Comprehensive assessment of sleep in newly diagnosed pediatric brain
Background. Children with a brain tumor are at risk of developing
sleep problems. It remains unclear whether these problems arise at an
early or later stage, and insights can facilitate timely interventions.
The aim of this study is to examine sleep problems and contributing
factors shortly after diagnosis. Methods. Children 6-16 years
with a newly diagnosed (≤3 months) primary brain tumor were recruited
for a prospective study. Sleep was measured using actigraphy and
questionnaires (PROMIS Sleep Disturbance and Sleep Related Impairment,
self- and parent-reports). Prevalence of clinical sleep problems were
established using PROMIS cut-off scores. Mean PROMIS scores, prevalence
of sleep problems and actigraphic outcomes were compared to norms
(t-test, chi-square, linear regression). Demographic and medical risk
factors were explored with multivariable linear regression models.
Results. Sixty-nine children (68% male, mean age 11.6±2.8 years,
53±28 days after diagnosis) participated. Parents reported more sleep
disturbances (mean T=53.7, P<.01) compared to norms.
Rates of self- and parent-reported severe sleep disturbances were
elevated (11% versus 5% in norms, P<.04). Parents
also reported higher rates of moderate sleep disturbance (31%) and
sleep related impairment (42%) than norms (25%,
P<.03). Actigraphic outcomes did not differ from norms.
Only shorter time since diagnosis was identified as independent risk
factor (self-reported sleep disturbances, B=-.11, 95%CI -0.19;-0.03).
Conclusions. Sleep problems are more frequently reported by
children and parents shortly after pediatric brain tumor diagnosis,
compared to healthy controls. Attention for sleep around brain tumor
diagnosis is important, as sleep is vital for recovery and
health-related quality of life.