A psychoeducational sleep health intervention for children with acute lymphoblastic leukemia during maintenance therapy: a proof-of-concept pilot study.

Abstract

Objective: Although sleep disturbances are common and impairing side effects of treatment for pediatric acute lymphoblastic leukemia (ALL), no research has studied whether prevention programs are effective. The current study assessed feasibility and acceptability of a brief sleep health education program during maintenance chemotherapy for ALL.

Methods: Twenty-five caregivers of children with ALL aged 4-8 years old (M = 5.6 years, SD = 1.3) receiving maintenance chemotherapy enrolled. An oncology nurse navigator (ONN) met individually with caregivers (15-30 min) to introduce them to a psychoeducational website on sleep during ALL treatment and a sleep action plan. Questionnaires were collected at baseline and 1-month follow-up. Medical records were reviewed for the 3 months prior to and following the ONN meeting for appointments documenting sleep discussions.

Results: The program was feasible (of 27 caregivers approached, 25 [93%] enrolled; of 25 enrolled, 22 [88%] completed the follow-up assessment), and the majority of caregivers (77%) rated the intervention as acceptable. Approximately 40% of children experienced clinically meaningful improvements in sleep disturbance or impairment from baseline to follow-up. The average proportion of physician appointments per patient with documented sleep discussions was lower at follow-up (34%) than at baseline (41%), although this was not statistically significant (p = .17).

Conclusions: A brief sleep health education program is feasible and acceptable during maintenance therapy for pediatric ALL. Providing families with comprehensive information on sleep during ALL treatment may improve child sleep and reduce the need to discuss sleep with oncologists. Findings support evaluation of Sleep ALL Night in a statistically powered, randomized trial.