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Erschienen in: Supportive Care in Cancer 9/2016

23.04.2016 | Original Article

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

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

Erschienen in: Supportive Care in Cancer | Ausgabe 9/2016

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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.
Literatur
1.
Zurück zum Zitat Pound CM, Clark C, Ni A, Athale U, Lewis V, Halton JM (2012) Corticosteroids, behavior, and quality of life in children treated for acute lymphoblastic leukemia; a multicentered trial. J Pediatr Hematol Oncol 34(7):517–23. doi:10.1097/MPH.0b013e318257fdac CrossRefPubMed Pound CM, Clark C, Ni A, Athale U, Lewis V, Halton JM (2012) Corticosteroids, behavior, and quality of life in children treated for acute lymphoblastic leukemia; a multicentered trial. J Pediatr Hematol Oncol 34(7):517–23. doi:10.​1097/​MPH.​0b013e318257fdac​ CrossRefPubMed
3.
Zurück zum Zitat Eiser C, Davies H, Jenney M, Stride C, Glaser A (2006) HRQOL implications of treatment with dexamethasone for children with acute lymphoblastic leukemia (ALL). Pediatr Blood Cancer 46(1):35–9. doi:10.1002/pbc.20432 CrossRefPubMed Eiser C, Davies H, Jenney M, Stride C, Glaser A (2006) HRQOL implications of treatment with dexamethasone for children with acute lymphoblastic leukemia (ALL). Pediatr Blood Cancer 46(1):35–9. doi:10.​1002/​pbc.​20432 CrossRefPubMed
4.
Zurück zum Zitat Bostrom BC, Sensel MR, Sather HN, Gaynon PS, La MK, Johnston K et al (2003) Dexamethasone versus prednisone and daily oral versus weekly intravenous mercaptopurine for patients with standard-risk acute lymphoblastic leukemia: a report from the Children’s Cancer Group. Blood 101(10):3809–17CrossRefPubMed Bostrom BC, Sensel MR, Sather HN, Gaynon PS, La MK, Johnston K et al (2003) Dexamethasone versus prednisone and daily oral versus weekly intravenous mercaptopurine for patients with standard-risk acute lymphoblastic leukemia: a report from the Children’s Cancer Group. Blood 101(10):3809–17CrossRefPubMed
5.
Zurück zum Zitat Ahmed SF, Tucker P, Mushtaq T, Wallace AM, Williams DM, Hughes IA (2002) Short-term effects on linear growth and bone turnover in children randomized to receive prednisolone or dexamethasone. Clin Endocrinol (Oxf) 57(2):185–91. doi:10.1046/j.1365-2265.2002.01580.x CrossRef Ahmed SF, Tucker P, Mushtaq T, Wallace AM, Williams DM, Hughes IA (2002) Short-term effects on linear growth and bone turnover in children randomized to receive prednisolone or dexamethasone. Clin Endocrinol (Oxf) 57(2):185–91. doi:10.​1046/​j.​1365-2265.​2002.​01580.​x CrossRef
6.
Zurück zum Zitat Mattano Jr LA, Devidas M, Nachman JB, Sather HN, Hunger SP, Steinherz PG et al. Effect of alternate-week versus continuous dexamethasone scheduling on the risk of osteonecrosis in paediatric patients with acute lymphoblastic leukaemia: results from the CCG-1961 randomised cohort trial. Lancet Oncol. 2012;13(9):906–15. doi:http://dx.doi.org/10.1016/S1470-2045(12)70274-7. Mattano Jr LA, Devidas M, Nachman JB, Sather HN, Hunger SP, Steinherz PG et al. Effect of alternate-week versus continuous dexamethasone scheduling on the risk of osteonecrosis in paediatric patients with acute lymphoblastic leukaemia: results from the CCG-1961 randomised cohort trial. Lancet Oncol. 2012;13(9):906–15. doi:http://​dx.​doi.​org/​10.​1016/​S1470-2045(12)70274-7.
7.
Zurück zum Zitat te Winkel ML, Pieters R, Hop WCJ, de Groot-Kruseman HA, Lequin MH, van der Sluis IM et al (2011) Prospective study on incidence, risk factors, and long-term outcome of osteonecrosis in pediatric acute lymphoblastic leukemia. J Clin Oncol. doi:10.1200/jco.2011.37.3217 te Winkel ML, Pieters R, Hop WCJ, de Groot-Kruseman HA, Lequin MH, van der Sluis IM et al (2011) Prospective study on incidence, risk factors, and long-term outcome of osteonecrosis in pediatric acute lymphoblastic leukemia. J Clin Oncol. doi:10.​1200/​jco.​2011.​37.​3217
8.
