title: Sleep disordered breathing risk in childhood cancer survivors: an exploratory study.
abstract: BACKGROUND
  Sleep disordered breathing (SDB) is emerging as a significant health condition for children. The purpose of this study is to evaluate SDB symptoms in childhood cancer survivors and identify associations with quality of life (QOL) and psychological symptoms.
  
  
  METHODS
  A sample of 62 survivors aged 8-18 years were recruited during routine survivorship visits. All subjects and their parents completed questionnaires to evaluate sleep, QOL and psychological symptoms; scales included were: Pediatric Sleep Questionnaire, Sleep Disordered Breathing Subscale (PSQ-SDBS), Pediatric Quality of Life Inventory (PedsQL) and Depression Anxiety Stress Scale (DASS-21). Continuous data were used for all scales and a threshold score of >0.33 on the PSA-SDBS was used to identify risk of SDB. The relationships between measures of sleep and independent variables were examined using Pearson correlations and multiple linear regression models for significant associations.
  
  
  RESULTS
  Of the 62 subjects enrolled, underlying diagnoses included 29 leukemias, 30 solid tumors and 3 non-malignant diseases. Nineteen percent of subjects were identified as having SDB risk on the PSQ-SDBS. The lowest mean PedsQL subscale score for parent and child ratings were school QOL; Parent mean 73(±SD 19) and Child mean 71(±SD 20). The severity of SDB per the PSQ was significantly associated with reduced total and school QOL which remained significant after adjusting for stress.
  
  
  CONCLUSIONS
  Symptoms suggestive of SDB are common in childhood cancer survivors with negative implications for overall quality of life and school performance.
authors.affiliation: Johns Hopkins University, School of Medicine, Division of Pediatric Oncology, Baltimore, Maryland.
authors.forename: Ruble
authors.initials: R
authors.lastname: Kathy
authors.forename: George
authors.initials: G
authors.lastname: Anna
authors.forename: Lisa
authors.initials: L
authors.lastname: Gallicchio
authors.forename: Charlene
authors.initials: C
authors.lastname: Gamaldo
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009369:Neoplasms; D011788:Quality of Life; D012307:Risk Factors; D012891:Sleep Apnea Syndromes / Q000209:etiology / Q000503:physiopathology* / Q000523:psychology*; D011795:Surveys and Questionnaires; D017741:Survivors / Q000523:psychology*
keywords: cancer survivor; pediatric; quality of life; sleep disordered breathing