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Sleep complaints in survivors of pediatric brain tumors
Chasity Brimeyer1,2, Leah Adams1,3, Liang Zhu4
1Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, USA.
Insights
Pediatric brain tumor survivors experience excessive daytime sleepiness (EDS), with poor parent-adolescent agreement on sleep issues. Obesity is a key factor in managing EDS for these young individuals.
Area of Science:
- Pediatric Oncology
- Sleep Medicine
- Neuro-oncology
Background:
- Pediatric brain tumor survivors face a higher risk of sleep disturbances, notably excessive daytime sleepiness (EDS).
- Limited research has explored the prevalence and contributing factors of sleep issues in this vulnerable population.
Purpose of the Study:
- To investigate the prevalence of sleep problems, particularly EDS, in pediatric brain tumor survivors.
- To examine the concordance between children/adolescents and their parents in reporting sleep disturbances.
- To identify potential factors associated with EDS in this population.
Main Methods:
- A cross-sectional study involving 153 pediatric brain tumor survivors (ages 8-18), at least 5 years post-diagnosis and 2 years post-treatment.
- Validated questionnaires were administered to participants and their parents, including measures for sleepiness, sleep patterns, and sleep hygiene.
- Statistical analyses examined group differences and associations between EDS and factors like age at diagnosis, BMI, tumor location, and treatment received.
Main Results:
- One-fifth of children and one-third of adolescents reported EDS.
- Parent-child agreement on EDS was fair in children but poor in adolescents.
- Poor sleep hygiene and extended weekend sleep were common; obesity was linked to higher parent-reported EDS in children.
Conclusions:
- A significant proportion of pediatric brain tumor survivors experience EDS, despite reporting adequate sleep duration.
- Discrepancies in self- and parent-reports underscore the need for comprehensive sleep assessments.
- Obesity presents a modifiable target for reducing EDS; further research is needed on the unexpected lack of association with tumor-related factors.
Purpose:
Pediatric brain tumor survivors have increased risk of sleep problems, particularly excessive daytime sleepiness (EDS). Few studies have examined sleep disturbances in this population.
Methods:
153 children and adolescents ages 8-18 and their parents completed questionnaires (Modified Epworth Sleepiness Scale, Kosair Children's Hospital Sleep Questionnaire, Children's Report of Sleep Patterns, Children's Sleep Hygiene Scale) during clinic visits. Participants were at least 5 years from diagnosis and 2 years post-treatment. Group differences in age at diagnosis, body mass index, type of treatment received, and tumor location were examined.
Results:
One-third of adolescents and one-fifth of children reported EDS. Children and parents had fair concordance (kappa coefficient = .64) in their report of EDS, while adolescents and parents had poor concordance (kappa coefficient = .37). Per parents, most children slept 8 to 9 h per night. Poor bedtime routines were reported for children, while adolescents endorsed poor sleep stability. Extended weekend sleep was reported across age groups. A BMI in the obese range was related to higher parent-reported EDS in children. Sleep-disordered breathing was associated with elevated BMI in adolescents.
Conclusions:
While survivors reported achieving recommended amounts of sleep each night, 20 to 30% reported EDS. Poor concordance among parent and adolescent report highlights the importance of obtaining self-report when assessing sleep concerns. Obesity is a modifiable factor in reducing symptoms of EDS in this population. Finally, the lack of association between EDS and brain tumor location, BMI, or treatment received was unexpected and warrants further investigation.
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