Zurück zum Zitat Warris LT, van den Heuvel-Eibrink MM, den Hoed MAH, Aarsen FK, Pieters R, van den Akker ELT (2014) Does dexamethasone induce more neuropsychological side effects than prednisone in pediatric acute lymphoblastic leukemia? A systematic review. Pediatr Blood Cancer 61(7):1313–8. doi:10.1002/pbc.24988 CrossRefPubMed Warris LT, van den Heuvel-Eibrink MM, den Hoed MAH, Aarsen FK, Pieters R, van den Akker ELT (2014) Does dexamethasone induce more neuropsychological side effects than prednisone in pediatric acute lymphoblastic leukemia? A systematic review. Pediatr Blood Cancer 61(7):1313–8. doi:10.​1002/​pbc.​24988 CrossRefPubMed
9.
Zurück zum Zitat Hart CN, Palermo TM, Rosen CL, Hart CN, Palermo TM, Rosen CL (2005) Health-related quality of life among children presenting to a pediatric sleep disorders clinic. Behav Sleep Med 3(1):4–17CrossRefPubMed Hart CN, Palermo TM, Rosen CL, Hart CN, Palermo TM, Rosen CL (2005) Health-related quality of life among children presenting to a pediatric sleep disorders clinic. Behav Sleep Med 3(1):4–17CrossRefPubMed
10.
Zurück zum Zitat Buckhalt J, El-Sheikh M, Keller P (2007) Children’s sleep and cognitive functioning: Race and socioeconomic status as moderators of effects. Child Dev 78:213–31CrossRefPubMed Buckhalt J, El-Sheikh M, Keller P (2007) Children’s sleep and cognitive functioning: Race and socioeconomic status as moderators of effects. Child Dev 78:213–31CrossRefPubMed
11.
Zurück zum Zitat Lavigne J, Arend R, Rosenbaum D, Smith A, Weissbluth M, Binns H (1999) Sleep and behavior problems among preschoolers. J Dev Behav Pediatr 20:164–9CrossRefPubMed Lavigne J, Arend R, Rosenbaum D, Smith A, Weissbluth M, Binns H (1999) Sleep and behavior problems among preschoolers. J Dev Behav Pediatr 20:164–9CrossRefPubMed
12.
Zurück zum Zitat Smaldone A, Honig J, Byrne M (2007) Sleepless in America: inadequate sleep and relationships to health and well-being of our nation’s children. Pediatrics 119(Supplement 1):S29–S37CrossRefPubMed Smaldone A, Honig J, Byrne M (2007) Sleepless in America: inadequate sleep and relationships to health and well-being of our nation’s children. Pediatrics 119(Supplement 1):S29–S37CrossRefPubMed
14.
15.
Zurück zum Zitat Everson CA (1993) Sustained sleep deprivation impairs host defense. Am J Physiol 265(5 Pt 2):R1148–54PubMed Everson CA (1993) Sustained sleep deprivation impairs host defense. Am J Physiol 265(5 Pt 2):R1148–54PubMed
16.
Zurück zum Zitat Hui L, Hua F, Diandong H, Hong Y, Hui L, Hua F et al (2007) Effects of sleep and sleep deprivation on immunoglobulins and complement in humans. Brain Behav Immun 21(3):308–10CrossRefPubMed Hui L, Hua F, Diandong H, Hong Y, Hui L, Hua F et al (2007) Effects of sleep and sleep deprivation on immunoglobulins and complement in humans. Brain Behav Immun 21(3):308–10CrossRefPubMed
19.
20.
Zurück zum Zitat Hinds PS, Hockenberry MJ, Gattuso JS, Srivastava DK, Tong X, Jones H et al (2007) Dexamethasone alters sleep and fatigue in pediatric patients with acute lymphoblastic leukemia. Cancer 110(10):2321–30CrossRefPubMed Hinds PS, Hockenberry MJ, Gattuso JS, Srivastava DK, Tong X, Jones H et al (2007) Dexamethasone alters sleep and fatigue in pediatric patients with acute lymphoblastic leukemia. Cancer 110(10):2321–30CrossRefPubMed
21.
Zurück zum Zitat Rosen G, Harris AK, Liu M, Dreyfus J, Krueger J, Messinger YH. The effects of dexamethasone on sleep in young children with acute lymphoblastic leukemia. Sleep Med. 2015;16(4):503–9. doi:http://dx.doi.org/10.1016/j.sleep.2014.11.002. Rosen G, Harris AK, Liu M, Dreyfus J, Krueger J, Messinger YH. The effects of dexamethasone on sleep in young children with acute lymphoblastic leukemia. Sleep Med. 2015;16(4):503–9. doi:http://​dx.​doi.​org/​10.​1016/​j.​sleep.​2014.​11.​002.
22.
Zurück zum Zitat Sung L, Yanofsky R, Klaassen RJ, Dix D, Pritchard S, Winick N et al (2011) Quality of life during active treatment for pediatric acute lymphoblastic leukemia. Int J Cancer 128(5):1213–20. doi:10.1002/ijc.25433 CrossRefPubMed Sung L, Yanofsky R, Klaassen RJ, Dix D, Pritchard S, Winick N et al (2011) Quality of life during active treatment for pediatric acute lymphoblastic leukemia. Int J Cancer 128(5):1213–20. doi:10.​1002/​ijc.​25433 CrossRefPubMed
23.
Zurück zum Zitat Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A, American Academy of Sleep Medicine (2006) Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep 29(10):1263–76PubMed Mindell JA, Kuhn B, Lewin DS, Meltzer LJ, Sadeh A, American Academy of Sleep Medicine (2006) Behavioral treatment of bedtime problems and night wakings in infants and young children. Sleep 29(10):1263–76PubMed
24.
Zurück zum Zitat Hollingshead A (1975) Four factor index of social status Hollingshead A (1975) Four factor index of social status
26.
Zurück zum Zitat Owens JA, Spirito A, McGuinn M (2000) The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 23(8):1043–51PubMed Owens JA, Spirito A, McGuinn M (2000) The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 23(8):1043–51PubMed
27.
Zurück zum Zitat Acebo C, Sadeh A, Seifer R, Tzischinsky O, Hafer A, Carskadon MA (2005) Sleep/wake patterns derived from activity monitoring and maternal report for healthy 1- to 5 year-old children. Sleep 28:1568–77PubMed Acebo C, Sadeh A, Seifer R, Tzischinsky O, Hafer A, Carskadon MA (2005) Sleep/wake patterns derived from activity monitoring and maternal report for healthy 1- to 5 year-old children. Sleep 28:1568–77PubMed
29.
Zurück zum Zitat Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–91CrossRefPubMed Faul F, Erdfelder E, Lang A-G, Buchner A (2007) G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 39(2):175–91CrossRefPubMed
32.
Zurück zum Zitat Gregory AM, Caspi A, Eley TC, Moffitt TE, O’Connor TG, Poulton R (2005) Prospective longitudinal associations between persistent sleep problems in childhood and anxiety and depression disorders in adulthood. J Abnorm Child Psychol 33(2):157–63CrossRefPubMed Gregory AM, Caspi A, Eley TC, Moffitt TE, O’Connor TG, Poulton R (2005) Prospective longitudinal associations between persistent sleep problems in childhood and anxiety and depression disorders in adulthood. J Abnorm Child Psychol 33(2):157–63CrossRefPubMed
33.
Zurück zum Zitat Shanahan L, Copeland WE, Angold A, Bondy CL, Costello EJ. Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry. 2014;53(5):550–8. doi:http://dx.doi.org/10.1016/j.jaac.2013.12.029. Shanahan L, Copeland WE, Angold A, Bondy CL, Costello EJ. Sleep problems predict and are predicted by generalized anxiety/depression and oppositional defiant disorder. J Am Acad Child Adolesc Psychiatry. 2014;53(5):550–8. doi:http://​dx.​doi.​org/​10.​1016/​j.​jaac.​2013.​12.​029.
34.
Zurück zum Zitat Fauci A (1976) Mechanisms of corticosteroid action on lymphocyte subpopulations. II. Differential effects of in vivo hydrocortisone, prednisone and dexamethasone on in vitro expression of lymphocyte function. Clin Exp Immunol 24(1):54PubMedPubMedCentral Fauci A (1976) Mechanisms of corticosteroid action on lymphocyte subpopulations. II. Differential effects of in vivo hydrocortisone, prednisone and dexamethasone on in vitro expression of lymphocyte function. Clin Exp Immunol 24(1):54PubMedPubMedCentral
35.
