analyses were used to examine sociodemographic and medical characteristics and emotional difficulties and hyperactivity/inattention (Strength and Difficulties Questionnaire) as potential risk factors for sleep problems, and to assess the association between sleep and executive functioning. RESULTS Forty-eight percent of survivors (n = 82, 7.0 ± 3.6 years post diagnosis, age 13.8 ± 3.2 years) had sleep problems and scored significantly worse than the norm on the subscales Initiating and Maintaining Sleep, Excessive Somnolence, and the total scale (effect sizes 0.58-0.92). Emotional problems and/or hyperactivity/inattention were independent potential risk factors. Sleep problems were associated with worse parent-reported executive functioning. CONCLUSIONS Sleep problems occur among half of childhood brain tumor survivors with neurocognitive problems, and are associated with worse executive functioning. Future studies should focus on the development of sleep interventions for this population, to improve sleep as well as executive functioning.
Collapse
Affiliation(s)
- Jojanneke A M C van Kooten
- Department of Pediatric Oncology-Hematology, Amsterdam UMC, VU University, Amsterdam, The Netherlands.,Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Heleen Maurice-Stam
- Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Antoinette Y N Schouten
- Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Department of Pediatric Oncology, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Dannis G van Vuurden
- Department of Pediatric Oncology-Hematology, Amsterdam UMC, VU University, Amsterdam, The Netherlands.,Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Bernd Granzen
- Department of Pediatrics, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Corrie Gidding
- Department of Pediatric Oncology/Hematology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Marieke A de Ruiter
- Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| | - Raphaële R L van Litsenburg
- Department of Pediatric Oncology-Hematology, Amsterdam UMC, VU University, Amsterdam, The Netherlands.,Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Martha A Grootenhuis
- Princess Màxima Center for Pediatric Oncology, Utrecht, The Netherlands.,Psychosocial Department, Amsterdam UMC, Emma Children's Hospital, University of Amsterdam, Amsterdam, The Netherlands
| |
Collapse
|
14
|
Chang MC, Chun MH. The Effect of Hypnotics on Sleep Quality and Cognitive Function in Patients with Brain Tumors. J Korean Neurosurg Soc 2019; 63:261-267. [PMID: 31533416 PMCID: PMC7054112 DOI: 10.3340/jkns.2019.0057] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Accepted: 05/19/2019] [Indexed: 02/05/2023] Open
Abstract
Objective We investigated the effect of hypnotics on sleep quality, cognitive function, and depressive mood in patients with insomnia following brain tumor resection.
Methods From patients who underwent brain tumor resection, we recruited 10 patients with insomnia who received hypnotics for more than 1 week during a 3-week follow-up period (insomnia group). We also recruited 12 control patients with brain tumors but without insomnia (control group). We evaluated sleep quality at baseline and 3 weeks later using the Insomnia Severity Index (ISI), the Pittsburgh Sleep Quality Index (PSQI), the Stanford Sleepiness Scale (SSS), and the Epworth Sleepiness Scale (ESS) and investigated cognitive function and depression using the Computerized Neuropsychological Test and the Beck Depression Inventory (BDI).
Results At baseline, SSS, ISI, PSQI, and BDI scores were significantly higher and visual continuous performance test (VCPT) and auditory continuous performance test (ACPT) scores were significantly lower in the insomnia than in the control group. Three weeks later, the patients who had received hypnotics had significantly higher ISI, PSQI, ESS, VCPT, ACPT, visual span forward and backward, and visual recognition test scores, and significantly lower BDI scores.
Conclusion Quality of sleep in patients with insomnia following brain tumor resection was initially poor but improved significantly after taking hypnotic medication. Further, the hypnotic medications appeared to contribute to the amelioration of cognitive impairments and depressive moods in patients who previously underwent brain tumor resection. We thus recommend the use of hypnotics for patients with brain tumors with insomnia.
