The sleep-anxiety-cancer triad in pediatrics: Unraveling a vicious cycle

Background Sleep disorders in children are associated with developmental and cognitive impairments, but their interaction with cancer has been unclear in previous studies. This cross-sectional study was conducted to investigate the association between sleep disorders in children with cancer and their impact on anxiety in these children. Methods The present study examined children with various types of cancer who were referred to Amir Kabir Hospital, Markazi Province, Iran, over a 6-month period, using the Spence Children's Anxiety Questionnaire (SCAS) and the Children's Sleep Disorders Questionnaire (CSHQ). Children underwent anthropometric examinations, and child weight, child height, child head circumference, body mass index, weight-for-height ratio (wasting), height-for-age ratio (nutritional short stature), and weight-for-age ratio (underweight) were statistically analyzed along with sleep and anxiety scores. Results The mean total sleep disorder score among these children was 26.55, and the mean anxiety score among children was 34.74. A direct relationship was observed between anxiety and delayed sleep onset, an inverse relationship with parasomnia, and a direct and significant relationship with daytime sleepiness. A positive correlation was found between sleep disorders and cancer type and chemotherapy, and a negative correlation was observed between anxiety and chemotherapy and relapse. Conclusion Sleep disturbance associated with cancer can increase anxiety, creating a cycle that may worsen cancer-related factors. This cycle can lead to lower treatment effectiveness in children. The obtained evidence suggests that managing sleep disorders may be a crucial first step in breaking this cycle.