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Dissertation
Sleep during the maintenance phase of treatment for acute lymphoblastic leukemia: a comparison of dexamethasone and prednisone
Doctor of Philosophy (Ph.D.), Drexel University
May 2011
DOI:
https://doi.org/10.17918/etd-3512
Abstract
Treatment for acute lymphoblastic leukemia (ALL) continues to increase in effectiveness, making considerations of side-effect profiles of treatment an important focus for improving quality of life. The maintenance phase of ALL treatment lasts for 2 to 3 years and sees children cycling on and off the corticosteroids dexamethasone or prednisone. Corticosteroids have been linked to changes in sleep patterns, mood, and behavior in previous research; though effects of these drugs on quality of life in children with ALL have not been fully described. During the maintenance phase, children may return to school and activities they enjoyed pre-cancer, but if side-effects keep children from fully engaging in these activities, health-related quality of life (QoL) may suffer even more. Sleep is an important and often understudied area of QoL. The current study described sleep patterns of children taking corticosteroids over a 28-day period using a repeated-measures design to compare time on steroids and time off steroids as well as differences between participants taking dexamethasone versus prednisone. Parents of 37 children 3 to 12 years of age diagnosed with ALL and in the maintenance phase of treatment enrolled in the study. Daily sleep diaries and measures of QoL and fatigue were completed by 24 families. Results indicated that children with ALL exhibit more behavioral sleep difficulties and sleep longer at night compared to normative values for healthy peers. Sleep opportunity, total sleep time, and napping varied significantly across the month between steroids. Children taking prednisone slept for a shorter amount of time than children taking dexamethasone, but they napped more frequently, possibly to compensate. Fatigue and QoL were significantly lower during time on steroids compared to time off steroids. QoL during time on steroids was related to sleep disruptions, suggesting that improving sleep, specifically night wakings and sleep quality, could improve QoL. Future research should explore the processes contributing to disrupted sleep in children taking corticosteroids as well as begin to examine the feasibility of brief behavioral interventions for families to address behavioral sleep concerns during steroid bursts.
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Details
- Title
- Sleep during the maintenance phase of treatment for acute lymphoblastic leukemia
- Creators
- Lauren Daniel - DU
- Contributors
- Jacqueline D. Kloss (Advisor) - Drexel University (1970-)Lamia Barakat (Advisor) - DU
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Philosophy (Ph.D.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- Psychological and Brain Sciences (Psychology); College of Arts and Sciences; Drexel University
- Other Identifier
- 3512; 991014632428504721