Collapse
Affiliation(s)
- Min Cheol Chang
- Department of Rehabilitation Medicine, College of Medicine, Yeungnam University, Daegu, Korea
| | - Min Ho Chun
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| |
Collapse
|
15
|
Ju M, Tao Y, Lu Y, Ding L, Weng X, Wang S, Fu Q, Li X. Evaluation of sleep quality in adolescent patients with osteosarcoma using Pittsburgh Sleep Quality Index. Eur J Cancer Care (Engl) 2019; 28:e13065. [PMID: 31012535 DOI: 10.1111/ecc.13065] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 10/17/2018] [Accepted: 03/25/2019] [Indexed: 11/29/2022]
Abstract
The sleep quality of patients with osteosarcoma (OS) was poorly understood. We aimed to evaluate the prevalence of sleep dysfunction in adolescent patients with OS using the Pittsburgh Sleep Quality Index (PSQI) and to further investigate the psychometric properties of the PSQI in this cohort of patients. Fifty four adolescent patients with OS who underwent chemotherapy treatment in our clinic centre were included. Sleep quality was assessed with the Chinese PSQI. Cronbach's alpha was calculated to evaluate the internal consistency. The confirmatory factor analysis (CFA) was used to determine the fitness of a two-factor structure. Sleep disturbance was observed in 57.4% (31/54) of the patients. Patients with the presence of metastasis or more than 2 cycles of chemotherapy were found to have remarkably higher median global score. The overall Cronbach's alpha was 0.87. The CFA showed an overall comparative fit index of 0.97, a root mean square error of approximation of 0.06 and a standardised root mean square residual of 0.07 respectively. PSQI was a reliable instrument to evaluate the sleep quality of adolescent patients with OS. Over half of the patients may experience sleep disturbance during the treatment. Early psychological interventions were recommended to improve the sleep quality of the patients.
Collapse
Affiliation(s)
- Mingqing Ju
- Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yuhuan Tao
- Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Yuanyuan Lu
- Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Li Ding
- Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xiaobei Weng
- Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Shoufeng Wang
- Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Qiaomei Fu
- Department of Nursing, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| | - Xinhua Li
- Department of Orthopedic Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
| |
Collapse
|
16
|
Botchway EN, Godfrey C, Nicholas CL, Hearps S, Anderson V, Catroppa C. Objective sleep outcomes 20 years after traumatic brain injury in childhood. Disabil Rehabil 2019; 42:2393-2401. [PMID: 30945574 DOI: 10.1080/09638288.2019.1578422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Purpose: To assess objective sleep outcomes and correlates in young adults with a history of childhood traumatic brain injury.Materials and methods: Participants included 45 young adults who sustained brain injury in childhood (mild = 12, moderate = 22, and severe = 11) and 13 typically developing control participants. Sleep was assessed with actigraphy and sleep diaries recorded over 14 consecutive days. Rates of good sleep (sleep efficiency ≥ 85%) and poor sleep (sleep efficiency < 85%) were also evaluated.Results: At 20-years postinjury, participants with traumatic brain injury and controls presented with similar outcomes across the objective sleep parameters (all p > 0.050) and rates of poor sleepers were also similar between these groups (p = 0.735): 67% and 77%, respectively. However, moderate and severe traumatic brain injury and female sex were associated with longer sleep duration.Conclusions: These findings provide preliminary insights into objective sleep outcome and associated factors in the very-long-term after childhood brain injuries. They also indicate the need to monitor sleep outcomes in young adults with and without traumatic brain injury.Implication for rehabilitationSustaining traumatic brain injury in childhood can impact on several functional domains including sleep.Sleep disturbances, particularly insomnia-related symptoms, are common in this population, with evidence of poor outcomes reported until adolescence postinjury, while outcomes beyond adolescence remain unexplored.In this first investigation of objective sleep outcomes in young adults with a history of childhood traumatic brain injury, we showed that insomnia-related symptoms are highly prevalent in both young adults with traumatic brain injury (67%) and healthy controls (77%).These findings suggest the need to routinely evaluate and treat sleep problem in young adults in general, irrespective of history of childhood traumatic brain injury.
