title: Sleep complaints in survivors of pediatric brain tumors.
abstract: OBJECTIVE
  Pediatric brain tumor survivors have increased risk of sleep problems, particularly excessive daytime sleepiness (EDS). Few studies have examined sleep disturbances in this population.
  
  
  METHODS
  153 children and adolescents ages 8-18 and their parents completed questionnaires (Modified Epworth Sleepiness Scale, Kosair Children's Hospital Sleep Questionnaire, Children's Report of Sleep Patterns, Children's Sleep Hygiene Scale) during clinic visits. Participants were at least 5 years from diagnosis and 2 years post-treatment. Group differences in age at diagnosis, body mass index, type of treatment received, and tumor location were examined.
  
  
  RESULTS
  One-third of adolescents and one-fifth of children reported EDS. Children and parents had fair concordance (kappa coefficient = .64) in their report of EDS, while adolescents and parents had poor concordance (kappa coefficient = .37). Per parents, most children slept 8 to 9 h per night. Poor bedtime routines were reported for children, while adolescents endorsed poor sleep stability. Extended weekend sleep was reported across age groups. A BMI in the obese range was related to higher parent-reported EDS in children. Sleep-disordered breathing was associated with elevated BMI in adolescents.
  
  
  CONCLUSIONS
  While survivors reported achieving recommended amounts of sleep each night, 20 to 30% reported EDS. Poor concordance among parent and adolescent report highlights the importance of obtaining self-report when assessing sleep concerns. Obesity is a modifiable factor in reducing symptoms of EDS in this population. Finally, the lack of association between EDS and brain tumor location, BMI, or treatment received was unexpected and warrants further investigation.
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, USA.|Jane B. Pettit Pain Management and Headache Center, Children's Hospital of Wisconsin, Milwaukee, WI, USA.
authors.forename: Chasity
authors.initials: C
authors.lastname: Brimeyer
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, USA.|Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Adams
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Liang
authors.initials: L
authors.lastname: Zhu
authors.affiliation: Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, TN, USA.
authors.forename: Deo Kumar
authors.initials: DK
authors.lastname: Srivastava
authors.affiliation: Methodist Healthcare Sleep Disorders Center, Memphis, TN, USA.
authors.forename: Merrill
authors.initials: M
authors.lastname: Wise
authors.affiliation: Departments of Oncology and Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, 38105, USA.
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Hudson
authors.affiliation: Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, USA. valerie.crabtree@stjude.org.
authors.forename: Valerie McLaughlin
authors.initials: VM
authors.lastname: Crabtree
mesh_terms: D000293:Adolescent; D001932:Brain Neoplasms / Q000150:complications*; D002648:Child; D006970:Disorders of Excessive Somnolence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications*; D010290:Parents; D057566:Self Report; D012890:Sleep / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D017741:Survivors
keywords: Cancer; Obesity; Pediatric; Sleep