A psychoeducational sleep health intervention for children with acute lymphoblastic leukemia during maintenance
Lydia Chevalier1,2, Morgan A Paul3, Lucille Lokko4
1Department of Supportive Oncology, Dana-Farber Cancer Institute, Boston, MA, United States.
Insights
A sleep health education program for children with acute lymphoblastic leukemia (ALL) was feasible and acceptable. The intervention showed potential to improve pediatric sleep and reduce oncologist discussions.
Area of Science:
- Pediatric Oncology
- Sleep Medicine
- Health Education
Background:
- Sleep disturbances are common and impairing side effects in pediatric acute lymphoblastic leukemia (ALL) treatment.
- No prior research has evaluated the effectiveness of sleep prevention programs for these children.
Purpose of the Study:
- To assess the feasibility and acceptability of a brief sleep health education program for children undergoing maintenance chemotherapy for ALL.
- To explore the program's impact on child sleep and physician discussions about sleep.
Main Methods:
- A psychoeducational program was delivered by an oncology nurse navigator to 25 caregivers of children (aged 4-8) with ALL.
- The program included a website and a sleep action plan, with assessments at baseline and 1-month follow-up.
- Medical records were reviewed for sleep discussion documentation in physician appointments.
Main Results:
- The program demonstrated feasibility (93% enrollment, 88% completion) and acceptability (77% of caregivers).
- Approximately 40% of children showed clinically meaningful sleep improvements.
- Documented sleep discussions in physician appointments decreased post-intervention, though not significantly.
Conclusions:
- A brief sleep health education program is feasible and acceptable for families of children with ALL during maintenance therapy.
- This intervention may improve pediatric sleep and decrease reliance on oncologists for sleep management.
- Further evaluation in a randomized controlled trial is warranted.
Objective:
Although sleep disturbances are common and impairing side effects of treatment for pediatric acute lymphoblastic leukemia (ALL), no research has studied whether prevention programs are effective. The current study assessed feasibility and acceptability of a brief sleep health education program during maintenance chemotherapy for ALL.
Methods:
Twenty-five caregivers of children with ALL aged 4-8 years old (M = 5.6 years, SD = 1.3) receiving maintenance chemotherapy enrolled. An oncology nurse navigator (ONN) met individually with caregivers (15-30 min) to introduce them to a psychoeducational website on sleep during ALL treatment and a sleep action plan. Questionnaires were collected at baseline and 1-month follow-up. Medical records were reviewed for the 3 months prior to and following the ONN meeting for appointments documenting sleep discussions.
Results:
The program was feasible (of 27 caregivers approached, 25 [93%] enrolled; of 25 enrolled, 22 [88%] completed the follow-up assessment), and the majority of caregivers (77%) rated the intervention as acceptable. Approximately 40% of children experienced clinically meaningful improvements in sleep disturbance or impairment from baseline to follow-up. The average proportion of physician appointments per patient with documented sleep discussions was lower at follow-up (34%) than at baseline (41%), although this was not statistically significant (p = .17).
Conclusions:
A brief sleep health education program is feasible and acceptable during maintenance therapy for pediatric ALL. Providing families with comprehensive information on sleep during ALL treatment may improve child sleep and reduce the need to discuss sleep with oncologists. Findings support evaluation of Sleep ALL Night in a statistically powered, randomized trial.
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