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Sleep problems linger after childhood cancer

Sleep problems and fatigue are common among childhood cancer survivors and can dramatically reduce their thinking and reasoning abilities.

Sleep problems linger after childhood cancer

Sleep problems and fatigue are common among childhood cancer survivors and can dramatically reduce their thinking and reasoning abilities.

Advances in childhood cancer treatment mean about 80 percent of patients today will become long-term survivors. But therapies also leave survivors at risk for a variety of problems. Particularly vulnerable for neurocognitive problems are those who were younger than age 6 when their cancer was found or those whose treatment included high-dose cranial irradiation, steroids or certain chemotherapy agents known as anti-metabolites. These problems can profoundly impact a survivor's life as cognitive problems make it less likely survivors will hold a job, live independently, marry or form other social connections. Designing more effective therapies requires better understanding of that variability.

Researchers in America and Canada did an analysis of questionnaires completed by 1,426 participants in the Childhood Cancer Survivor Study, an investigation of long-term outcomes of survivors of eight different childhood cancers who were treated between 1970 and 1986, and 384 healthy siblings. Participants completed several tests proven to reliably measure memory, organization, task efficiency and emotional regulation - all indicators of neurocognitive functioning. The participants also completed questionnaires to measure fatigue, sleep quality, daytime sleepiness and vitality.

More than 20 percent of participants reported cognitive impairment, such as trouble with attention and memory. Those at a two-fold higher risk of memory problems included survivors treated with high-dose cranial irradiation as well as those who scored highest on measures of daytime sleepiness and decreased vitality. Research found survivors with low vitality scores were three times more likely to have problems controlling their emotions. Fatigue and poor sleep quality were also linked to an increased risk of neurocognitive problems. The link was independent of the survivor's age, sex or cancer treatment.

This is the first study to show that childhood cancer survivors are particularly vulnerable to impaired memory, emotional control, organization and related neurocognitive skills due to fatigue and sleep problems. The researchers suggest that survivors might benefit from periodic screenings for fatigue and sleep disturbances and hope this will lead to new strategies for improved neurocognitive functioning in this growing population.
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