Collapse
Affiliation(s)
- Edith N Botchway
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Celia Godfrey
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Christian L Nicholas
- Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia.,Institute for Breathing and Sleep, Austin Health, Heidelberg, Australia
| | - Stephen Hearps
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia
| | - Vicki Anderson
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Cathy Catroppa
- Murdoch Children's Research Institute, Melbourne, Australia.,Royal Children's Hospital, Melbourne, Australia.,Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| |
Collapse
|
17
|
Daniel LC, Wang M, Mulrooney DA, Srivastava DK, Schwartz LA, Edelstein K, Brinkman TM, Zhou ES, Howell RM, Gibson TM, Leisenring W, Oeffinger KC, Neglia J, Robison LL, Armstrong GT, Krull KR. Sleep, emotional distress, and physical health in survivors of childhood cancer: A report from the Childhood Cancer Survivor Study. Psychooncology 2019; 28:903-912. [PMID: 30817058 DOI: 10.1002/pon.5040] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Revised: 02/22/2019] [Accepted: 02/25/2019] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Sleep disorders are associated with psychological and physical health, although reports in long-term survivors of childhood cancer are limited. We characterized the prevalence and risk factors for behaviors consistent with sleep disorders in survivors and examined longitudinal associations with emotional distress and physical health outcomes. METHODS Survivors (n = 1933; median [IQR] age = 35 [30, 41]) and siblings (n = 380; age = 33 [27, 40]) from the Childhood Cancer Survivor Study completed measures of sleep quality, fatigue, and sleepiness. Emotional distress and physical health outcomes were assessed approximately 5 years before and after the sleep survey. Multivariable logistic or modified Poisson regression models examined associations with cancer diagnosis, treatment exposures, and emotional and physical health outcomes. RESULTS Survivors were more likely to report poor sleep efficiency (30.8% vs 24.7%; prevalence ratio [PR] = 1.26; 95% confidence interval, 1.04-1.53), daytime sleepiness (18.7% vs 14.2%; PR = 1.31 [1.01-1.71]), and sleep supplement use (13.5% vs 8.3%; PR = 1.56 [1.09-2.22]) than siblings. Survivors who developed emotional distress were more likely to report poor sleep efficiency (PR = 1.70 [1.40-2.07]), restricted sleep time (PR = 1.35 [1.12-1.62]), fatigue (PR = 2.11 [1.92-2.32]), daytime sleepiness (PR = 2.19 [1.71-2.82]), snoring (PR = 1.85 [1.08-3.16]), and more sleep medication (PR = 2.86 [2.00-4.09]) and supplement use (PR = 1.89[1.33-2.69]). Survivors reporting symptoms of insomnia (PR = 1.46 [1.02-2.08]), fatigue (PR = 1.31 [1.01-1.72]), and using sleep medications (PR = 2.16 [1.13-4.12]) were more likely to develop migraines/headaches. CONCLUSIONS Survivors report more sleep difficulties and efforts to manage sleep than siblings. These sleep behaviors are related to worsening or persistently elevated emotional distress and may result in increased risk for migraines. Behavioral interventions targeting sleep may be important for improving health outcomes.
