High prevalence of parent‐reported sleep problems in pediatric patients with acute lymphoblastic leukemia after induction therapy

Objective To assess sleep problems (prevalence and predictors) in pediatric patients with acute lymphoblastic leukemia (ALL) after the most intensive phase of therapy (induction). Methods Patients (≥2 years) treated according to the Dutch ALL‐11 protocol were included. Sleep was measured using parent‐reports and self‐reports (Children's Sleep Habits Questionnaire; CSHQ) and actigraphy. Parental sleep (Medical Outcome Study Sleep Scale) and distress and parenting problems (Distress Thermometer for Parents) were assessed with questionnaires. Z‐scores were calculated for total CSHQ scores using age‐appropriate scores of healthy Dutch children. The prevalence of sleep problems (defined as a Z‐score > 1) in patients with ALL was compared to healthy children (chi‐square tests). Actigraphic sleep estimates were collected in healthy Dutch children (n = 86, 2‐18 years) for comparison with patients (linear regression). Determinants of parent‐reported child sleep (total CSHQ Z‐score) were identified with regression models. Results Responses were collected for 124 patients (response rate 67%), comprising 123 parent‐reports, 34 self‐reports, and 69 actigraphy assessments. Parents reported sleep problems in 38.0% of the patients compared to 15.2% in healthy children (P