title: Objective assessment of sleep status and its correlates in hospitalized children with cancer: Exploratory study.
abstract: BACKGROUND
  Children with cancer are known to have sleep problems. Although hospitalization and psychosocial factors are considered to be the factors affecting children's sleep, few studies have confirmed these effects. The aims of this study were to describe the sleep status of hospitalized children with cancer and to explore the correlates.
  
  
  METHODS
  The sleep status of 11 hospitalized children (aged 2-12 years) with cancer was measured using actigraph and sleep diary during hospitalization and a short home stay. Possible correlates were assessed using a questionnaire.
  
  
  RESULTS
  The participants had significantly longer sleep onset latency, earlier bedtime, and poorer self-evaluated sleep quality during hospitalization than the short home stay. They had shorter total sleep time, longer wake time after sleep onset, and less sleep efficiency at home, compared with healthy historical controls. Children's age, symptoms, hospitalization period, Cognitive Fatigue, Procedural Anxiety, Treatment Anxiety, Social Anxiety, and Separation Anxiety, as well as caregiver anxiety, Receptive and Focused Attitude, and Regimented Attitude were significantly correlated with sleep variables.
  
  
  CONCLUSIONS
  Hospitalization decreased self-evaluated sleep quality, and difficulty falling asleep. The sleep of the participants at home was disturbed compared with that of healthy children. Hospitalization, patient characteristics, disease-related, and some psychosocial factors were associated with sleep variables. Medical professionals should develop a favorable environment for falling asleep in hospital for individual children. Children with cancer in the early period of hospitalization need increased care to facilitate good sleep.
authors.affiliation: Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Ami
authors.initials: A
authors.lastname: Setoyama
authors.affiliation: Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Department of Family Nursing, Division of Health Sciences and Nursing, Graduate School of Medicine, University of Tokyo, Tokyo, Japan. kkamibeppu-tky@umin.ac.jp.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Kamibeppu
mesh_terms: D002648:Child; D002673:Child, Hospitalized; D002675:Child, Preschool; D005260:Female; D006760:Hospitalization / Q000639:trends; D006801:Humans; D008297:Male; D009369:Neoplasms / Q000150:complications / Q000503:physiopathology*; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires
keywords: actigraph; inpatient; pediatric oncology nursing; quality of life; sleep problem