Journal of Clinical and Diagnostic Research. 2023 May, Vol-17(5): SC17-SC19 17 17 DOI: 10.7860/JCDR/2023/63042.17827 Original Article Paediatrics Section Prevalence of Insomnia among Paediatric Cancer Patients: A Hospital-based Observational Study INTRODUCTION Sleep disturbances like insomnia, increased daytime sleepiness, increased time to sleep onset, decreased sleep duration, poor sleep quality, etc., are the common consequences of cancer and its treatment in paediatric patients [1]. Advances in the treatment of paediatric cancer have led to significant increases in long-term survival, highlighting the need to address not only survival but treatment associated morbidity and improved quality of life as well [1-3]. In paediatric patients, cancer and its treatment can result in impaired cognitive function, functional impairment, activity limitations and impaired mental health issues like pain and anxiety [1]. One of the most chronic and disturbing side-effects reported by paediatric cancer patients and survivors is problems with sleep, suggesting that this is a major quality of life concern. Surgery, chemotherapy and radiotherapy, in addition to the effect of the cancer, can all cause short-and long-term sleep disturbance [4-9]. Sleep represents a complex, multi-staged process required for survival, daily functioning, neurocognitive and physical development [10,11]. Poor sleep in the children is associated with deleterious effects on mood and neurocognition; a higher risk of clinical depression and anxiety; increased behavioural difficulties, including increased rates of hyperactivity; and less success in school. Sleep disorders are linked with pain, fatigue, and hospitalisation in paediatric cancer patients [12-15]. Thus, it is important to identify and address insomnia and other sleep disturbances in paediatric patients with cancer for their holistic management and improvement in quality of life. This study was conducted to estimate the prevalence of insomnia among cancer patients aged 1-15 years admitted in the Paediatric Oncology ward. MATERIALS AND METHODS This prospective observational, hospital-based study was conducted in the Paediatric Oncology ward, Shri Maharaja Gulab Singh (SMGS) Hospital, Government Medical College, Jammu, India, from June 2022 to August 2022. Ethical clearance was obtained from the Institutional Ethics Committee (no IEC/GMCJ/2022/1069) before conducting the study. Fifty patients, in the age group of 1-15 years, diagnosed with malignancy {leukaemia (n=30, 60%), lymphoma (n=7, 14%), aplastic anaemia (n=4, 8%), hepatoblastoma (n=3, 6%), germ cell tumour (n=2, 4%) and others (n=4, 8%)}, were enrolled after taking informed consent from their parents. A total of 68 patients were admitted in Paediatric Oncology ward during the study period out of which 12 patients were excluded because of critical illness while parents of six patients refused to give consent to participate in the study. Remaining 50 patients were included in the study after obtaining informed consent from their parents. Inclusion criteria: Patients in the age group of 1-15 years diagnosed with cancer, either on chemotherapy or admitted in the hospital for any other complications (n=50) were included in the study. Exclusion criteria: Critically, ill patients admitted in Intensive Care Unit (ICU), children of parents who refused to give consent to participate in the study (n=18) were excluded from the study. Study Procedure A prestructured questionnaire as per the Hindi version of Insomnia Severity Index (ISI) was administered and the severity of insomnia SANJANA SHARMA 1 , POOJA BHARTI 2 , PALLAVI SHARMA 3 , SANJEEV KUMAR DIGRA 4 , SUNIL DUTT SHARMA 5 , GHANSHYAM SAINI 6 Keywords: Children, Malignancy, Oncology, Sleep ABSTRACT Introduction: Insomnia and other sleep disturbances are the common occurrences in paediatric patients suffering from cancer. These may be attributed to the disease itself or its treatment and accompanying psychosocial stress. Sleep disorders including insomnia are known to have a detrimental effect on the quality of life in these patients. Aim: To estimate the prevalence of insomnia among cancer patients aged 1-15 years admitted in the paediatric oncology ward. Materials and Methods: A prospective observational, hospital-based study was conducted in the Paediatric Oncology ward, Shri Maharaja Gulab Singh (SMGS) Hospital, Government. Medical College (tertiary care institute), Jammu, India, from June 2022 to August 2022. A total of 50 patients, in the age group of 1-15 years, diagnosed with malignancies like leukaemia, lymphoma, aplastic anaemia, hepatoblastoma, etc., were enrolled after taking informed consent from their parents. Insomnia Severity Index (ISI) was administered to parents of children below 10 years age and to patients themselves who were between 10-15 years to screen for symptoms of insomnia with the help of their parents/investigators as and when required. Continuous variables were expressed as mean±Standard Deviation (SD) and categorical variables were summarised as frequencies and percentages. Results: The study subjects were distributed according to their age into three groups, as 1-5 years (n=26), 6-10 years (n=16), and 11-15 years (n=8). There were 24 (48%) males and 26 (52%) females. In this study, 32 (64%) study subjects did not have insomnia, 5 (10%) had subthreshold insomnia,13 (26%) had moderate insomnia and none had severe insomnia. Conclusion: The prevalence of insomnia found in the study was 26%. Insomnia is common in paediatric cancer patients necessitating its recognition and management for improved quality of life.