Collapse
Affiliation(s)
- Lauren C Daniel
- Department of Psychology, Rutgers University-Camden, Camden, New Jersey
| | - Mingjuan Wang
- Department of Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Daniel A Mulrooney
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Deo Kumar Srivastava
- Department of Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Lisa A Schwartz
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.,Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kim Edelstein
- Pencer Brain Tumor Centre, Princess Margaret Hospital, Toronto, Ontario, Canada
| | - Tara M Brinkman
- Department of Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Eric S Zhou
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, Massachusetts.,Department of Pediatrics, Harvard Medical School, Boston, Massachusetts
| | - Rebecca M Howell
- Department of Radiation Physics, University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Todd M Gibson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Wendy Leisenring
- Cancer Prevention, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Kevin C Oeffinger
- Division of Medical Oncology, Departments of Medicine and Community and Family Medicine, Duke University Medical Center, Durham, North Carolina
| | - Joseph Neglia
- Department of Pediatrics, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Psychology and Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
18
|
Zhou ES, Clark K, Recklitis CJ, Obenchain R, Loscalzo M. Sleepless from the Get Go: Sleep Problems Prior to Initiating Cancer Treatment. Int J Behav Med 2018; 25:502-516. [PMID: 29546585 DOI: 10.1007/s12529-018-9715-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
PURPOSE Cancer patients are likely to experience sleep problems. Understanding their perception of sleep problems is important as subjective symptom experience is associated with treatment-seeking behavior. We explored the prevalence of sleep problems and its correlates in a large sample of cancer patients at an important but understudied stage of their cancer journey: prior to initiating treatment. METHODS Cancer patients (5702) (67.5% female; 76.9% White; 23.0% Hispanic), following diagnosis and prior to initiating cancer treatment, completed an electronic screening instrument. Patients across eight different cancer diagnoses (breast, gastrointestinal, gynecological, head and neck, hematological, lung, prostate, urinary) rated their sleep problems on a five-point scale, with those reporting "severe" or "very severe" sleep problems classified as having high sleep problems. RESULTS Overall, 12.5% of patients reported high sleep problems. Across diagnoses, the proportion of patients reporting high sleep problems ranged from 4.3 to 13.8%, with prostate cancer patients least likely and gastrointestinal cancer patients most likely to report high sleep problems. Older age, having a partner, higher education, and higher household income were associated with a lower likelihood of experiencing sleep problems. Being female, Black, Hispanic, and reporting anxiety or depression was associated with an increased likelihood of sleep problems. CONCLUSIONS A sizeable proportion of cancer patients experience significant problems with their sleep before any treatment has occurred. This clinical issue cannot be ignored as treatment is likely to worsen existing sleep problems. Oncology providers should routinely screen for sleep-related problems. Identifying and treating patients for sleep problems during a vulnerable period early in their cancer trajectory should be an essential component of clinical care.
Collapse
Affiliation(s)
- Eric S Zhou
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, MA, USA.
- Pediatrics, Harvard Medical School, Boston, MA, USA.
| | - Karen Clark
- Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA
| | - Christopher J Recklitis
- Perini Family Survivors' Center, Dana-Farber Cancer Institute, Boston, MA, USA
- Pediatrics, Harvard Medical School, Boston, MA, USA
| | - Richard Obenchain
- Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA
| | - Matthew Loscalzo
- Supportive Care Medicine, City of Hope National Medical Center, Duarte, CA, USA
| |
Collapse
|
19
|
Mandrell BN, Moore C, Crabtree VM. Assessing Common Sleep Disturbances in Survivors of Childhood Cancer. J Nurse Pract 2018. [DOI: 10.1016/j.nurpra.2017.11.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
20
|
Zhou ES, Suh S, Youn S, Chung S. Adapting Cognitive-Behavior Therapy for Insomnia in Cancer Patients. SLEEP MEDICINE RESEARCH 2017. [DOI: 10.17241/smr.2017.00080] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
21
|
Measurements and status of sleep quality in patients with cancers. Support Care Cancer 2017; 26:405-414. [DOI: 10.1007/s00520-017-3927-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2017] [Accepted: 10/09/2017] [Indexed: 01/04/2023]
|
22
|
Zhou ES, Vrooman LM, Manley PE, Crabtree VM, Recklitis CJ. Adapted Delivery of Cognitive-Behavioral Treatment for Insomnia in Adolescent and Young Adult Cancer Survivors: A Pilot Study. Behav Sleep Med 2017; 15:288-301. [PMID: 27077226 DOI: 10.1080/15402002.2015.1126597] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Adolescent and young adult cancer survivors (AYACS) are at risk for the development of insomnia, though it remains vastly undertreated. Limited research has evaluated cognitive-behavioral treatment for insomnia (CBT-I) in AYACS. The present study piloted adapted CBT-I designed to improve treatment accessibility by delivering a three-session intervention in person and via videoconference. AYACS with insomnia (N = 12) enrolled in the study. Ten AYACS completed the intervention, with six in person and four via videoconference. Sleep variables improved immediately postintervention and were sustained at two-month follow-up. Within sample effect sizes of the adapted intervention for sleep, variables were large, and there were no noted differences on sleep outcomes between the in-person and videoconference participants. These pilot findings indicate that an adapted CBT-I intervention is feasible and promising in AYACS populations.
