title: Sleep, fatigue, depression, and quality of life in survivors of childhood acute lymphoblastic leukemia.
abstract: BACKGROUND
  With the improved survival of childhood acute lymphoblastic leukemia (ALL), the effect of treatment on psychosocial well-being becomes increasingly relevant. Literature on sleep and fatigue during treatment is emerging. However, information on these subjects after treatment is sparse. This cross-sectional study examined sleep and fatigue in relation to depression and quality of life (QoL) after treatment for childhood ALL.
  
  
  METHODS
  Sleep, fatigue, depression, and QoL were evaluated by parent proxy and/or child self-reports of the Children's Sleep Habits Questionnaire, the PedsQL™ multidimensional fatigue scale, the Children's Depression Inventory and the Child Health Questionnaire. All total scores were compared to Dutch norm references.
  
  
  RESULTS
  Sixty-two children were included, being 36 (interquartile range 22-62) months after finishing treatment. Parents rated the ALL survivors as having more disturbed sleep, more fatigue and poorer physical QoL compared to the Dutch norm. ALL survivors themselves reported less sleep problems, less depressive symptoms, and better psychosocial QoL than the Dutch norm. More sleep disturbances and fatigue correlated with more symptoms of depression and a worse QoL.
  
  
  CONCLUSIONS
  Differences in parental and self-reports, including worse parental ratings, might be explained by worried parents and/or the adaptive style of the children. Impaired sleep and fatigue correlated with more depressive symptoms and a worse QoL.
authors.affiliation: Department of Pediatrics, Division Oncology/Hematology, VU University Medical Center, 1007 MB Amsterdam, The Netherlands. ms.gordijn@vumc.nl
authors.forename: Maartje S
authors.initials: MS
authors.lastname: Gordijn
authors.forename: Raphaële R
authors.initials: RR
authors.lastname: van Litsenburg
authors.forename: Reinoud J
authors.initials: RJ
authors.lastname: Gemke
authors.forename: Jaap
authors.initials: J
authors.lastname: Huisman
authors.forename: Marc B
authors.initials: MB
authors.lastname: Bierings
authors.forename: Peter M
authors.initials: PM
authors.lastname: Hoogerbrugge
authors.forename: Gertjan J L
authors.initials: GJ
authors.lastname: Kaspers
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005221:Fatigue / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D057566:Self Report; D012893:Sleep Wake Disorders / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology* / Q000706:statistics & numerical data*