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The impact of dexamethasone and prednisone on sleep in children with acute lymphoblastic leukemia

Lauren C Daniel1, Yimei Li2,3, Jacqueline D Kloss4

  • 1Division of Oncology, The Children's Hospital of Philadelphia, 34th and Civic Center Blvd., CTRB 10-300, Philadelphia, PA, 19104, USA. daniell@email.chop.edu.

Supportive Care in Cancer : Official Journal of the Multinational Association of Supportive Care in Cancer
|April 25, 2016
PubMed

Insights

Dexamethasone significantly disrupts sleep more than prednisone in children with acute lymphoblastic leukemia (ALL), impacting their quality of life. Early screening for sleep issues and interventions can improve well-being.

Area of Science:

  • Pediatric Oncology
  • Pharmacology
  • Sleep Medicine

Background:

  • Corticosteroids are crucial in treating acute lymphoblastic leukemia (ALL).
  • Dexamethasone and prednisone are common corticosteroids with potential sleep and behavioral side effects.
  • Limited research exists on the differential sleep impact of these steroids in pediatric ALL patients.

Purpose of the Study:

  • To investigate the differential effects of dexamethasone versus prednisone on sleep patterns in children with ALL.
  • To understand how these corticosteroid-induced sleep changes influence health-related quality of life (HRQL).

Main Methods:

  • A study involving 81 children (3-12 years) with ALL undergoing maintenance therapy.
  • Parent-reported baseline sleep measures and 28-day sleep diaries during a 5-day corticosteroid course.
  • Assessment of HRQL and fatigue at the end of steroid courses and monthly.

Main Results:

  • Children on dexamethasone reported more baseline sleep disturbances than those on prednisone.
  • Dexamethasone use was associated with poorer sleep quality and more night awakenings compared to prednisone.
  • Sleep disturbances significantly impacted HRQL and fatigue, both during and after corticosteroid treatment.

Conclusions:

  • Sleep disruption is a significant factor affecting HRQL in pediatric ALL patients on corticosteroids.
  • Dexamethasone poses a greater risk for sleep disturbances than prednisone in this population.
  • Proactive screening and interventions for steroid-related sleep issues are recommended to enhance patient HRQL.
Abstract

Keywords:
Acute lymphoblastic leukemiaCorticosteroidQuality of lifeSleep

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