Sleep Quality and Fatigue in Childhood Cancer Survivors
Summary
Survivors of childhood cancer frequently experience persistent disturbances in sleep quality and elevated levels of fatigue that extend well into adulthood. These late effects arise from a combination of treatment-related factors—such as exposure to cranial irradiation, corticosteroids and anthracyclines—and ensuing chronic health conditions including cardiometabolic complications and endocrine dysfunction. Common manifestations include insomnia, fragmented sleep with frequent night‐time awakenings, reduced sleep duration and circadian misalignment. Fatigue in this population often presents as pervasive daytime sleepiness that is not alleviated by rest and may exacerbate cognitive difficulties, mood disturbances and reduced physical activity. Behavioural, psychosocial and environmental factors—ranging from erratic sleep schedules and co-sleeping practices to anxiety and depression—also contribute. Assessment relies on self-report instruments and objective measures such as actigraphy. Intervention strategies encompass cognitive behavioural therapy for insomnia, sleep hygiene education and, in some cases, pharmacological support. Addressing sleep disturbances and fatigue is vital for enhancing neurocognitive functioning, quality of life and long-term health outcomes in this growing survivor population.
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Sleep Quality and Fatigue in Childhood Cancer Survivors publication trend
The graph below shows the total number of articles in sleep quality and fatigue in childhood cancer survivors across all publications each year (not limited to Nature Index journals).
Technical terms
Insomnia: Difficulty initiating or maintaining sleep, often accompanied by daytime impairment.
Fatigue: Persistent state of physical and mental exhaustion not relieved by rest.
Circadian rhythm: Endogenous 24-hour cycle regulating sleep-wake patterns and other physiological processes.
Pittsburgh Sleep Quality Index (PSQI): Self-report questionnaire assessing multiple domains of sleep quality and disturbances.
Actigraphy: Non-invasive method using a wearable sensor to record movement and infer sleep-wake cycles.
Sleep efficiency: Proportion of time spent asleep relative to time spent in bed, expressed as a percentage.
References
- Mechanisms of sleep disturbances in long-term cancer survivors: a childhood cancer survivor study report. JNCI Cancer Spectrum (2024).
- Prevalence of Sleep Disorders, Risk Factors and Sleep Treatment Needs of Adolescents and Young Adult Childhood Cancer Patients in Follow-Up after Treatment. Cancers (2022).
- Insomnia Symptoms and Daytime Fatigue Co-Occurrence in Adolescent and Young Adult Childhood Cancer Patients in Follow-Up after Treatment: Prevalence and Associated Risk Factors. Cancers (2022).
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