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Supportive Care in Cancer

Published in:

01-09-2016 | Original Article

The impact of dexamethasone and prednisone on sleep in children with acute lymphoblastic leukemia

Authors: Lauren C. Daniel, Yimei Li, Jacqueline D. Kloss, Anne F. Reilly, Lamia P. Barakat

Published in: Supportive Care in Cancer | Issue 9/2016

Abstract

Purpose

Corticosteroids can affect sleep patterns, mood, and behavior. Two of the most commonly prescribed corticosteroids in acute lymphoblastic leukemia (ALL), dexamethasone and prednisone, may impact sleep differently, but no research has compared these medications in children. The current study tested the hypothesis that dexamethasone and prednisone differentially affect sleep in children with ALL to understand how these medications contribute to health-related quality of life (HRQL).

Methods

Parents of 81 children 3–12 years old in maintenance therapy for ALL completed a baseline measure of child sleep (dexamethasone n = 55, prednisone n = 26), and 61 parents returned 28 days of child sleep diaries starting the first day of a 5-day steroid course (dexamethasone n = 43, prednisone n = 18). Parents also completed measures of HRQL and fatigue on the last day of steroids and the last day of the month.

Results

At baseline, parents reported more sleep disturbances in children taking dexamethasone than prednisone. Across the month, children taking dexamethasone experienced poorer sleep quality compared to children taking prednisone. During corticosteroid treatment, children taking dexamethasone also experienced more night awakenings than children taking prednisone. Sleep variables accounted for almost half of the variance in HRQL during time off steroids and also significantly contributed to fatigue during the corticosteroids course and time off corticosteroids.

Conclusions

Sleep is an essential component of HRQL in children taking corticosteroids, and the impact on sleep is more pronounced in children taking dexamethasone compared to prednisone. Screening for sleep disturbances and offering brief interventions to manage steroid-related sleep disruptions may improve HRQL.

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Title: The impact of dexamethasone and prednisone on sleep in children with acute lymphoblastic leukemia
Authors: Lauren C. Daniel
Yimei Li
Jacqueline D. Kloss
Anne F. Reilly
Lamia P. Barakat
Publication date: 01-09-2016
Publisher: Springer Berlin Heidelberg
Published in: Supportive Care in Cancer / Issue 9/2016
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI: https://doi.org/10.1007/s00520-016-3234-y

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