Research could help young cancer survivors sleep easier

CALGARY — It’s a bitter irony that many kids with cancer who have overcome their illnesses are then challenged by an everyday function that most people take for granted: the ability to fall and stay asleep.

Difficulties with sleeping that can develop in hospital can also stick with kids after they’ve returned home – and sometimes even into adulthood.

Researchers with Alberta Health Services (AHS) and the University of Calgary are trying to better understand the scope of the problem so they can develop therapies to help cancer survivors and their families sleep better.

“Sleeping well is critical for children’s cognitive, physical and social development,” says Dr. Lianne Tomfohr-Madsen, PhD, assistant professor with the University of Calgary’s Department of Psychology and a member of the Alberta Children’s Hospital Research Institute (ACHRI).

“Many people will occasionally experience difficulties falling asleep but, when it happens regularly, it can seriously impact health and quality of life,” says Tomfohr-Madsen, who holds the Alberta Children’s Hospital Foundation Professorship in Child Psychology.

There are a number of reasons children’s sleep patterns are often disrupted while they’re in hospital.

• The effects of the illness or treatment might make sleep difficult.
• Health care providers sometimes need to wake children to monitor their condition.
• With little else to do, kids might increase the amount of time they’re watching TV or using handheld electronic devices, which can negatively affect sleep.
• Co-sleeping with a parent might be a short-term solution that facilitates sleep but can present challenges when families return home.

Dr. Fiona Schulte, PhD, co-investigator and an AHS psychologist and ACHRI member, says stress is a significant barrier to sleep – both in and out of hospital.

“Parents and children often have fears about monitoring the child’s condition when they return home,” Dr. Schulte says. “That anxiety turns bedtime into a challenge and may lead to a cycle of waking up in the middle of the night. The rhythms of the whole family can be disrupted.”

Researchers are looking for children between the ages of 8-18 who have had leukemia, as well as healthy children for a comparison group. They hope to enrol 100 families, 50 for each group.

Participants are asked to fill out a series of questionnaires, keep a sleep diary, and at night wear a wristwatch-like device that measures sleep quality. Sleep activity is monitored over seven days.

Researchers hope that by comparing the two groups they’ll better understand the onset, frequency and duration of sleep disruption in cancer survivors and their families.

“The data will hopefully provide some insights on possible patterns or triggers for sleep difficulties, and help us tailor better therapeutic approaches to promote healthy sleep,” says Dr. Tomfohr-Madsen.

Traci Rhyason’s nine-year-old son Leland, a study participant who completed his last chemotherapy treatment for leukemia in 2014, wakes up three or four times a night.

“He’s often exhausted when he gets up to go to school in the morning. He’s almost learned to live on no sleep,” Traci says.

She adds the sleep difficulties also affect Leland socially, since he’s unable to participate in friends’ sleepovers. Traci now reads a relaxation script before bedtime in an effort to ease some of the anxieties around sleep.

“It’s one of those things you don’t appreciate until it’s gone,” she says.

For more information, see familysleepstudy.com/ or phone 403-220-5086.

Alberta Health Services is the provincial health authority responsible for planning and delivering health supports and services for more than four million adults and children living in Alberta. Its mission is to provide a patient-focused, quality health system that is accessible and sustainable for all Albertans.

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