“This study shows that 38% of children with ALL have sleep problems; that’s twice as many as healthy children. We also see that sleep problems persist even one year after the treatment,” says Raphaële. Young children, teenagers and girls are at greater risk of sleep problems, as are children who are treated with dexamethasone, are physically less active, or have another chronic disease in addition to cancer. Parents of children with cancer also often suffer from insomnia. 3.5 years after their child’s diagnosis, 37% of parents still have sleep problems. This is more than twice as many as the general population. The majority of parents indicate that they feel stressed. Poor sleep and stress make it particularly difficult for parents to help their child develop healthy sleeping habits again.
“Sleeping in hospital is not conducive to a good night’s rest,” she continues. “On average, children are ‘disturbed’ 14 times a night by staff entering the room or alarms going off. The alarm of an infusion pump goes off five times a night on average, for a total of nine minutes. That is why we are conducting a study into silent infusion pumps, whose alarms are longer heard in the room, but only in the nurses’ office. At the Máxima there is also the possibility to put the drips outside the room. In addition, there is the DEXA days study led by Prof. van den Heuvel and Prof. Grootenhuis where children on dexamethasone are also given hydrocortisone (adrenocortical hormone) to establish whether this helps them sleep better. The so-called Suspect study looks into the relationship between sleep, stress and cognitive problems (such as impaired concentration or impaired memory). Teenagers and young adults struggling with insomnia can also participate in the MICADO study, which looks into the treatment of insomnia through an online course.”
New care path
More knowledge of sleep is important to prevent (serious) sleep problems. That is why information material on this subject is being developed for both parents and children. Raphaële van Litsenburg says, “In addition to the ongoing studies, a care path for sleep problems will be set up in the Máxima. In this way, we try to put into practice everything we have learned during our research. Anything to prevent sleep problems.”
Tips to treat sleep problems
- Ensure a healthy sleeping pattern
- Go to bed and get out of bed every day at about the same times
- Exercise sufficiently during the day
- Try to relax toward evening: no busy activities before bedtime
- Avoid screens before bedtime
- Establish a predictable evening ritual: then the body will know it is bedtime
This article was written jointly by Dr. Raphaële van Litsenburg, pediatrician-epidemiologist and Rosanneke Jongbloed, VOKK.