ID #571 From home to hospital a longitudinal study of sleep quality and risk factors in children with cns tumors
Dina KhraishaAbstract
Background
Sleep-wake regulation is a critical determinant of neurocognitive recovery and quality of life in pediatric oncology. Children with central nervous system (CNS) tumors are uniquely vulnerable to sleep disturbances due to neuroanatomical damage and iatrogenic stressors. However, the progression of sleep patterns from the pre-morbid baseline to the acute diagnostic phase remains poorly characterized.
Aim
To quantify the impact of CNS tumors on sleep quality and identify multidimensional risk factors-including clinical, environmental, and treatment-related variables-contributing to sleep dysfunction.
Methodology
This longitudinal observational study at An-Najah National University Hospital enrolled parents of children (4-16 years) newly diagnosed with CNS tumors. Sleep quality was assessed using the Children’s Sleep Habits Questionnaire (CSHQ) for a retrospective pre-diagnosis baseline and an acute post-diagnosis time point (within 30 days). Risk factors-including disease characteristics, treatment variables, and hospital-related environmental stressors-were identified via Sleep Assessment Metrics (SAM) and medical records. Paired t-tests evaluated longitudinal changes, and multivariate regression identified independent predictors of sleep deterioration.
Result
Analysis revealed that sleep quality worsened significantly following diagnosis, with mean CSHQ scores increasing from 38 ± 5 at baseline (below clinical cutoff) to 52 ± 8 post-diagnosis (p < 0.001; Cohen’s d = 1.8). Multivariate regression identified hypothalamic tumor involvement and poorly controlled pain were the strongest predictors of severe sleep fragmentation and daytime sleepiness. SAM metrics highlighted frequent clinical interventions and auditory equipment alarms as the leading environmental contributors to sleep disruption.
Conclusion
Sleep deterioration in this population is driven by a synergy of neuroanatomical tumor effects and iatrogenic hospital disruptions. These findings underscore the importance of integrating targeted pain management and “protected sleep” protocols into routine care to reduce clinical interruptions and optimize recovery in high-risk pediatric patients.