Cognitive problems following hematopoietic stem cell transplant: relationships with sleep, depression and fatigue

• Published in: Bone marrow transplantation (Basingstoke) Vol. 52; no. 2; pp. 279 - 284
• Main Authors: Ghazikhanian, S E, Dorfman, C S, Somers, T J, O'Sullivan, M L, Fisher, H M, Edmond, S N, Wren, A A, Kelleher, S A, Rowe Nichols, K A, Chao, N, Shelby, R A
• Format: Journal Article
• Language: English
• Published: England Nature Publishing Group 01.02.2017
• Subjects: Adult; Aged; Aged, 80 and over; Allografts; Autografts; Bone marrow; Cognitive ability; Cognitive disorders; Cognitive Dysfunction - epidemiology; Cognitive Dysfunction - etiology; Cognitive Dysfunction - physiopathology; Cognitive tasks; Complications and side effects; Depression (Mood disorder); Depression - epidemiology; Depression - etiology; Depression - physiopathology; Fatigue; Fatigue - epidemiology; Fatigue - etiology; Fatigue - physiopathology; Female; Health aspects; Hematopoietic Stem Cell Transplantation; Hematopoietic stem cells; Humans; Male; Mental depression; Middle Aged; Pain; Patients; Psychological aspects; Questionnaires; Risk factors; Sleep; Sleep deprivation; Sleep disorders; Sleep Wake Disorders - epidemiology; Sleep Wake Disorders - etiology; Sleep Wake Disorders - physiopathology; Stem cell transplantation; Stem cells
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/bmt.2016.248

Cognitive problems are a significant, persistent concern for patients undergoing hematopoietic stem cell transplant (HSCT). Sleep is important for many cognitive tasks; however, the relationship between sleep and cognitive problems for HSCT patients is unknown. This study examined the relationship between sleep and cognitive problems for HSCT patients from pre to post transplant. Patients undergoing HSCT (N=138) completed questionnaires at pre-transplant and during the 12 months following transplant. Questionnaires assessed sleep and cognitive problems as well as commonly co-occurring symptoms: depressive symptoms, fatigue and pain. Post hoc analyses examined the relationship of specific sleep problems with cognitive problems. Sleep problems covaried with cognitive problems even after controlling for depressive symptoms, fatigue and pain. Depressive symptoms and fatigue were also uniquely related to cognitive problems. Post hoc analyses suggest that sleep somnolence, shortness of breath, snoring and perceptions of inadequate sleep may contribute to the association found between sleep and cognitive problems. Findings suggest that sleep problems are associated with and may contribute to cognitive problems for HSCT patients. However, sleep problems are rarely screened for or discussed during clinic visits. Assessing and treating specific sleep problems in addition to depressive symptoms and fatigue may have implications for improving cognitive problems for HSCT patients.