Purpose How cancer history and distress relate to sleep outcomes of adolescents and young adults (AYAs) is unclear. The current study compares AYA cancer survivors to controls on indicators of sleep and fatigue; examines the concurrent association between psychological status, sleep, and fatigue; and investigates the lagged relationship between sleep and fatigue problems with psychological functioning. Methods AYA cancer survivors (n=167) and controls (n= 170), ages 16 to 30, completed measures at a survivorship clinic/primary care visit (time 1) and 2 months later (time 2). Participants completed questions about sleep quality, quantity, sleep medication use, self-reports of sleep problems, and fatigue in addition to measures of depression, anxiety, and post-traumatic stress symptoms (PTSS). Results There were no differences in sleep quantity or quality between survivors and controls, but survivors reported significantly more fatigue. Within groups, AYAs with self-reported sleep and fatigue problems reported significantly higher depression, anxiety, and PTS symptoms. Controlling for baseline depression, sleep, and fatigue problems at time 1 significantly predicted depression at time 2 in survivors but not in controls. Conclusion This study offers important insight into the psychological functioning of childhood cancer survivors and prospectively describes sleep and fatigue as risk factors for poor psychological functioning in survivors. These findings support screening for sleep problems in AYA survivors as these difficulties are closely related to mental health functioning.

SummaryThis article reviews a growing body of research that examines sleep among lesbian, gay, bisexual and transgender (LGBT) populations. An extensive search of the literature was conducted using multiple medical and psychological search engine platforms. In total, this search yielded 31 reports that included sleep data collected from sexual and gender minority participants. Overall, research findings are mixed and include several publications of studies conducted in the same sample. Our review suggests that sleep health among LGBT individuals may be an unmet health need. Critically, sleep disturbances affected LGBT subgroups differently based on sex/gender and diverse sexual orientations (e.g., bisexual women). Although not directly tested, evidence from parallel LGBT health research suggests that minority stress may contribute to these observed sleep disparities and will need to be directly assessed in future studies. In sum, continued investigation of sleep disparities among sexual and gender minority communities is needed, as is the inclusion of sleep health in theoretical models of LGBT health disparities. Given the importance of sleep in overall mental and physical health, addressing sleep health may serve to promote and protect healthy functioning among LGBT individuals.

The authors are grateful to the many childhood cancer survivors and their families who participated. We would also like to express our sincere thanks to the scientific advisory committee who provided feedback and our collaborator LifeScience Technologies. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Purpose: Despite cure, adolescents and young adults (AYA) who complete cancer treatment remain at risk for numerous physical and psychological late effects. However, engagement in recommended follow-up care, knowledge of cancer treatment history and risks, and adoption of health promoting behaviors are often suboptimal. The pilot randomized controlled trial assessed the feasibility and acceptability of a text messaging intervention (THRIVE; Texting Health Resources to Inform, motiVate, and Engage) designed to promote well-being, and health knowledge and behaviors. Methods: Sixty-one AYA who recently completed cancer therapy enrolled and were randomized to receive THRIVE (n = 31) or an AYA survivor handbook (n = 30). Participants from both groups completed baseline measures and follow-up surveys 16 weeks later. AYA randomized to THRIVE received one to two health-related text messages per day over 16 weeks.Results: THRIVE demonstrated a high level of acceptability and feasibility. Exploratory analyses highlighted promising improvements in knowledge, fruit/vegetable intake, and perceptions of health vulnerability. Conclusions:Text messaging is an acceptable and feasible intervention approach for improving well-being and health of AYA survivors. Future research is needed to test the impact of text messaging in a larger trial, including whether or not such an intervention can improve clinical outcomes, such as survivors' engagement in follow-up care.

TRI represents the first multi-informant, rigorously developed transition readiness item pool that comprehensively measures the social-ecological components of transition readiness. Discussion includes clinical implications, the application of TRI and the methods to develop the item pool to other populations, and next steps for further validation and refinement.