A Sleep Hygiene and Relaxation Intervention for Children With Acute Lymphoblastic Leukemia: A Pilot Randomized Controlled Trial.
Sue Zupanec, Heather Jones, Lyndsey McRae and 3 others
PMID 27922922WHAT IT FOUND
Families found a nurse-led sleep hygiene and relaxation session helpful and easy to use.
Objective sleep improved slightly but not significantly. Most children still slept far less than recommended, and fatigue remained moderate in both groups.
Key findings
01The intervention was feasible and acceptable: all families who evaluated it rated the education session useful, and most used sleep hygiene tips and relaxation books several times a week.
02Objective sleep outcomes showed no statistically significant difference between groups, though the intervention group had a 35-minute increase in nighttime sleep and a 44-minute decrease in wake time after sleep onset compared to control.
03There were no differences between groups in subjective sleep disturbance, family sleep habits, or parent-reported fatigue, and most children continued to score above the cutoff for clinically significant sleep disturbance.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was a pilot with a very small sample size (n=20 randomized), meaning it was not powered to detect differences in sleep or fatigue outcomes. Recruitment was limited by strict timing windows aligned with specific chemotherapy cycles, leading to many eligible families being missed. School attendance data were largely incomplete, preventing analysis of functional outcomes. The study population was predominantly male (90%) and white (45%), limiting generalizability. Blinding of families to the intervention was not possible, which could influence subjective reporting.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not interpret the 35-minute increase in sleep duration or the 44-minute decrease in wake time as evidence that the intervention works. These differences were not statistically significant (P = .30 and P = .08), and the study was a pilot designed only to test feasibility, not efficacy.