A Sleep Hygiene and Physical Activity Intervention for Children With Cancer: A quasi-experimental intervention study

Objective This study aimed to evaluate the effectiveness of a combined non-pharmacological intervention, integrating sleep hygiene education and physical activity, on improving sleep quality and increasing physical activity levels among pediatric cancer patients undergoing chemotherapy. Methods A quasi-experimental study was conducted with 80 children from two Chinese hospitals, who were non-randomly assigned to an intervention group (n = 40) or a control group (n = 40). The intervention group received a 10-week program of combined sleep hygiene education and supervised physical activity, delivered through a hybrid model. Primary outcomes were sleep quality, measured by the Pittsburgh Sleep Quality Index (PSQI), and physical activity levels, assessed using the Children's Leisure Activities Study Survey-Chinese version. Data were collected at baseline, 5 weeks, and 10 weeks, and analyzed using Generalized Estimating Equations. Results A significant time-by-group interaction was found for sleep quality (χ²=14.812, p = 0.001). The intervention group demonstrated a substantial and statistically significant improvement in sleep quality, reflected by a reduction in PSQI scores (mean change: -1.35, p < 0.001). Furthermore, this group showed a significant increase of 35.68 minutes per week in moderate-to-vigorous physical activity. All reported between-group differences were statistically significant (p < 0.05). Conclusion A combined intervention of sleep hygiene and physical activity is an effective strategy for simultaneously improving sleep quality and promoting beneficial physical activity patterns in children during cancer treatment. This multi-component approach offers a viable non-pharmacological option for managing these common and distressing symptoms in pediatric oncology care.