Impact of Sleep Disorders and Fatigue in Children with Cancer

A study of children with cancer identified an association between physical activity, fatigue, and sleep and quality of life (QOL), particularly distress. In addition, children on active treatment have a higher frequency of distress compared to those in survivorship. These findings were published in Cancer Nursing.

The authors wrote, “Fatigue, sleep disturbance, and physical inactivity have been increasingly recognized as health issues that negatively affect QOL for children with cancer. Existing studies focus either on children receiving treatment or in survivorship, but not on both populations in a study. This causes difficulty in examining differences of these issues between treatment statuses and identifying associations of these issues with QOL.”

Assessing Children with Cancer at Varying Treatment Stages

For this study, the researchers investigated whether there were differences in fatigue, sleep disturbance, physical activity, and QOL between patients currently on treatment for childhood cancer versus those currently off treatment. They also evaluated any association between these differences and overall QOL.

“This study is unique in that a frame of reference is addressed to gain insight into the distinct developmental issues of school-aged children undergoing cancer treatment and in survivorship,” wrote the authors.

QOL in Active Treatment vs. Survivorships

In total, 100 children with cancer were evaluated. Patients were aged from 7 to 12 years old. The researchers utilized descriptive, bivariate, and multivariate regression analyses.

The results showed that children with cancer currently undergoing treatment demonstrated higher levels of fatigue (P=0.002) and physical inactivity (P=0.004) compared to patients currently in survivorship. Patients receiving treatment also reported increased distress compared to those not receiving active therapy (P=0.001).

Relationship Between Fatigue, Sleep, and QOL

Fatigue and sleep disturbance were both significantly associated with QOL distress (P<0.001 and P=0.004, respectively). Other factors associated with QOL distress were age (P<0.001) and sex (P=0.023), in favor of older and female patients.

The clinical takeaway of these results, according to the authors, is, “Interventions to increase QOL should target children who are younger, male, and have higher levels of fatigue and sleep disturbance. Diagnosis and treatment of sleep disturbance should be considered as part of routine activities.”