Collapse
Affiliation(s)
- Eric S Zhou
- a David B. Perini Jr. Quality of Life Clinic , Dana-Farber Cancer Institute , Boston , Massachusetts.,b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts
| | - Lynda M Vrooman
- a David B. Perini Jr. Quality of Life Clinic , Dana-Farber Cancer Institute , Boston , Massachusetts.,b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts.,c Department of Pediatrics, Boston Children's Hospital , Boston , Massachusetts
| | - Peter E Manley
- b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts.,c Department of Pediatrics, Boston Children's Hospital , Boston , Massachusetts.,d Pediatric Neuro-Oncology Clinic, Dana-Farber Cancer Institute , Boston , Massachusetts
| | - Valerie M Crabtree
- e Department of Psychology, St. Jude Children's Research Hospital , Memphis , Tennessee
| | - Christopher J Recklitis
- a David B. Perini Jr. Quality of Life Clinic , Dana-Farber Cancer Institute , Boston , Massachusetts.,b Department of Pediatrics, Harvard Medical School , Boston , Massachusetts
| |
Collapse
|
23
|
Daniel LC, Aggarwal R, Schwartz LA. Sleep in Adolescents and Young Adults in the Year After Cancer Treatment. J Adolesc Young Adult Oncol 2017. [PMID: 28628351 DOI: 10.1089/jayao.2017.0006] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
PURPOSE Adolescents and young adults (AYA) with cancer are a vulnerable group facing more intense treatments, higher symptom burden, and poorer treatment outcomes relative to younger children. Sleep disruption is common during cancer treatment and sleep problems persist into adulthood for some survivors of AYA cancer. The developmental period of adolescence/emerging adulthood confers greater biological and behavioral risk for insufficient sleep relative to older or younger ages. Thus, understanding AYA sleep disturbances shortly after completing treatment can inform interventions to manage cancer-related symptoms and improve quality of life. METHODS Sixty-one AYA (ages 12-25) within 1 year of finishing cancer treatment completed the Pittsburgh Sleep Quality Index (PSQI) and the Minneapolis-Manchester Quality of Life Instrument-Adolescent Form. Treatment variables were extracted from electronic medical records. RESULTS Forty-seven percent of participants were classified as "poor sleepers," 41% reported prolonged sleep onset latency (>30 minutes), 31% reported sleep efficiency suggestive of insomnia, and 33% slept <8 hours nightly. Age moderated the relationship between time off treatment and PSQI total score: for younger AYA the relationship was positive and for older AYA the relationship was negative. Better sleep and higher quality of life were strongly related (r = -0.57, p < 0.001). CONCLUSIONS For almost half of AYA cancer survivors studied, sleep is disrupted as indicated by long sleep-onset latencies, sleep efficiency suggestive of insomnia, and inadequate total sleep time. Screening for sleep disturbances after AYA complete cancer therapy may reduce the impact of sleep on quality of life and identify those at risk for insomnia.
