title: The effects of dexamethasone on sleep in young children with acute lymphoblastic leukemia.
abstract: OBJECTIVE
  Corticosteroids, which are a mainstay in the treatment of acute lymphoblastic leukemia (ALL), have a well-documented adverse effect on sleep. We sought to characterize the effects of dexamethasone on sleep over an entire 28-day treatment cycle using actigraphy, an objective measure of sleep.
  
  
  METHODS
  The sleep of 25 children aged 2-9 years (mean 4.5 years) with ALL treated with dexamethasone were evaluated during maintenance chemotherapy using a within-subject experimental design, actigraphy, and standardized questionnaires to assess sleep, sleep problems, and fatigue.
  
  
  RESULTS
  During the five days of dexamethasone treatment, sleep time increased during the night (535 vs. 498 min; p = 0.004) and daytime napping increased the following day (14 vs. 0 min; p = 0.002), and the number of wake episodes during the night was lower (14 vs. 20; p =  ≤ 0.001). However, when assessed individually, sleep-onset time, efficiency, and wake after sleep onset during the night were unchanged during dexamethasone treatment; when the cumulative effect of all of these factors was assessed, there was a statistically and clinically significant increase in nighttime sleep duration during dexamethasone treatment.
  
  
  CONCLUSIONS
  During the five days of treatment with dexamethasone, an increase in nighttime sleep as well as daytime napping was observed in young children with ALL. The increases in sleep duration return to baseline one day after the discontinuation of dexamethasone.
authors: Sleep Medicine, Children's Hospitals and Clinics of Minnesota, St. Paul, MN, United States. Electronic address: rosen052@umn.edu.
authors: Gerald
authors: G
authors: Rosen
authors: Pediatric Hematology/Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States.
authors: Anne K
authors: AK
authors: Harris
authors: Research & Sponsored Programs, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States.
authors: Meixia
authors: M
authors: Liu
authors: Research & Sponsored Programs, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States.
authors: Jill
authors: J
authors: Dreyfus
authors: Sleep and Performance Research Center, Washington State University, Spokane, WA, United States.
authors: James
authors: J
authors: Krueger
authors: Pediatric Hematology/Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN, United States.
authors: Yoav H
authors: YH
authors: Messinger
mesh_terms: D056044:Actigraphy; D002648:Child; D002675:Child, Preschool; D003907:Dexamethasone / Q000009:adverse effects*; D005221:Fatigue / Q000209:etiology; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D008297:Male; D054198:Precursor Cell Lymphoblastic Leukemia-Lymphoma / Q000188:drug therapy*; D012890:Sleep / Q000187:drug effects*; D012893:Sleep Wake Disorders / Q000139:chemically induced; D011795:Surveys and Questionnaires
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Acute lymphoblastic leukemia; Cytokines; Psychology