Short sleep duration and physical and psychological health outcomes among adult survivors of childhood cancer
Margaret M. Lubas
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorBelinda N. Mandrell
Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorKirsten K. Ness
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorDeo Kumar Srivastava
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorMatthew J. Ehrhardt
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorZhaoming Wang
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorMelissa M. Hudson
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorLeslie L. Robison
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorKevin R. Krull
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorCorresponding Author
Tara M. Brinkman
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
Correspondence
Tara M. Brinkman, Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN 38105, USA.
Email:[email protected]
Search for more papers by this authorMargaret M. Lubas
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorBelinda N. Mandrell
Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorKirsten K. Ness
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorDeo Kumar Srivastava
Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorMatthew J. Ehrhardt
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorZhaoming Wang
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorMelissa M. Hudson
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorLeslie L. Robison
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorKevin R. Krull
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
Search for more papers by this authorCorresponding Author
Tara M. Brinkman
Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
Correspondence
Tara M. Brinkman, Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, 262 Danny Thomas Place, MS 735, Memphis, TN 38105, USA.
Email:[email protected]
Search for more papers by this authorAbstract
Background
To examine associations between phenotypes of short sleep duration and clinically assessed health conditions in long-term survivors of childhood cancer.
Methods
Survivors recruited from the St. Jude Lifetime Cohort (n = 911; 52% female; mean age 34 years; 26 years postdiagnosis) completed behavioral health surveys and underwent comprehensive physical examinations. Sleep was assessed with the Pittsburgh Sleep Quality Index. Short sleep was defined as ≤6 h per night with phenotypes of short sleep including poor sleep efficiency (<85%), prolonged sleep onset latency (SOL; ≥30 min), and wake after sleep onset (≥3 times per week). Covariates included childhood cancer treatment exposures, demographics, body mass index, and physical inactivity. Separate modified Poisson regression models were computed for each health category to estimate relative risks (RR) and 95% confidence intervals (CI). Multinomial logistic regression models examined associations between sleep and an aggregated burden of chronic health conditions.
Results
Short sleep duration was reported among 44% (95% CI 41%–47%) of survivors. In multivariable models, short sleep duration alone was associated with pulmonary (RR = 1.35, 95% CI 1.08–1.69), endocrine (RR = 1.22, 95% CI 1.06–1.39) and gastrointestinal/hepatic conditions (RR = 1.46, 95% CI 1.18–1.79), and anxiety (RR 3.24, 95% CI 1.64–6.41) and depression (RR = 2.33, 95% CI 1.27–4.27). Short sleep with prolonged SOL was associated with a high/severe burden of health conditions (OR = 2.35, 95% CI 1.12–4.94).
Conclusions
Short sleep duration was associated with multiple clinically ascertained adverse health conditions. Although the temporality of these associations cannot be determined in this cross-sectional study, sleep is modifiable and improving sleep may improve long-term health in survivors.
CONFLICT OF INTEREST
The authors declared that there is no conflict of interest.
Supporting Information
| Filename | Description |
|---|---|
| pbc28988-sup-0001-TableS1.docx46.2 KB | Table S1. Intervention study inclusion and exclusion criteria for sleep and cognition intervention Table S2a. Frequency of grades 2-4 cardiovascular conditions in sample of SJLIFE survivors (n = 911) Table S2b. Frequency of grades 2-4 endocrine conditions in sample of SJLIFE survivors (n = 911) Table S2c. Frequency of grades 2-4 pulmonary conditions in sample of SJLIFE survivors (n = 911) Table S2d. Frequency of grades 2-4 renal conditions in sample of SJLIFE survivors (n = 911) Table S2e. Frequency of grades 2-4 musculoskeletal conditions in sample of SJLIFE survivors (n = 911) Table S2f. Frequency of grades 2-4 gastrointestinal/hepatic conditions in sample of SJLIFE survivors (n = 911) Table S2g. Frequency of grades 2-4 neurologic conditions in sample of SJLIFE survivors (n = 911) Table S3. Frequency of health severity/burden categories Table S4. Multivariable† associations between phenotypes of short sleep and severity/burden of physical health conditions (n = 897) ‡ |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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