Collapse
Affiliation(s)
- Lauren C Daniel
- 1 Department of Psychology, Rutgers University-Camden , Camden, New Jersey.,2 Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania
| | - Richa Aggarwal
- 2 Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.,3 Department of Psychology, Temple University , Philadelphia, Pennsylvania
| | - Lisa A Schwartz
- 2 Division of Oncology, The Children's Hospital of Philadelphia , Philadelphia, Pennsylvania.,4 Department of Pediatrics, Perelman School of Medicine of the University of Pennsylvania , Philadelphia, Pennsylvania
| |
Collapse
|
24
|
Zhou ES, Partridge AH, Syrjala KL, Michaud AL, Recklitis CJ. Evaluation and treatment of insomnia in adult cancer survivorship programs. J Cancer Surviv 2017; 11:74-79. [PMID: 27495283 PMCID: PMC5865603 DOI: 10.1007/s11764-016-0564-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/26/2016] [Indexed: 11/26/2022]
Abstract
PURPOSE Insomnia is commonly experienced by cancer survivors. Chronic insomnia is associated with significant physical and psychosocial consequences if not properly treated. Both the National Cancer Institute (NCI) and the National Comprehensive Cancer Network (NCCN) recommend the evaluation of sleep disturbances and evidence-based treatment of insomnia during routine survivorship care. To better understand current clinical practices, we conducted a survey of major cancer centers across the United States (US). METHODS Adult survivorship programs at the 25 US cancer centers that are both NCI-designated comprehensive cancer centers and NCCN member institutions were surveyed about the evaluation and treatment of insomnia in their hospital. RESULTS All institutions responded to the survey. Thirteen centers (56 %) reported screening <25 % of survivors for sleep disorders, and few clinicians providing survivorship care were well-prepared to conduct a proper sleep evaluation. Insomnia was most commonly treated with sleep hygiene, or pharmacotherapy, rather than cognitive-behavioral therapy. No program reported that >50 % of their survivors were receiving optimal insomnia-related care. A variety of methods to improve insomnia care were endorsed by respondents. CONCLUSIONS There is a clear need to improve the evaluation and treatment of insomnia for cancer survivors at institutions across the country. Cancer centers deemed a number of modalities relevant for improving provider confidence in addressing sleep challenges. IMPLICATIONS FOR CANCER SURVIVORS To improve the quality of insomnia care for survivors, systematic interventions to increase standardized screening for sleep disorders, providing additional sleep medicine training for survivorship clinicians, and optimizing the role of sleep medicine specialists in the oncology setting should be considered.
Collapse
Affiliation(s)
- Eric S Zhou
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA.
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA.
| | - Ann H Partridge
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| | - Karen L Syrjala
- Fred Hutchinson Cancer Research Center, 1100 Fairview Avenue N, Seattle, WA, 98109, USA
| | - Alexis L Michaud
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
| | - Christopher J Recklitis
- Dana-Farber Cancer Institute, 450 Brookline Avenue, Boston, MA, 02215, USA
- Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA
| |
Collapse
|
25
|
Hwang JH, Park HS. The Influences of Quality of Sleep and Mood State on Fatigue in Primary Brain Tumor Patients. ASIAN ONCOLOGY NURSING 2017. [DOI: 10.5388/aon.2017.17.2.87] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jae Hyun Hwang
- College of Nursing, Pusan National University, Yangsan, Korea
| | | |
Collapse
|
26
|
Nijs J, Leysen L, Pas R, Adriaenssens N, Meeus M, Hoelen W, Ickmans K, Moloney N. Treatment of pain following cancer: applying neuro-immunology in rehabilitation practice. Disabil Rehabil 2016; 40:714-721. [DOI: 10.1080/09638288.2016.1261418] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Laurence Leysen
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roselien Pas
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Nele Adriaenssens
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Oncology, University Hospital Brussels, Brussels, Belgium
| | - Mira Meeus
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Antwerp University, Antwerp, Belgium
- Department of Rehabilitation Sciences, Ghent University, Ghent, Belgium
| | - Wouter Hoelen
- De Berekuyl, Private practice for physiotherapy in oncology & lymphology, Hierden, the Netherlands
| | - Kelly Ickmans
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Niamh Moloney
