Mechanisms of sleep disturbances in Long-Term cancer survivors: a childhood cancer survivor study report.
Journal
JNCI cancer spectrum
ISSN: 2515-5091
Titre abrégé: JNCI Cancer Spectr
Pays: England
ID NLM: 101721827
Informations de publication
Date de publication:
15 Feb 2024
15 Feb 2024
Historique:
received:
07
11
2023
revised:
26
01
2024
accepted:
10
02
2024
medline:
17
2
2024
pubmed:
17
2
2024
entrez:
17
2
2024
Statut:
aheadofprint
Résumé
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. Childhood cancer survivors (≥5 years from diagnosis; n = 12,340; 51.5% female; mean[SD] age = 39.4[9.6] years) and siblings (n = 2395; 57.1% female; age = 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 BMI. Survivors were more likely to report clinically-elevated composite PSQI scores (>5; 45.1% vs 40.0%, adjusted prevalence ratio [PR] 1.20, 95%CI 1.13-1.27), symptoms of insomnia (38.8% vs 32.0%, PR = 1.26, 95%CI 1.18-1.35), snoring (18.0% vs 17.4%, PR = 1.11, 95%CI 1.01-1.23), and sleep medication use (13.2% vs 11.5%, PR = 1.28, 95%CI 1.12-1.45) compared to siblings. Within cancer survivors, PSQI scores were similar across diagnoses. Anthracycline exposure (PR = 1.13, 95%CI 1.03-1.25), abdominal radiation (PR = 1.16 95%CI 1.04-1.29) and increasing CHC burden were associated with elevated PSQI scores (PRs 1.21-1.48). Among survivors, sleep problems were more closely related to CHC than diagnosis or treatment history, though 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.
Sections du résumé
BACKGROUND
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
METHODS
Childhood cancer survivors (≥5 years from diagnosis; n = 12,340; 51.5% female; mean[SD] age = 39.4[9.6] years) and siblings (n = 2395; 57.1% female; age = 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 BMI.
RESULTS
RESULTS
Survivors were more likely to report clinically-elevated composite PSQI scores (>5; 45.1% vs 40.0%, adjusted prevalence ratio [PR] 1.20, 95%CI 1.13-1.27), symptoms of insomnia (38.8% vs 32.0%, PR = 1.26, 95%CI 1.18-1.35), snoring (18.0% vs 17.4%, PR = 1.11, 95%CI 1.01-1.23), and sleep medication use (13.2% vs 11.5%, PR = 1.28, 95%CI 1.12-1.45) compared to siblings. Within cancer survivors, PSQI scores were similar across diagnoses. Anthracycline exposure (PR = 1.13, 95%CI 1.03-1.25), abdominal radiation (PR = 1.16 95%CI 1.04-1.29) and increasing CHC burden were associated with elevated PSQI scores (PRs 1.21-1.48).
CONCLUSIONS
CONCLUSIONS
Among survivors, sleep problems were more closely related to CHC than diagnosis or treatment history, though 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.
Identifiants
pubmed: 38366608
pii: 7609044
doi: 10.1093/jncics/pkae010
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press.