130 - Device-Assessed Sleep Efficiency Among Adolescent and Young Adults (AYA) During Cancer Treatment

Publication Number: 2125.130

Kethan Shirodkar, Childrens Hospital of Philadelphia, Philadelphia, PA, United States; Polina Poliakova, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Jonathan Mitchell, CHOP, Philadelphia, PA, United States; Alexandra Psihogios, Northwestern University The Feinberg School of Medicine, Chicago, IL, United States; Lauren C. Daniel, Rutgers University Camden, Camden, NJ, United States; Tracey Jubelirer, Children's Hospital of Philadelphia, Philadelphia, PA, United States; Lisa Schwartz, Children's Hospital of Philadelphia/UPENN, Philadelphia, PA, United States; Sara King-Dowling, Children's Hospital of Philadelphia, Philadelphia, PA, United States

Background: Sleep quality is important for health and well-being, especially for adolescents and young adults (AYA) with cancer who may face both developmental- and treatment-related sleep disruptions. Limited research exists on sleep quality for AYA on treatment, particularly device-assessed (e.g., actigraphy) sleep efficiency (SE), which has previously been associated with health outcomes in oncology.

Objective: 1) Characterize actigraphy-assessed SE in AYA receiving cancer treatment and 2) examine demographic, medical, and psychosocial correlates of SE.

Design/Methods: AYA (N=80, ages 14-24) receiving cancer treatment were recruited from the Children’s Hospital of Philadelphia. Diagnoses and treatment information were extracted from the electronic medical record. AYA completed measures of demographics, anxiety, depression, and pain interference and wore an accelerometer (ActiGraph GT9X) for 2 weeks to assess physical activity (PA) and SE. Average nighttime sleep duration and SE, the percentage of time in bed spent asleep, was scored in ActiLife using the Sadeh algorithm. Only AYA who wore the device for >3 nights were included in the analyses [n(%)=62(78%), Mage(SD)=17.6(2.1), 37% male, 35% non-Hispanic White, 57% leukemia/lymphoma]. Pearson's correlations, t-tests, and ANOVAs were used to examine potential biopsychosocial correlates of SE.

Results: AYA slept an average of 6.1± 0.7 hrs/night and SE ranged from 68.0%-94.2% (M=81.0±5.9). Forty-eight (77.4%) AYA had SE < 85%, suggestive of clinical insomnia. Overall, there were no demographic [age (r=-.02, p=.88), sex (t=0.1, p=.96), race/ethnicity (t=1.2, p=.22)], medical [diagnosis type (F=0.12, p=.89), number of treatment modalities (t=1.3, p=.21)] or psychosocial [pain interference (r=.18, p=.17), anxiety (r=.21, p=.10), depression (r=.20, p=.13), PA (r=.11, p=.38)] factors associated with SE.

Conclusion(s): This was one of the first studies to quantify SE using actigraphy in a diverse sample of AYA receiving cancer treatment, demonstrating lower SE than healthy AYA populations (85-90%), and 77% experiencing insomnia symptoms. That none of the hypothesized associates were related to SE is contrary to prior oncology research and indicates that there may be more complex biopsychosocial factors related to actigraphy-assessed SE in AYA. Additionally, 22% of AYA did not meet minimum wear criteria, possibly excluding patients with the most disrupted sleep. Future actigraphy research in AYA oncology should explore how to enhance compliance, examine more nuanced treatment-related associates of SE (e.g., chemotherapy regimens), and how SE relates to treatment outcomes.