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Evaluating Sleep in Pediatric Cancer: A Scoping Review of Assessment Tools for Quality and Care
Elena Rostagno1, Veronica Rivi2, Pierfrancesco Sarti2
1Pediatric Hematology and Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
Insights
Assessing sleep in pediatric cancer patients is challenging. This review evaluates tools like actigraphy and sleep diaries, finding they have limitations, while polysomnography is less feasible for clinical use.
Area of Science:
- Pediatric Oncology
- Sleep Medicine
- Clinical Research Methodology
Background:
- Pediatric cancer patients face significant sleep disturbances impacting neurocognition and quality of life.
- Accurate sleep assessment is crucial but challenging in this vulnerable population.
- Disease, treatment, and hospitalization contribute to complex sleep issues.
Purpose of the Study:
- To evaluate current sleep quality assessment tools for pediatric oncology patients.
- Focus on reliability, feasibility, and clinical/research relevance of these tools.
- Provide guidance for selecting appropriate sleep assessment methods.
Main Methods:
- Scoping review methodology used to identify and synthesize relevant studies.
- Reviewed tools included actigraphy, sleep diaries, validated sleep scales, and polysomnography.
- Analyzed studies for reliability, feasibility, and applicability to pediatric cancer concerns.
Main Results:
- Actigraphy and sleep diaries are common but have consistency and interpretability limitations.
- Sleep scales show variable psychometric properties and relevance across patient groups.
- Polysomnography is the gold standard but often infeasible due to complexity and cost.
- Observed variability in how measured sleep parameters align with clinical issues in pediatric cancer.
Conclusions:
- Multiple tools exist for pediatric oncology sleep assessment, each with pros and cons.
- Tool selection must consider specific sleep issues, patient age, context, and resources.
- Informed choices and thoughtful integration of sleep assessments are encouraged for practice and research.
Background:
Pediatric cancer patients experience unique and multifaceted sleep disturbances due to the disease, treatment regimens, and the hospital environment. These disruptions can detrimentally impact neurocognitive functioning, emotional well-being, and overall quality of life, making accurate sleep assessment critical yet challenging in this population.
Objective:
To examine and evaluate the current tools used to assess sleep quality in pediatric oncology patients, with a focus on their reliability, feasibility, and relevance to clinical and research settings.
Methods:
A scoping review methodology was employed to identify and synthesize studies using various sleep assessment tools in pediatric cancer populations. Tools reviewed included actigraphy, sleep diaries, validated sleep scales, and polysomnography. Studies were analyzed for general reliability, feasibility in clinical and research contexts, and applicability to pediatric oncology-specific concerns.
Results:
The review found that while actigraphy and sleep diaries are frequently used because of their noninvasive nature and relative ease of implementation, limitations exist in terms of consistency and interpretability. Sleep scales varied in their psychometric properties and relevance across age groups and treatment phases. Polysomnography, though considered the gold standard, was less feasible in routine clinical settings because of its complexity and cost. Across tools, variability was observed in the alignment between measured parameters and clinically relevant sleep issues in pediatric cancer patients.
Conclusion:
A wide range of tools exists for assessing sleep in pediatric oncology, each with distinct strengths and limitations. Selection of the most appropriate tool should consider the specific sleep concern, patient age, clinical context, and resource availability. This review provides a framework for clinicians and researchers to make informed choices, encouraging thoughtful integration of sleep assessments into both practice and study design.
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