ORIGINAL ARTICLE Insomnia in adult survivors of childhood cancer: a report from project REACH

Purpose Insomnia is a common problem affecting cancer survivors even years after completion of therapy. Childhood cancer survivors may be at particular risk due to vulnerability to the effects of treatment and medical late effects which impact normal sleep development. Using an indicator of clin-ically significant insomnia (sleep efficiency), we examined a group of adult survivors of childhood cancer to (1) describe clinical insomnia rates, (2) identify physical and psychologi-cal correlates of insomnia, and (3) investigate the frequency with which sleep issues were evaluated during a cancer sur-vivorship medical visit. Methods A total of 122 adult survivors of childhood cancer completed standard measures of sleep, psychological distress, and health-related quality of life. Medical records of the 75 survivors with a survivorship medical visit on the day of self-report measure completion were reviewed for documentation of sleep-related issues. Results Twenty-eight percent of participants endorsed sleep efficiency below 85%, indicating clinically significant insom-nia. Insomnia was associated with poor physical health and anxiety but not with demographic or cancer treatment vari-ables. Medical providers failed to document sleep in visit notes for 67 % of patients with self-reported insomnia. Conclusions A significant proportion of adult survivors of childhood cancer report insomnia, which is associated with physical and psychological health. Few survivors with insom-nia discuss this issue with oncology providers during survi-vorship care. There is a clear need to screen for insomnia in this population. Patients and providers should take greater responsibility for discussing sleep issues and seeking out proper treatment referrals when it is identified