Sleep Disturbance Patterns in Children with Leukemia and Lymphoma: Domain-Specific Associations with Hospitalization...

Objectives: The importance of sleep disturbance as a component of supportive care in pediatric oncology has recently been recognized, but the characteristics of sleep for this particular disease category have yet to be elucidated. Methods: This cross-sectional study included 54 pediatric patients diagnosed with leukemia or lymphoma and 56 age- and sex-matched clinically stable children attending routine pediatric hematology outpatient follow-up for benign hematological conditions. Sleep was assessed using the Children's Sleep Habits Questionnaire (CSHQ). Global and domain-specific sleep scores were compared. Multivariable linear regression was used to identify correlates of global sleep disturbance, including parental educational attainment. Within the patient group, recent hospitalization and corticosteroid exposure were modeled separately because of strong collinearity. Results: Patients had higher global CSHQ scores than the comparison group (53.56 ± 8.28 vs. 49.07 ± 8.09, p = 0.005; Cohen's d = 0.55). Differences were most evident in sleep anxiety and parasomnias (exploratory subscale findings), whereas sleep duration did not differ significantly. In the whole-sample model, patient status (B = 4.16, p = 0.006) and higher parental educational attainment (B = -2.13, p < 0.001) were independently associated with global sleep disturbance. Within the patient group, recent hospitalization was the strongest clinical correlate of sleep burden (B = 11.18, p < 0.001; R² = 0.433). Corticosteroid exposure was associated with higher sleep disturbance only in models excluding hospitalization. Conclusions: Children with leukemia and lymphoma showed a selective parent-reported sleep disturbance pattern characterized mainly by sleep anxiety and parasomnias rather than reduced sleep duration. Recent hospitalization and parental educational attainment appear to be important correlates of sleep burden in pediatric hematology-oncology care.