- Department of Health Professions, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, Australia
| |
Collapse
|
27
|
Randazzo D, Peters KB. Psychosocial distress and its effects on the health-related quality of life of primary brain tumor patients. CNS Oncol 2016; 5:241-9. [PMID: 27397796 PMCID: PMC6040083 DOI: 10.2217/cns-2016-0010] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 05/05/2016] [Indexed: 11/21/2022] Open
Abstract
All cancer patients experience distress from the diagnosis, the effects of the disease or the treatment. Clinically significant distress decreases overall quality of life and the recognition of distress with prompt intervention is essential. The National Comprehensive Cancer Network distress thermometer (NCCN-DT) is a validated measuring tool that has been utilized in the primary brain tumor population to detect psychologic distress thereby provoking a referral process to the appropriate support system. Brain tumor patients commonly reported emotional and physical distress encompassing: fatigue, fears, memory and concentration and worry. More research is needed to identify the stressors of all primary brain tumor patients and their caretakers and integrate appropriate interventions to improve health-related quality of life in both groups.
Collapse
Affiliation(s)
- Dina Randazzo
- Department of Neurology, Duke University Medical Center, The Preston Robert Tisch Brain Tumor Center, Durham, NC 27710, USA
| | - Katherine B Peters
- Department of Neurology, Duke University Medical Center, The Preston Robert Tisch Brain Tumor Center, Durham, NC 27710, USA
| |
Collapse
|
28
|
|
29
|
Jacola LM, Conklin HM, Scoggins MA, Ashford JM, Merchant TE, Mandrell BN, Ogg RJ, Curtis E, Wise MS, Indelicato DJ, Crabtree VM. Investigating the Role of Hypothalamic Tumor Involvement in Sleep and Cognitive Outcomes Among Children Treated for Craniopharyngioma. J Pediatr Psychol 2016; 41:610-22. [PMID: 27189690 PMCID: PMC4913761 DOI: 10.1093/jpepsy/jsw026] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 01/25/2016] [Accepted: 01/25/2016] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVE Despite excellent survival prognosis, children treated for craniopharyngioma experience significant morbidity. We examined the role of hypothalamic involvement (HI) in excessive daytime sleepiness (EDS) and attention regulation in children enrolled on a Phase II trial of limited surgery and proton therapy. METHODS Participants completed a sleep evaluation (N = 62) and a continuous performance test (CPT) during functional magnetic resonance imaging (fMRI; n = 29) prior to proton therapy. RESULTS EDS was identified in 76% of the patients and was significantly related to increased HI extent (p = .04). There was no relationship between CPT performance during fMRI and HI or EDS. Visual examination of group composite fMRI images revealed greater spatial extent of activation in frontal cortical regions in patients with EDS, consistent with a compensatory activation hypothesis. CONCLUSION Routine screening for sleep problems during therapy is indicated for children with craniopharyngioma, to optimize the timing of interventions and reduce long-term morbidity.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Elizabeth Curtis
- Indiana University School of Medicine, Indiana University-Purdue University
| | | | | | | |
Collapse
|
30
|
Beebe DW. Sleep Problems as Consequence, Contributor, and Comorbidity: Introduction to the Special Issue on Sleep, Published in Coordination With Special Issues in Clinical Practice in Pediatric Psychology and Journal of Developmental and Behavioral Pediatrics. J Pediatr Psychol 2016; 41:583-7. [PMID: 27189693 DOI: 10.1093/jpepsy/jsw037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 04/10/2016] [Indexed: 02/01/2023] Open
Abstract
Despite long-standing public and scientific interest in the phenomenon of sleep, the current decade has shown tremendous growth in our understanding of the sleep of children who have medical or developmental conditions. To accommodate, promote, and guide that growth, Journal of Pediatric Psychology, Clinical Practice in Pediatric Psychology, and Journal of Developmental and Behavioral Pediatrics have published coordinated special issues, encompassing >30 relevant articles. This article introduces the special issue in Journal of Pediatric Psychology, highlighting papers that illustrate how sleep problems are not only commonly comorbid with childhood medical and developmental conditions; they are also likely caused by and contribute to these conditions. In doing so, these coordinated special issues guide clinical care and reveal opportunities for future research.
