The relationship between child and caregiver sleep in acute lymphoblastic leukemia maintenance

Abstract

Purpose The purposes of this study are to describe sleep quality and sleep disturbance among caregivers of children in the maintenance phase of acute lymphoblastic leukemia (ALL) and to examine the relationship between sleep quality, child sleep disturbance, and caregiver guilt and worry. Methods Caregivers of 68 children with ALL, ages 3 to 12 years old, completed measures of caregiver guilt and worry, caregiver sleep quality, and child’s developmental history and sleep habits. Demographic and treatment correlates of poor caregiver sleep were examined, and caregiver guilt and worry was tested as a moderator between child and caregiver sleep. Results More than half of caregivers (55.9%) reported clinically significant poor sleep and less than 40% were obtaining adequate sleep durations. Caregiver sleep was significantly related to child age at diagnosis, child sleep, and caregiver guilt and worry. Caregiver guilt and worry did not moderate the relationship between child sleep and caregiver sleep. Conclusions Poor sleep is common in caregivers of children with cancer. Further research on the timing of sleep interventions and the most effective intervention targets are needed to maximize caregiver functioning during a child’s cancer treatment. Targeted interventions seeking to improve caregiver sleep should be directed towards caregivers of children diagnosed in early childhood, caregivers of children with poor sleep, and caregivers with high guilt and worry.

High prevalence of parent‐reported sleep problems in pediatric patients with acute lymphoblastic leukemia after induction therapy

“…Parent‐reported sleep problems were mainly predicted by parental sleep and parenting factors in our model. The correlation between parental and child sleep has previously been described during ALL maintenance treatment . This relationship is probably bidirectional.…”

“…The correlation between parental and child sleep has previously been described during ALL maintenance treatment. 19 This relationship is probably bidirectional.…”

“…The potential influence of parental functioning and parenting behaviors on these outcomes is often not taken into account. 15,19 However, sleep problems are common in parents of pediatric cancer patients, with prevalence rates up to 71% in the hospital setting. 17,[19][20][21][22][23][24][25] Many parents report elevated levels of distress shortly after diagnosis and during treatment.…”

Concurrence of sleep problems and distress: prevalence and determinants in parents of children with cancer

“…Besides, we did not include a formal PTSS/PTSD instrument, as mentioned before. Finally, it would have been interesting to have information on parental pre-existing psychopathology and include questionnaires on personality traits, sleep behaviours and coping styles, as well as to include child's sleep, since we know from previous research that these aspects influence parental sleep and functioning as well (Cousino & Hazen, 2013;Daniel et al, 2018;Matthews et al, 2014;Price et al, 2016).…”

“…The estimated prevalence of sleep problems in parents of children with cancer ranges from 48% during (outpatient) treatment to 71% in a hospital setting (Coleman et al, 2018;Daniel, Walsh, Meltzer, Barakat, & Kloss, 2018;McLoone, Wakefield, Yoong, & Cohn, 2013;Zupanec et al, 2010). Although the evidence is sparse, there are reports of ongoing parental sleep problems after the end of their child's cancer treatment (Pollock et al, 2013).…”