TY - JOUR
T1 - Mechanisms of sleep disturbances in long-term cancer survivors
T2 - a childhood cancer survivor study report
AU - Daniel, Lauren C.
AU - Wang, Huiqi
AU - Brinkman, Tara M.
AU - Ruble, Kathy
AU - Zhou, Eric S.
AU - Palesh, Oxana
AU - Stremler, Robyn
AU - Howell, Rebecca
AU - Mulrooney, Daniel A.
AU - Crabtree, Valerie M.
AU - Mostoufi-Moab, Sogol
AU - Oeffinger, Kevin
AU - Neglia, Joseph
AU - Yasui, Yutaka
AU - Armstrong, Gregory T.
AU - Krull, Kevin
N1 - Publisher Copyright:
© The Author(s) 2024. Published by Oxford University Press.
PY - 2024/4/1
Y1 - 2024/4/1
N2 - Background: Sleep problems following childhood cancer treatment may persist into adulthood, exacerbating cancer-related late effects and putting survivors at risk for poor physical and psychosocial functioning. This study examines sleep in long-term survivors and their siblings to identify risk factors and disease correlates. Methods: Childhood cancer survivors (≥5 years from diagnosis; n ¼ 12 340; 51.5% female; mean [SD] age ¼ 39.4 [9.6] years) and siblings (n ¼ 2395; 57.1% female; age ¼ 44.6 [10.5] years) participating in the Childhood Cancer Survivor Study completed the Pittsburgh Sleep Quality Index (PSQI). Multivariable Poisson-error generalized estimating equation compared prevalence of binary sleep outcomes between survivors and siblings and evaluated cancer history and chronic health conditions (CHC) for associations with sleep outcomes, adjusting for age (at diagnosis and current), sex, race/ethnicity, and body mass index. Results: Survivors were more likely to report clinically elevated composite PSQI scores (>5; 45.1% vs 40.0%, adjusted prevalence ratio [PR] ¼ 1.20, 95% CI ¼ 1.13 to 1.27), symptoms of insomnia (38.8% vs 32.0%, PR ¼ 1.26, 95% CI ¼ 1.18 to 1.35), snoring (18.0% vs 17.4%, PR ¼ 1.11, 95% CI ¼ 1.01 to 1.23), and sleep medication use (13.2% vs 11.5%, PR ¼ 1.28, 95% CI ¼ 1.12 to 1.45) compared with siblings. Within cancer survivors, PSQI scores were similar across diagnoses. Anthracycline exposure (PR ¼ 1.13, 95% CI ¼ 1.03 to 1.25), abdominal radiation (PR ¼ 1.16, 95% CI ¼ 1.04 to 1.29), and increasing CHC burden were associated with elevated PSQI scores (PRs ¼ 1.21-1.48). Conclusions: Among survivors, sleep problems were more closely related to CHC than diagnosis or treatment history, although longitudinal research is needed to determine the direction of this association. Frequent sleep-promoting medication use suggests interest in managing sleep problems; behavioral sleep intervention is advised for long-term management.
AB - Background: Sleep problems following childhood cancer treatment may persist into adulthood, exacerbating cancer-related late effects and putting survivors at risk for poor physical and psychosocial functioning. This study examines sleep in long-term survivors and their siblings to identify risk factors and disease correlates. Methods: Childhood cancer survivors (≥5 years from diagnosis; n ¼ 12 340; 51.5% female; mean [SD] age ¼ 39.4 [9.6] years) and siblings (n ¼ 2395; 57.1% female; age ¼ 44.6 [10.5] years) participating in the Childhood Cancer Survivor Study completed the Pittsburgh Sleep Quality Index (PSQI). Multivariable Poisson-error generalized estimating equation compared prevalence of binary sleep outcomes between survivors and siblings and evaluated cancer history and chronic health conditions (CHC) for associations with sleep outcomes, adjusting for age (at diagnosis and current), sex, race/ethnicity, and body mass index. Results: Survivors were more likely to report clinically elevated composite PSQI scores (>5; 45.1% vs 40.0%, adjusted prevalence ratio [PR] ¼ 1.20, 95% CI ¼ 1.13 to 1.27), symptoms of insomnia (38.8% vs 32.0%, PR ¼ 1.26, 95% CI ¼ 1.18 to 1.35), snoring (18.0% vs 17.4%, PR ¼ 1.11, 95% CI ¼ 1.01 to 1.23), and sleep medication use (13.2% vs 11.5%, PR ¼ 1.28, 95% CI ¼ 1.12 to 1.45) compared with siblings. Within cancer survivors, PSQI scores were similar across diagnoses. Anthracycline exposure (PR ¼ 1.13, 95% CI ¼ 1.03 to 1.25), abdominal radiation (PR ¼ 1.16, 95% CI ¼ 1.04 to 1.29), and increasing CHC burden were associated with elevated PSQI scores (PRs ¼ 1.21-1.48). Conclusions: Among survivors, sleep problems were more closely related to CHC than diagnosis or treatment history, although longitudinal research is needed to determine the direction of this association. Frequent sleep-promoting medication use suggests interest in managing sleep problems; behavioral sleep intervention is advised for long-term management.
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U2 - 10.1093/jncics/pkae010
DO - 10.1093/jncics/pkae010
M3 - Article
C2 - 38366608
AN - SCOPUS:85187717939
SN - 2515-5091
VL - 8
JO - JNCI Cancer Spectrum
JF - JNCI Cancer Spectrum
IS - 2
M1 - pkae010
ER -