Bedtime digital media use, sleep and fatigue among survivors of childhood cancer, their siblings and healthy control sibling pairs

ABSTRACT

Bedtime digital media use (BDM) is linked to poor sleep and fatigue in many populations. Pediatric cancer patients have been observed to engage in BDM in clinical settings, but it is unknown whether BDM rates are higher in this population or how this impacts their sleep and fatigue during treatment and into survivorship. The goal of this study was to evaluate patterns of BDM and its relationship with sleep and fatigue in a sample of pediatric cancer survivors and to compare these patterns with children from their own family (i.e. siblings) and children from unaffected families (i.e. healthy matched controls and siblings of controls). Ninety-nine children (4 groups: 24 acute lymphoblastic leukemia survivors, 13 survivor siblings, 33 controls, 29 control siblings) ages 8–18 were recruited from a long-term survivor clinic at a large children’s hospital and via community advertisements. Survivors were 2–7 years post-treatment (M = 4.80 years). Children’s BDM was parent-reported. Children completed 7 consecutive days of sleep actigraphy and the PedsQL Multidimensional Fatigue Scale. Most survivors (66.67%) engaged in BDM; smartphones were the most common medium. BDM patterns were equivalent across survivors, their siblings, controls, and control siblings. Statistical trends suggested that BDM was associated with fewer minutes of sleep and greater fatigue for all children; these relationships were equivalent across groups. BDM was common among survivors, but usage was not different from their own siblings or compared to healthy control children and sibling pairs. This study underscores the importance of assessing bedtime digital media use in childhood cancer survivors, although other factors impacting sleep should be explored. Clinicians should emphasize established recommendations for healthy media use and sleep habits in pediatric oncology settings.

KEYWORDS:

• Pediatric oncology
• survivorship
• digital media
• screen time
• sleep
• fatigue

Acknowledgments

This work was supported by the Alberta Children’s Hospital Research Institute 2015-16 ARC Award in Family Centered Care. We extend our deepest gratitude to the patients and families who participated in this research, as well as the Long-Term Survivor Clinic at the Alberta Children’s Hospital.

Disclosure statement

No potential conflict of interest was reported by the authors.

Notes

1. Sex was associated with SE (Model 2a: p = .022, Model 2b: p = .017); age was not associated with SE (Model 2a: p = .311, Model 2b: p = 305). An exploratory trimmed model including only the covariate of sex was conducted and the pattern was equivalent to the fully adjusted model.

2. Reported results for fatigue (Models 5a, 5b, 6) are from unadjusted models, given that age and sex were not associated with fatigue in any models (ps ≥ .185) and the subsequent lack of power in the fully adjusted model. Results from the fully adjusted models are as follows: Model 5a: F (1, 69.03) = 2.07, p = .154; Model 5b: F (3, 75.49) = 0.93, p = .429; Model 6: ps ≥ .241.

Additional information

Funding

The work was supported by the Alberta Children’s Hospital Research Institute [2015-16 ARC Award in Family Centered Care].