Sleep Disorders in Young and Middle-Aged Adults with Acute Leukemia Undergoing Chemotherapy: A Qualitative Study from a Biopsychosocial Perspective.

Background and objectives: Sleep disorders frequently affect acute leukemia patients during chemotherapy, significantly impacting treatment outcomes and quality of life. Using the biopsychosocial model, this study explores young and middle-aged patients' perceptions and influencing factors of sleep disturbances to guide targeted interventions.

Methods: Purposive sampling method was used to select 16 patients from the Department of Hematology of a tertiary hospital in Yantai City from December 2024 to January 2025 for semi-structured interviews, based on the biopsychosocial model, and Colaizzi's seven-step analysis method was used to refine the themes.

Results: Seven themes were extracted: 1) Chemotherapy and the physiological burden of the disease itself (discomfort symptoms such as body pain and fatigue, particularly severe sleep problems during the induced remission period); 2) The physical and mental reactions caused by the uncertainty of disease progression and treatment (anxiety about the condition and treatment, fear of disease progression, and concern about recurrent pain); 3) Cognitive and emotional distress towards sleep (excessive sleep expectations, rumination further affecting sleep); 4) Polarization in coping (actively implementing self-regulation and generating negative avoidance thoughts); 5) Medical environment and institutional barriers (poor hospitalization environment, unmet sleep management needs of medical staff); 6) Economic and role pressures (heavy economic pressure, insufficient social support); 7) Family and peer relationships (yearning for family support and striving to establish peer support).

Conclusion: Young and Middle-Aged Adults leukemia patients during chemotherapy have poor sleep quality, which is influenced by multiple biological, psychological, and social factors. These findings provide new insights into the challenges of patient-centered sleep management during chemotherapy and highlight the inadequacy of psychosocial support and institutional care. Clinicians should combine these influencing factors to develop targeted interventions to improve patients' sleep quality and enhance their quality of life.