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Objective assessment of sleep status and its correlates in hospitalized children with cancer: Exploratory study
Ami Setoyama1, Mari Ikeda1, Kiyoko Kamibeppu2
1Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Insights
Hospitalized children with cancer experience worse sleep quality and longer times to fall asleep. Their sleep at home is also disturbed compared to healthy children, highlighting the need for better hospital sleep environments.
Area of Science:
- Pediatric Oncology
- Sleep Medicine
- Psychosocial Oncology
Background:
- Children with cancer frequently experience sleep disturbances.
- Hospitalization and psychosocial factors are suspected contributors to sleep issues in these children.
- Limited research has confirmed the impact of these factors on pediatric cancer patients' sleep.
Purpose of the Study:
- To characterize the sleep status of hospitalized children with cancer.
- To identify factors correlated with sleep disturbances in this population.
Main Methods:
- Actigraphy and sleep diaries were used to measure sleep in 11 children (aged 2-12) with cancer during hospitalization and a short home stay.
- A questionnaire assessed potential correlates of sleep problems.
Main Results:
- Hospitalization was associated with longer sleep onset latency, earlier bedtime, and poorer self-rated sleep quality compared to home stays.
- Participants exhibited shorter total sleep time, longer wake after sleep onset, and reduced sleep efficiency at home versus healthy controls.
- Sleep variables correlated significantly with patient age, symptoms, hospitalization duration, various anxiety and attitude measures, and caregiver anxiety.
Conclusions:
- Hospitalization negatively impacts self-assessed sleep quality and increases sleep onset latency.
- The sleep of children with cancer is disrupted even during home stays compared to healthy peers.
- Sleep disturbances are linked to hospitalization, patient characteristics, disease factors, and psychosocial elements, necessitating targeted interventions and supportive hospital environments.
Background:
Children with cancer are known to have sleep problems. Although hospitalization and psychosocial factors are considered to be the factors affecting children's sleep, few studies have confirmed these effects. The aims of this study were to describe the sleep status of hospitalized children with cancer and to explore the correlates.
Methods:
The sleep status of 11 hospitalized children (aged 2-12 years) with cancer was measured using actigraph and sleep diary during hospitalization and a short home stay. Possible correlates were assessed using a questionnaire.
Results:
The participants had significantly longer sleep onset latency, earlier bedtime, and poorer self-evaluated sleep quality during hospitalization than the short home stay. They had shorter total sleep time, longer wake time after sleep onset, and less sleep efficiency at home, compared with healthy historical controls. Children's age, symptoms, hospitalization period, Cognitive Fatigue, Procedural Anxiety, Treatment Anxiety, Social Anxiety, and Separation Anxiety, as well as caregiver anxiety, Receptive and Focused Attitude, and Regimented Attitude were significantly correlated with sleep variables.
Conclusions:
Hospitalization decreased self-evaluated sleep quality, and difficulty falling asleep. The sleep of the participants at home was disturbed compared with that of healthy children. Hospitalization, patient characteristics, disease-related, and some psychosocial factors were associated with sleep variables. Medical professionals should develop a favorable environment for falling asleep in hospital for individual children. Children with cancer in the early period of hospitalization need increased care to facilitate good sleep.
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