0831 Sleep in Long-Term Childhood Cancer Survivors Compared to Siblings: A Report from the Childhood Cancer Survivor Study
Bibliographic record
Abstract
Abstract Introduction Sleep problems following treatment for childhood cancer may persist into adulthood. Because some sleep problems increase with age, it is important to understand whether cancer elevates this risk and assess associations with co-morbidities that frequently develop in long-term childhood cancer survivors. The current study compares sleep in long-term survivors to sibling controls. Methods Childhood cancer survivors (≥5 years from diagnosis; n=12,340; 51.5% female; mean [SD] age=39.4 [9.6] years; years since diagnosis=30.9 [7.9]; age at diagnosis=8.5 [5.8]) and siblings (n=2395; 57.1% female; age=44.6 [10.5]) participating in the Childhood Cancer Survivor Study completed the Pittsburgh Sleep Quality Index (PSQI). Binary sleep behaviors (Total Score >5, Short Sleep Duration [< 6 hours], Frequent Snoring [>3 times/week], Frequent Sleep Medication Use [≥3 times/week]) were compared between survivors and siblings using a multivariable generalized estimating equation with Poisson error to account for intra-family correlations, adjusting for age, sex, race, and BMI. Poisson regression models evaluated treatment and chronic health conditions (CHCs) as predictors of PSQI Total Score among survivors with the same adjustment variables. Results Survivors were more likely to report Short Sleep Duration (12.0% vs 10.6%; adjusted prevalence ratio [aPR] 1.18, 95% confidence interval [CI] 1.04-1.34), elevated PSQI Total Score (45.1% vs 40.0%; aPR 1.17, 95%CI 1.11-1.23), Frequent Snoring (18.0% vs 17.4%; aPR 1.11, 95%CI 1.01-1.23), and Frequent Sleep Medication Use (13.2% vs 11.5%; aPR 1.28, 95% CI 1.14-1.45) compared to siblings. Among survivors, elevated PSQI Total Score was associated with female sex (aPR 1.29, 95%CI 1.21-1.37) and BMI (overweight: aPR 1.13, 95%CI 1.06-1.22; obese: aPR 1.32, 95%CI 1.23-1.42), while age at diagnosis and cancer treatment exposures (i.e., chemotherapy/radiation) were not significantly associated. Survivors with 2+ CHCs had increased prevalence of elevated PSQI Total Score (aPR 1.39, 95%CI 1.28-1.50) relative to survivors without CHCs. Conclusion Childhood cancer survivors exhibit elevated risk for poor sleep quality, short sleep, and snoring relative to siblings well into middle age. These sleep problems are driven by demographics and current chronic health conditions rather than prior treatment exposures. Elevated use of sleep-promoting medications suggests interest in managing sleep difficulties and an opportunity for future behavioral sleep intervention trials. Support (if any) NCI 5U24CA055727-26 (PI: Armstrong)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.000 |
| Bibliometrics | 0.001 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".