HMN 2025: How ‘Sleep ALL night’ program helps children with leukemia sleep better during treatment

Disrupted sleep is a common, often overlooked problem for pediatric patients being treated for acute lymphoblastic leukemia (ALL). To address this issue, researchers at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center Institute created Sleep ALL Night—a program designed to protect children’s sleep during treatment.

“Our goal is to change the expectation that poor sleep should be considered a necessary treatment side effect for pediatric ALL patients,” said Dr. Eric Zhou, Staff Psychologist at Dana-Farber Cancer Institute and Associate Professor at Harvard Medical School, who co-led the study.

Researchers developed an educational website that creates clear expectations around when a child’s sleep warrants attention and provides families with evidence-based strategies to help improve sleep. These tools were introduced to families in a brief, nurse-led visit that occurred while the child was in the Jimmy Fund Clinic for a routine medical appointment. Families found the approach easy to incorporate into their busy schedules, and a good fit for their needs.

The findings were published in the Journal of Pediatric Psychology.

Sleep often gets worse during treatment for ALL. Medications, like steroids can disrupt sleep, and that can lead to daytime fatigue, behavioral issues, trouble with attention and memory, and lower quality of life. Without support, short-term sleep problems can turn into chronic insomnia that lasts well beyond treatment. Prior studies suggest that about one in three survivors of childhood ALL may face insomnia in adulthood, underscoring the need for early help.

“Preventive programs for physical late effects of pediatric cancer treatments, such as routine cardiac surveillance, are standard of care. However, this forward-thinking approach has not been implemented for sleep disturbances in pediatric oncology,” Zhou said.

In this trial, 25 caregivers of children ages 4 to 8 participated during their child’s maintenance therapy at Dana-Farber. Results showed that within a month, nearly 40% of children had a meaningful improvement in either nighttime sleep problems or how much poor sleep affected their day.

“We were very pleased to see how much a low-intensity program could benefit children and families,” said Dr. Zhou. “The visit with the oncology nurse took less than 30 minutes, making it something that could realistically be incorporated into future appointments as part of standard care for pediatric ALL patients.”

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