Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study

doi:10.1007/s11764-016-0583-y

. 2017 Apr;11(2):256-263.

doi: 10.1007/s11764-016-0583-y. Epub 2016 Nov 12.

Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study

Affiliations

¹ UVA Neurocognitive Assessment Lab, The University of Virginia Health System, Charlottesville, VA, 22908, USA.
² Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, 38105, USA.
³ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, Room S6047, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
⁴ Division of Pediatric Hematology-Oncology, David Geffen School of Medicine at UCLA, 22-464 MDCC, 10833 LeConte Ave, Los Angeles, CA, 90095, USA.
⁵ Emory Children's Center, 2015 Uppergate Dr. 416D, Atlanta, GA, 30322, USA.
⁶ Biostatistics, St. Jude Children's Research Hospital, MS 768, Room 6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
⁷ Department of Medical Social Sciences, Northwestern University, 633 N St. Clair 19th Floor, Chicago, IL, 60611, USA.
⁸ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, Room S6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
⁹ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
¹⁰ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Ms 735, Room S6037, 262 Danny Thomas Place, Memphis, TN, 38105, USA. kevin.krull@stjude.org.

PMID: 27837445
PMCID: PMC5357603
DOI: 10.1007/s11764-016-0583-y

Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study

Amanda M Rach et al. J Cancer Surviv. 2017 Apr.

. 2017 Apr;11(2):256-263.

doi: 10.1007/s11764-016-0583-y. Epub 2016 Nov 12.

Affiliations

¹ UVA Neurocognitive Assessment Lab, The University of Virginia Health System, Charlottesville, VA, 22908, USA.
² Department of Psychology, St. Jude Children's Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, 38105, USA.
³ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, Room S6047, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
⁴ Division of Pediatric Hematology-Oncology, David Geffen School of Medicine at UCLA, 22-464 MDCC, 10833 LeConte Ave, Los Angeles, CA, 90095, USA.
⁵ Emory Children's Center, 2015 Uppergate Dr. 416D, Atlanta, GA, 30322, USA.
⁶ Biostatistics, St. Jude Children's Research Hospital, MS 768, Room 6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
⁷ Department of Medical Social Sciences, Northwestern University, 633 N St. Clair 19th Floor, Chicago, IL, 60611, USA.
⁸ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, Room S6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
⁹ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, MS 735, 262 Danny Thomas Place, Memphis, TN, 38105, USA.
¹⁰ Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Ms 735, Room S6037, 262 Danny Thomas Place, Memphis, TN, 38105, USA. kevin.krull@stjude.org.

PMID: 27837445
PMCID: PMC5357603
DOI: 10.1007/s11764-016-0583-y

Abstract

Purpose: Survivors of pediatric Hodgkin's lymphoma (HL) are at risk for a number of debilitating late effects. Excessive fatigue and poor sleep quality are primary complaints of HL survivors. Understanding the emotional and physical factors that influence fatigue and sleep quality may provide opportunities for intervention to improve health-related quality of life for HL survivors.

Methods: Data from 751 adult survivors of childhood HL who participated in the Childhood Cancer Survivor Study (CCSS) from 2000-2002 were analyzed. Multivariable logistic regression analyses investigated the demographic, psychological, and physical variables that predicted clinically significant levels of poor sleep quality, fatigue, and excessive daytime sleepiness.

Results: Survivors' self-reported level of emotional distress, pain, and physical functioning limitations did not differ from population norms. Clinically elevated levels of emotional distress (OR 8.38, 95% CI 4.28-16.42) and pain (OR 3.73, 95% CI 2.09-6.67) increased the risk for endorsing elevated levels of fatigue. Survivors with elevated levels of emotional distress (OR 6.83, 95% CI 2.71-15.90) and pain (OR 5.27, 95% CI 1.78-15.61) were more likely to report poor sleep quality. Pain (OR 2.11, 95% CI 1.39-3.34) was related to excessive daytime sleepiness.

Conclusions: Emotional and physical factors are associated with elevated levels of fatigue, excessive daytime sleepiness, and poor sleep quality in survivors of pediatric HL. This is consistent with findings from research conducted with non-cancer survivors.

Implications for cancer survivors: These results suggest that interventions designed to _target sleep and fatigue difficulties in the general population may be well suited for pediatric HL survivors as well.

Keywords: Fatigue; Hodgkin’s lymphoma; Pediatric cancer; Psychological distress; Sleep.

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Conflict of interest statement

Conflict of Interest: None of the authors have a conflict of interest.

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[1] National Cancer Institute. Surveillance, Epidemiology, and End Results Program Cancer Statistics Review 1975-2012. National Cancer Institute;

[2] National Cancer Institute. Surveillance, Epidemiology, and End Results Program Cancer Statistics Review 1975-2012. National Cancer Institute;

[3] Epstein JB, Murphy BA. Late effects of cancer and cancer therapy on oral health and quality of life. Journal of the Massachusetts Dental Society. 2010;59(3):22. - PubMed

[4] Epstein JB, Murphy BA. Late effects of cancer and cancer therapy on oral health and quality of life. Journal of the Massachusetts Dental Society. 2010;59(3):22. - PubMed

[5] Nathan PC, Ness KK, Mahoney MC, Li Z, Hudson MM, Ford JS, et al. Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Annals of Internal Medicine. 2010;153(7):442–51. - PMC - PubMed

[6] Nathan PC, Ness KK, Mahoney MC, Li Z, Hudson MM, Ford JS, et al. Screening and surveillance for second malignant neoplasms in adult survivors of childhood cancer: a report from the childhood cancer survivor study. Annals of Internal Medicine. 2010;153(7):442–51. - PMC - PubMed

[7] Mulrooney DA, Ness KK, Neglia JP, Whitton JA, Green DM, Zeltzer LK, et al. Fatigue and sleep disturbance in adult survivors of childhood cancer: a report from the childhood cancer survivor study (CCSS) Sleep. 2008;31(2):271. - PMC - PubMed

[8] Mulrooney DA, Ness KK, Neglia JP, Whitton JA, Green DM, Zeltzer LK, et al. Fatigue and sleep disturbance in adult survivors of childhood cancer: a report from the childhood cancer survivor study (CCSS) Sleep. 2008;31(2):271. - PMC - PubMed

[9] Aistars J, editor. Oncology Nursing Forum. 1987. Fatigue in the cancer patient: a conceptual approach to a clinical problem. - PubMed

[10] Aistars J, editor. Oncology Nursing Forum. 1987. Fatigue in the cancer patient: a conceptual approach to a clinical problem. - PubMed

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Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study

Affiliations

Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin's lymphoma: a report from the Childhood Cancer Survivor Study

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