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Short Sleep Duration and Physical and Psychological Health Outcomes Among Adult Survivors of Childhood Cancer
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  • Margaret Lubas,
  • Belinda Mandrell,
  • Kirsten Ness,
  • Kumar Srivastava,
  • Matthew Ehrhardt,
  • Zhaoming Wang,
  • Melissa Hudson,
  • Leslie Robison,
  • Kevin Krull,
  • Tara Brinkman
Margaret Lubas
St Jude Children's Research Hospital
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Belinda Mandrell
St. Jude Children's Research Hospital
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Kirsten Ness
St. Jude Children's Research Hospital
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Kumar Srivastava
St. Jude Children
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Matthew Ehrhardt
St Jude Children's Research Hospital
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Zhaoming Wang
St Jude Children's Research Hospital
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Melissa Hudson
St. Jude Children’s Research Hospital
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Leslie Robison
St. Jude Children's Research Hospital
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Kevin Krull
St. Jude Children's Research Hospital
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Tara Brinkman
St. Jude Children's Research Hospital
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Abstract

Background: To examine associations between phenotypes of short sleep duration and clinically-assessed health conditions in long-term survivors of childhood cancer. Methods: Survivors recruited from the St. Jude Lifetime Cohort (n=911; 52% female; mean age 34 years; 26 years post-diagnosis) completed behavioral health surveys and underwent comprehensive physical examinations. Sleep was assessed with the Pittsburgh Sleep Quality Index. Short sleep was defined as <7 hours per night with phenotypes of short sleep including poor sleep efficiency (<85%), prolonged sleep onset latency (≥30 minutes), and wake after sleep onset (≥3 times per week). Covariates included childhood cancer treatment exposures, demographics, body mass index, and physical inactivity. Separate modified Poisson regression models were computed for each health category to estimate relative risks (RR) and 95% confidence intervals (CI). Multinomial logistic regression models examined associations between sleep and an aggregated burden of chronic health conditions. Results: Short sleep duration was reported among 44% (95% CI 41%-47%) of survivors. In multivariable models, short sleep duration alone was associated with pulmonary (RR=1.35, 95% CI 1.08-1.69), endocrine (RR=1.22, 95% CI 1.06-1.39) and gastrointestinal/hepatic conditions (RR=1.46, 95% CI 1.18-1.79), and anxiety (RR 3.24, 95% CI 1.64-6.41) and depression (RR=2.33, 95% CI 1.27-4.27). Short sleep with prolonged SOL was associated with a high/severe burden of health conditions (OR=2.35, 95% CI 1.12-4.94). Conclusions: Short sleep duration was associated with multiple clinically-ascertained adverse health conditions. Although the temporality of these associations cannot be determined in this cross-sectional study, sleep is modifiable, and improving sleep may improve long-term health in survivors.

Peer review status:Published

30 Sep 2020Submission Checks Completed
30 Sep 2020Assigned to Editor
30 Sep 2020Submitted to Pediatric Blood & Cancer
01 Oct 2020Reviewer(s) Assigned
02 Nov 2020Review(s) Completed, Editorial Evaluation Pending
03 Nov 2020Editorial Decision: Revise Major
25 Jan 2021Submission Checks Completed
25 Jan 2021Assigned to Editor
25 Jan 20211st Revision Received
27 Jan 2021Reviewer(s) Assigned
11 Feb 2021Review(s) Completed, Editorial Evaluation Pending
12 Feb 2021Editorial Decision: Accept
06 Apr 2021Published in Pediatric Blood & Cancer. 10.1002/pbc.28988