Collapse
Affiliation(s)
- Dean W Beebe
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine
| |
Collapse
|
31
|
Russo S, Fardell JE, Signorelli C, Wakefield CE, Mcloone JK, Cohn RJ. Sleep Disturbances in Childhood Cancer Survivors. Pediatr Blood Cancer 2016; 63:759-60. [PMID: 26814443 DOI: 10.1002/pbc.25858] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 11/05/2015] [Indexed: 11/11/2022]
Affiliation(s)
- Selena Russo
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW, Kensington, New South Wales, Australia
| | - Joanna E Fardell
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW, Kensington, New South Wales, Australia
| | - Christina Signorelli
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW, Kensington, New South Wales, Australia
| | - Claire E Wakefield
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW, Kensington, New South Wales, Australia
| | - Jordana K Mcloone
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW, Kensington, New South Wales, Australia
| | - Richard J Cohn
- Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, Randwick, New South Wales, Australia.,Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, UNSW, Kensington, New South Wales, Australia
| |
Collapse
|
32
|
Zhou ES, Partridge AH, Recklitis CJ. A pilot trial of brief group cognitive-behavioral treatment for insomnia in an adult cancer survivorship program. Psychooncology 2016; 26:843-848. [PMID: 26872123 DOI: 10.1002/pon.4096] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 12/17/2015] [Accepted: 01/18/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Cognitive-behavioral therapy for insomnia (CBT-Insomnia) is effective, yet rarely available for cancer survivors. This is unfortunate because survivors are at elevated risk for insomnia, which is associated with significant health consequences in this already at-risk population. Barriers to delivering CBT-Insomnia in oncology settings include a lack of trained providers, distance to cancer centers, and treatment duration. PURPOSE To address insomnia treatment barriers, we adapted standard CBT-Insomnia treatment and evaluated a pilot group-based approach for feasibility and efficacy in an adult cancer survivorship program. METHODS Thirty-eight cancer survivors (mean age = 52.2 years) enrolled in our three-session program delivered over 1 month. They were primarily diagnosed with breast cancer (58.6%) and were an average of 6.0 years post-diagnosis and 3.6 years post-treatment. Participants completed sleep logs throughout the study and measures of sleep at baseline and week 4. RESULTS Participants reported experiencing insomnia symptoms an average of 2.4 years, with 89.7% indicating that the cancer experience had caused/exacerbated symptoms. Significant pre/post-intervention group improvements in sleep efficiency (77.3% to 88.5%), sleep quality, and insomnia symptoms were reported (all ps < .01). Less than 1 in 3 had discussed insomnia symptoms with their oncology providers in the prior year. CONCLUSIONS Pilot data indicate that a brief, group-based CBT-Insomnia intervention in a survivorship setting is both feasible and efficacious. There is a need to increase awareness about insomnia and its treatment among both cancer survivors and oncology providers. If validated in future studies, this novel approach can improve cancer survivors' access to much needed insomnia treatment. Copyright © 2016 John Wiley & Sons, Ltd.
Collapse
Affiliation(s)
- Eric S Zhou
- Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Ann H Partridge
- Dana-Farber Cancer Institute, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | | |
Collapse
|