ArticleSleep2020
Sleep-wake rhythm disruption is associated with cancer-related fatigue in pediatric acute lymphoblastic leukemia.
Article in Sleep, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05009693 (The Effect of White Light on Fatigue Levels in Patients With Gynecological Cancer), which is not on this map. Cited by 18 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Effect of White Light on Fatigue Levels in Patients With Gynecological Cancer: A Double Blind Randomized Trial
Who cites it
18 citing papers in PubMed, 42 citations in OpenAlex.
- Relationships between rest-activity rhythms, cancer-related fatigue, and quality of life: Results from a time-restricted eating randomized controlled trial.Chronobiology international · 2026Trial
- Comparing the Efficacy of Acupressure and Foot Reflexology on Sleep Quality in Patients With Leukemia: A Comparative Clinical Trial.Integrative cancer therapiesTrial
- Pain Predicts Next-Day Fatigue in Adolescents and Young Adults Receiving Maintenance Treatment for Acute Lymphoblastic Leukemia.Journal of adolescent and young adult oncology · 2026Article
- Circadian rhythm-guided cellular therapy in hematologic malignancies: mechanisms, clinical evidence, and optimization strategies.Biomarker research · 2026Review
- Sleep and psychiatric problems in pediatric oncology patients: A case-control study.Sleep & breathing = Schlaf & Atmung · 2026Article
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- A Series of Personalized Virtual Light Therapy Interventions for Fatigue: Feasibility Randomized Crossover Trial for N-of-1 Treatment.JMIR formative research · 2023Article
- Exploring core symptoms and interrelationships among symptoms in children with acute leukemia during chemotherapy: A network analysis.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Article
- Article
- Physical Therapy Utilization Among Hospitalized Patients With Pediatric Acute Lymphoblastic Leukemia.JCO oncology practice · 2022Article
- Association between fatigue and sleep disturbances during treatment for pediatric acute lymphoblastic leukemia and posttreatment neurocognitive performance.Pediatric blood & cancer · 2022Article
- Prevalence and risk factors of cancer-related fatigue in childhood cancer survivors: A DCCSS LATER study.Cancer · 2022Article
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- Article
- Effect of Melatonin Plus Zinc Supplementation on Fatigue Perception in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: A Randomized, Double-Blind, Placebo-Controlled Trial.Antioxidants (Basel, Switzerland) · 2021Article
- Cerebrospinal Fluid Metabolomic Profiles Associated With Fatigue During Treatment for Pediatric Acute Lymphoblastic Leukemia.Journal of pain and symptom management · 2021Article
- Circadian activity rhythms and fatigue of adolescent cancer survivors and healthy controls: a pilot study.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2020Article
Corrections and comments
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Authors and funding
10 authors at 6 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
STUDY
objectivesTo compare sleep-wake rhythms, melatonin, and cancer-related fatigue in pediatric patients with acute lymphoblastic leukemia (ALL) to healthy children and to assess the association between sleep-wake outcomes and cancer-related fatigue.
methodsA national cohort of ALL patients (2-18 years) was included. Sleep-wake rhythms were measured using actigraphy and generated the following variables: Interdaily stability (IS): higher IS reflects higher stability; intradaily variability (IV): lower IV indicates less fragmentation; L5 and M10 counts: activity counts during the five least and 10 most active hours, respectively; and relative amplitude (RA): the ratio of L5 and M10 counts (higher RA reflects a more robust rhythm). The melatonin metabolite, 6-sulfatoxymelatonin (aMT6s), was assessed in urine. Cancer-related fatigue was assessed with the PedsQL Multidimensional Fatigue Scale. Using regression models sleep-wake rhythms, aMT6s, and cancer-related fatigue were compared to healthy children and associations between sleep-wake outcomes and cancer-related fatigue were assessed in ALL patients.
resultsIn total, 126 patients participated (response rate: 67%). IS, RA, and M10 counts were lower in patients compared to healthy children (p < 0.001). aMT6s levels were comparable to healthy children (p = 0.425). Patients with ALL were more fatigued compared to healthy children (p < 0.001). Lower IS, RA and M10 counts and higher IV were significantly associated with more parent-reported cancer-related fatigue. Associations between sleep-wake rhythms and self-reported cancer-related fatigue were not statistically significant.
conclusionsSleep-wake rhythm impairment is associated with more cancer-related fatigue in pediatric ALL patients. Interventions aimed to improve sleep hygiene and encourage physical activity may reduce cancer-related fatigue.
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