title: Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue.
abstract: Cognitive problems are a significant, persistent concern for patients undergoing hematopoietic stem cell transplant (HSCT). Sleep is important for many cognitive tasks; however, the relationship between sleep and cognitive problems for HSCT patients is unknown. This study examined the relationship between sleep and cognitive problems for HSCT patients from pre to post transplant. Patients undergoing HSCT (N=138) completed questionnaires at pre-transplant and during the 12 months following transplant. Questionnaires assessed sleep and cognitive problems as well as commonly co-occurring symptoms: depressive symptoms, fatigue and pain. Post hoc analyses examined the relationship of specific sleep problems with cognitive problems. Sleep problems covaried with cognitive problems even after controlling for depressive symptoms, fatigue and pain. Depressive symptoms and fatigue were also uniquely related to cognitive problems. Post hoc analyses suggest that sleep somnolence, shortness of breath, snoring and perceptions of inadequate sleep may contribute to the association found between sleep and cognitive problems. Findings suggest that sleep problems are associated with and may contribute to cognitive problems for HSCT patients. However, sleep problems are rarely screened for or discussed during clinic visits. Assessing and treating specific sleep problems in addition to depressive symptoms and fatigue may have implications for improving cognitive problems for HSCT patients.
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: S E
authors.initials: SE
authors.lastname: Ghazikhanian
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Dorfman
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: T J
authors.initials: TJ
authors.lastname: Somers
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: M L
authors.initials: ML
authors.lastname: O'Sullivan
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL, USA.
authors.forename: H M
authors.initials: HM
authors.lastname: Fisher
authors.affiliation: Health Psychology, VA Connecticut Healthcare System, New Haven, CT, USA.
authors.forename: S N
authors.initials: SN
authors.lastname: Edmond
authors.affiliation: Department of Anesthesiology, Perioperative and Pain Medicine, Standford University Medical Center, Palo Alto, CA, USA.
authors.forename: A A
authors.initials: AA
authors.lastname: Wren
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: S A
authors.initials: SA
authors.lastname: Kelleher
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: K A
authors.initials: KA
authors.lastname: Rowe Nichols
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: N
authors.initials: N
authors.lastname: Chao
authors.affiliation: Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
authors.forename: R A
authors.initials: RA
authors.lastname: Shelby
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D064591:Allografts; D064592:Autografts; D060825:Cognitive Dysfunction / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D003863:Depression / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D005221:Fatigue / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology