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Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin’s lymphoma: a report from the Childhood Cancer Survivor Study

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Abstract

Purpose

Survivors of pediatric Hodgkin’s lymphoma (HL) are at risk for a number of debilitating late effects. Excessive fatigue and poor sleep quality are primary complaints of HL survivors. Understanding the emotional and physical factors that influence fatigue and sleep quality may provide opportunities for intervention to improve health-related quality of life for HL survivors.

Methods

Data from 751 adult survivors of childhood HL who participated in the Childhood Cancer Survivor Study (CCSS) from 2000–2002 were analyzed. Multivariable logistic regression analyses investigated the demographic, psychological, and physical variables that predicted clinically significant levels of poor sleep quality, fatigue, and excessive daytime sleepiness.

Results

Survivors’ self-reported level of emotional distress, pain, and physical functioning limitations did not differ from population norms. Clinically elevated levels of emotional distress (OR 8.38, 95% CI 4.28–16.42) and pain (OR 3.73, 95% CI 2.09–6.67) increased the risk for endorsing elevated levels of fatigue. Survivors with elevated levels of emotional distress (OR 6.83, 95% CI 2.71–15.90) and pain (OR 5.27, 95% CI 1.78–15.61) were more likely to report poor sleep quality. Pain (OR 2.11, 95% CI 1.39–3.34) was related to excessive daytime sleepiness.

Conclusions

Emotional and physical factors are associated with elevated levels of fatigue, excessive daytime sleepiness, and poor sleep quality in survivors of pediatric HL. This is consistent with findings from research conducted with non-cancer survivors.

Implications for cancer survivors

These results suggest that interventions designed to target sleep and fatigue difficulties in the general population may be well suited for pediatric HL survivors as well.

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Author information

Authors and Affiliations

  1. UVA Neurocognitive Assessment Lab, The University of Virginia Health System, Charlottesville, VA, 22908, USA

    Amanda M. Rach

  2. Department of Psychology, St. Jude Children’s Research Hospital, 262 Danny Thomas Place, Mail Stop 101, Memphis, TN, 38105, USA

    Valerie McLaughlin Crabtree & Brooklee Tynes

  3. Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, MS 735, Room S6047, 262 Danny Thomas Place, Memphis, TN, 38105, USA

    Tara M. Brinkman

  4. Division of Pediatric Hematology-Oncology, David Geffen School of Medicine at UCLA, 22-464 MDCC, 10833 LeConte Ave, Los Angeles, CA, 90095, USA

    Lonnie Zeltzer

  5. Emory Children’s Center, 2015 Uppergate Dr. 416D, Atlanta, GA, 30322, USA

    Jordan Gilleland Marchak

  6. Biostatistics, St. Jude Children’s Research Hospital, MS 768, Room 6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA

    Deokumar Srivastava

  7. Department of Medical Social Sciences, Northwestern University, 633 N St. Clair 19th Floor, Chicago, IL, 60611, USA

    Jin-Shei Lai

  8. Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, MS 735, Room S6010, 262 Danny Thomas Place, Memphis, TN, 38105, USA

    Leslie L. Robison

  9. Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, MS 735, 262 Danny Thomas Place, Memphis, TN, 38105, USA

    Gregory T. Armstrong

  10. Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Ms 735, Room S6037, 262 Danny Thomas Place, Memphis, TN, 38105, USA

    Kevin R. Krull

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  1. Amanda M. Rach
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  8. Jin-Shei Lai
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Corresponding author

Correspondence to Kevin R. Krull.

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Funding

This study was funded by Grant No. CA55727 from the National Cancer Institute, by the Cancer Center Support CORE Grant No. CA21765, and by the American Lebanese Syrian Associated Charities.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Rach, A.M., Crabtree, V.M., Brinkman, T.M. et al. Predictors of fatigue and poor sleep in adult survivors of childhood Hodgkin’s lymphoma: a report from the Childhood Cancer Survivor Study. J Cancer Surviv 11, 256–263 (2017). https://doi.org/10.1007/s11764-016-0583-y

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  • DOI: https://doi.org/10.1007/s11764-016-0583-y

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