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. 2025 Jul;14(14):e71051.
doi: 10.1002/cam4.71051.

Evaluating Sleep in Pediatric Cancer: A Scoping Review of Assessment Tools for Quality and Care

Elena Rostagno  1 , Veronica Rivi  2 , Pierfrancesco Sarti  2 , Pietro Guastella  3 , Dorella Scarponi  3 , Johanna Maria Catharina Blom  2   4
Affiliations

Evaluating Sleep in Pediatric Cancer: A Scoping Review of Assessment Tools for Quality and Care

Elena Rostagno et al. Cancer Med. 2025 Jul.

Abstract

Background: Pediatric cancer patients experience unique and multifaceted sleep disturbances due to the disease, treatment regimens, and the hospital environment. These disruptions can detrimentally impact neurocognitive functioning, emotional well-being, and overall quality of life, making accurate sleep assessment critical yet challenging in this population.

Objective: To examine and evaluate the current tools used to assess sleep quality in pediatric oncology patients, with a focus on their reliability, feasibility, and relevance to clinical and research settings.

Methods: A scoping review methodology was employed to identify and synthesize studies using various sleep assessment tools in pediatric cancer populations. Tools reviewed included actigraphy, sleep diaries, validated sleep scales, and polysomnography. Studies were analyzed for general reliability, feasibility in clinical and research contexts, and applicability to pediatric oncology-specific concerns.

Results: The review found that while actigraphy and sleep diaries are frequently used because of their noninvasive nature and relative ease of implementation, limitations exist in terms of consistency and interpretability. Sleep scales varied in their psychometric properties and relevance across age groups and treatment phases. Polysomnography, though considered the gold standard, was less feasible in routine clinical settings because of its complexity and cost. Across tools, variability was observed in the alignment between measured parameters and clinically relevant sleep issues in pediatric cancer patients.

Conclusion: A wide range of tools exists for assessing sleep in pediatric oncology, each with distinct strengths and limitations. Selection of the most appropriate tool should consider the specific sleep concern, patient age, clinical context, and resource availability. This review provides a framework for clinicians and researchers to make informed choices, encouraging thoughtful integration of sleep assessments into both practice and study design.

Keywords: actigraphy; pediatric oncology; sleep assessment; sleep disorders; sleep quality; wearables.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

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FIGURE 1
PRISMA diagram.
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