Oswald Kaitlin A, Richard Annette, Hodges Elise, Heinrich Kimberley P
University of Michigan, Department of Psychiatry, USA.
University of Michigan, Department of Psychiatry, USA.
Sleep Med. 2021 Feb;78:153-159. doi: 10.1016/j.sleep.2020.12.026. Epub 2020 Dec 29.
Sleep problems are a common late effect in survivors of pediatric cancer. Growing literature suggests deficits in sleep functioning may be related to more impairing neurobehavioral outcomes. The purpose of the present study was to evaluate the prevalence of parent reported sleep concerns in survivors of pediatric cancer, as well as evaluate the relationship between sleep and neurobehavioral functioning utilizing both parent and teacher input.
The study included parent-teacher dyads of 75 survivors of pediatric cancer between the ages of six and 17 who completed a clinical neuropsychological evaluation with embedded measures of neurobehavioral functioning and sleep, including excessive daytime sleepiness and snoring. Bivariate correlations and multiple linear regressions were conducted to evaluate the relationship between sleep and neurobehavioral functioning.
No significant difference in parent reported sleep concerns was found with regard to demographic, diagnostic, or treatment variables. Daytime sleepiness was significantly elevated for 28% of the sample; snoring was not identified as a significant concern. Daytime sleepiness was significantly associated with worse neurobehavioral outcomes as reported by parents and teachers, including inattention, hyperactivity/impulsivity, peer difficulties, anxiety, depression, somatic complaints, and aggressive behaviors. Daytime sleepiness was not significantly related to report of learning problems.
Results further support that daytime sleepiness, as reported by parents, impacts approximately one third of survivors of pediatric cancer and is associated with worse neurobehavioral outcomes across home and school environments. As a result, it is vital that sleep functioning is a target of assessment in annual survivorship care. Future longitudinal studies are needed to further delineate the directionality of the sleep-neurobehavioral relationship in survivors.
睡眠问题是儿童癌症幸存者常见的晚期效应。越来越多的文献表明，睡眠功能缺陷可能与更严重的神经行为后果有关。本研究的目的是评估儿童癌症幸存者中家长报告的睡眠问题的患病率，并利用家长和教师的反馈评估睡眠与神经行为功能之间的关系。
该研究纳入了75对家长-教师组合，这些组合来自年龄在6至17岁之间的儿童癌症幸存者，他们完成了一项临床神经心理学评估，其中包括神经行为功能和睡眠的嵌入式测量，如白天过度嗜睡和打鼾。进行了双变量相关性分析和多元线性回归分析，以评估睡眠与神经行为功能之间的关系。
在人口统计学、诊断或治疗变量方面，家长报告的睡眠问题没有显著差异。28%的样本白天嗜睡情况显著升高；打鼾未被视为一个重大问题。家长和教师报告称，白天嗜睡与更差的神经行为后果显著相关，包括注意力不集中、多动/冲动、同伴关系困难、焦虑、抑郁、躯体不适和攻击行为。白天嗜睡与学习问题的报告没有显著关系。
结果进一步支持，家长报告的白天嗜睡影响了约三分之一的儿童癌症幸存者，并且与家庭和学校环境中更差的神经行为后果相关。因此，睡眠功能作为年度生存护理中的评估目标至关重要。未来需要进行纵向研究，以进一步阐明幸存者中睡眠与神经行为关系的方向性。
