Dysfunctional beliefs about sleep may be associated with chronic sleep disturbance in patients afflicted with cancer over the trajectory of their battle with cancer. The objective of this study was exploration of the utility of assessing the sleep disturbances suffered by cancer patients possibly emanating from two cancer-related informationally valid but nonetheless dysfunctional beliefs: "My immune system will have serious problems if I don't go to sleep at a certain time (question 1)" and "If I don't sleep well at night, my cancer can recur or metastasize (question 2). " The scores for these beliefs were significantly correlated with insomnia severity [measured using the Insomnia Severity Index (p < 0.01)] and fear of disease progression [measured using the Fear of Progression Questionnaire (p < 0.01)]. The question 2 score also correlated with younger age (p = 0.01) and high depression scores assessed using the Patient Health Questionnaire-9 (p = 0.04). We believe the scores for these two cancer-related dysfunctional beliefs can be used to help evaluate sleep disturbances in cancer patients.

Background and ObjectiveaaIt has been reported that preschool children attending a forest kindergarten had a more balanced development in the physical, emotional, and cognitive areas. We evaluated the effects of the forest kindergarten program on the sleep habits of preschool children. MethodsaaThirty-seven children (n = 18 in the forest kindergarten, n = 19 in a regular kindergarten) participated in this study. Parents of the children completed a Children's Sleep Habits Questionnaire (CSHQ) at the initial assessment, and the CSHQ was repeated after 8 months of attending the kindergarten program.ResultsaaThere were no significant differences between groups in terms of the CSHQ total and subscale measures at the initial assessment. After 8 months enrollment in a kindergarten program, the CSHQ total score (p < 0.01), the subscale scores of sleep disordered breathing (p = 0.04), and daytime sleepiness (p < 0.01) were significantly lower in children attending the forest kindergarten compared with those at the regular kindergarten. Within the forest kindergarten group, the total CSHQ score (p = 0.02) and the daytime sleepiness subscale score (p = 0.02) significantly decreased after 8 months in the program. ConclusionsaaPreschool children who are educated in forest kindergarten programs had less problematic sleep habits and daytime sleepiness compared with children in the regular kindergarten program. Forest kindergarten programs may positively influence daytime sleepiness in children.