Sleep Disturbances and Fatigue in Survivors of Pediatric Acute Lymphoblastic Leukemia and their Siblings

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Sleep disturbances and fatigue have been identified by patients with cancer as common and distressing. Conflicting evidence about the prevalence of these outcomes, however, exists for survivors of childhood cancers. Additionally, little is known about how the cancer trajectory might impact survivor siblings’ sleep and fatigue. The current study compared sleep and fatigue in survivors of acute lymphoblastic leukemia (ALL) (2-7 years off therapy) and their siblings to healthy control sibling dyads. We hypothesized that survivors would have less total sleep time (TST), greater wake after sleep onset (WASO), poorer sleep efficiency (SE), and higher ratings of fatigue than controls. Participants (survivors, n=45; survivor siblings, n=27; controls, n=45; control siblings, n=41; 58% male) aged 8-18 (m=11.64, SD=2.62) completed the PedsQL Multidimensional Fatigue Scale, a 7-day sleep diary, and 7-consecutive days of actigraphy. Parents (n=90) completed the Children’s Sleep Habits Questionnaire for each of their children. No between-group differences were found on measures of fatigue, 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 significantly related to poorer outcomes via actigraphy on TST, WASO, and SE, as well as sleep-onset latency (SOL) via sleep diaries. This research suggests that poorer sleep in later survivorship from childhood cancer may be related to late-effects, which may account for variability in these findings in the broader literature, and that siblings of survivors of childhood cancer may be at risk for sleep problems.
Childhood cancer, Survivorship, Sleep, Fatigue, Acute Lymphoblastic Leukemia, ALL, Oncology, Pediatric, Psychosocial, Psychology
Russell, K. B. (2019). Sleep Disturbances and Fatigue in Survivors of Pediatric Acute Lymphoblastic Leukemia and their Siblings (Master's thesis, University of Calgary, Calgary, Canada). Retrieved from