To test the feasibility, acceptability and effectiveness of a sleep hygiene and relaxation intervention to improve sleep and fatigue for children receiving maintenance therapy for acute lymphoblastic leukemia

Children and adolescents have told us that fatigue is one of the most distressing side effects related to their cancer treatment. They have described fatigue as a physical, mental and emotional tiredness that makes it difficult for them to participate in the activities they enjoy, to maintain their school performance and to keep up with social interactions. We have developed a combined sleep hygiene and relaxation intervention for children with acute lymphoblastic leukemia (ALL) intended to improve sleep habits and sleep quality and to decrease their level of fatigue. Before using this intervention in a large clinical study we must assess if the intervention does have an impact on fatigue distress, can be easily used by families at home and if the strategies included in the intervention are seen as helpful.

This study will enroll 30 children aged 4-10 with a diagnosis of ALL receiving steroid pulses during maintenance treatment. The study is a randomized controlled trial where half the families receive the sleep hygiene and relaxation intervention and the other half do not. All children will measure their sleep using actigraphs, watch-like devices that measure motion, and will answer questionnaires about their fatigue twice during the study. Parent(s) will also answer questionnaires about fatigue. If we find that this intervention works it is our hope that someday education about good sleep habits including relaxation exercises will become an important part of nursing care in pediatric oncology having a big impact on the quality of life of children with cancer.