Sleep in parents of children and adolescents with cancer

Abstract

Numerous studies have identified sleep as a major concern for parents of children and adolescents with cancer. Prevalence estimates of parental sleep disruption range between 37-71%, which is reflected in significant impairments in sleep quantity and quality. Poor sleep is associated with long-term adverse consequences to parents’ physical and psychological health and may have a direct impact on their capacity to care for their unwell child. Despite a well-documented need for effective sleep-targeted interventions in this population, none currently exist. This thesis comprises: 1.) A systematic review of existing non-pharmacological interventions addressing sleep in children/adolescents with a chronic illness; 2.) A cross-sectional controlled study (n=193), comparing the prevalence and predictors of self-reported sleep quantity and quality, mood, rumination and daytime functioning among parents of childhood cancer patients receiving outpatient treatment with parents of age-matched healthy children; 3.) A multi-perspective qualitative analysis (n=26) of parent and healthcare professional perceptions of barriers and facilitators to parents’ sleep on the paediatric oncology ward, and preferences for intervention; and 4.) A pilot evaluation (n=17) to establish the feasibility and acceptability of a theoretically driven, multi-component sleep intervention (CAT NAP: Carers at Night in Paediatrics), specifically tailored for parents of children with cancer sleeping overnight on the hospital ward. This thesis provides a comprehensive synthesis of sleep problems in parents of children and adolescents with cancer. It documents the systematic development and trial of an evidence-based intervention to support parents’ sleep needs and overall wellbeing, and provides directions for future research, including the potential applicability of cognitive behavioural therapy for insomnia in this population.