Zurück zum Zitat Sayers G, Travis R (1970) Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs. The pharmacological basis of therapeutics. Macmillan, New York, pp 1604–42 Sayers G, Travis R (1970) Adrenocorticotropic hormone; adrenocortical steroids and their synthetic analogs. The pharmacological basis of therapeutics. Macmillan, New York, pp 1604–42
37.
Zurück zum Zitat Born J, DeKloet ER, Wenz H, Kern W, Fehm HL (1991) Gluco- and antimineralocorticoid effects on human sleep: a role of central corticosteroid receptors. Am J Physiol Endocrinol Metab 260(2):E183–E8 Born J, DeKloet ER, Wenz H, Kern W, Fehm HL (1991) Gluco- and antimineralocorticoid effects on human sleep: a role of central corticosteroid receptors. Am J Physiol Endocrinol Metab 260(2):E183–E8
38.
Zurück zum Zitat Fehm H, Benkowitsch R, Kern W, Fehm-Wolfsdorf G, Pauschinger P, Born J (1986) Influences of corticosteroids, dexamethasone and hydrocortisone on sleep in humans. Neuropsychobiology 16(4):198–204CrossRefPubMed Fehm H, Benkowitsch R, Kern W, Fehm-Wolfsdorf G, Pauschinger P, Born J (1986) Influences of corticosteroids, dexamethasone and hydrocortisone on sleep in humans. Neuropsychobiology 16(4):198–204CrossRefPubMed
39.
Zurück zum Zitat Feinberg M, Carroll B, King D, Greden J (1984) The effect of dexamethasone on sleep: preliminary results in eleven patients. Biol Psychiatry 19(5):771–5PubMed Feinberg M, Carroll B, King D, Greden J (1984) The effect of dexamethasone on sleep: preliminary results in eleven patients. Biol Psychiatry 19(5):771–5PubMed
40.
Zurück zum Zitat Vallance K, Yang J, Li J, Crabtree VM, Hinds PS, Mandrell BN (2011) Disturbed sleep in pediatric patients with leukemia: the potential role of interleukin-6 (−174GC) and tumor necrosis factor (−308GA) polymorphism. Oncol Nurs Forum 38(5):E365–72CrossRefPubMed Vallance K, Yang J, Li J, Crabtree VM, Hinds PS, Mandrell BN (2011) Disturbed sleep in pediatric patients with leukemia: the potential role of interleukin-6 (−174GC) and tumor necrosis factor (−308GA) polymorphism. Oncol Nurs Forum 38(5):E365–72CrossRefPubMed
41.
Zurück zum Zitat Wolfson A, Lacks P, Futterman A (1992) Effects of parent training on infant sleeping patterns, parents’ stress, and perceived parental competence. J Consult Clin Psychol 60(1):41–8CrossRefPubMed Wolfson A, Lacks P, Futterman A (1992) Effects of parent training on infant sleeping patterns, parents’ stress, and perceived parental competence. J Consult Clin Psychol 60(1):41–8CrossRefPubMed
42.
Zurück zum Zitat Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L et al (2015) National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health 1(1):40–3. doi:10.1016/j.sleh.2014.12.010 CrossRef Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L et al (2015) National Sleep Foundation’s sleep time duration recommendations: methodology and results summary. Sleep Health 1(1):40–3. doi:10.​1016/​j.​sleh.​2014.​12.​010 CrossRef
44.
Zurück zum Zitat Owens JA, Dalzell V. Use of the ‘BEARS’ sleep screening tool in a pediatric residents’ continuity clinic: a pilot study. Sleep Med. 2005;6(1):63–9. doi:http://dx.doi.org/10.1016/j.sleep.2004.07.015. Owens JA, Dalzell V. Use of the ‘BEARS’ sleep screening tool in a pediatric residents’ continuity clinic: a pilot study. Sleep Med. 2005;6(1):63–9. doi:http://​dx.​doi.​org/​10.​1016/​j.​sleep.​2004.​07.​015.
Metadaten
Titel
The impact of dexamethasone and prednisone on sleep in children with acute lymphoblastic leukemia
verfasst von
Lauren C. Daniel
Yimei Li
Jacqueline D. Kloss
Anne F. Reilly
Lamia P. Barakat
Publikationsdatum
23.04.2016
Verlag
Springer Berlin Heidelberg
Erschienen in
Supportive Care in Cancer / Ausgabe 9/2016
Print ISSN: 0941-4355
Elektronische ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-016-3234-y

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