Sleep quality following hematopoietic stem cell transplantation: Longitudinal trajectories and biobehavioral correlates

A. M. Nelson, C. L. Coe, M. B. Juckett, M. E. Rumble, P. J. Rathouz, P. Hematti, E. S. Costanzo

Research output: Contribution to journalArticlepeer-review

32 Scopus citations


The present study examined changes in sleep quality following hematopoietic stem cell transplantation (HSCT) and investigated associations with biobehavioral factors. Individuals undergoing HSCT for hematologic malignancies (N=228) completed measures of sleep quality and psychological symptoms pre-transplant and 1, 3, 6 and 12 months post transplant. Circulating inflammatory cytokines (IL-6, TNF-α) were also assessed. Sleep quality was poorest at 1 month post transplant, improving and remaining relatively stable after 3 months post transplant. However, approximately half of participants continued to experience significant sleep disturbance at 6 and 12 months post transplant. Mixed-effects linear regression models indicated that depression and anxiety were associated with poorer sleep quality, while psychological well-being was associated with better sleep. Higher circulating levels of IL-6 were also linked with poorer sleep. Subject-level fixed effects models demonstrated that among individual participants, changes in depression, anxiety and psychological well-being were associated with corresponding changes in sleep after covarying for the effects of time since transplant. Sleep disturbance was most severe when depression and anxiety were greatest and psychological well-being was lowest. Findings indicate that sleep disturbance is a persistent problem during the year following HSCT. Patients experiencing depression or anxiety and those with elevated inflammation may be at particular risk for poor sleep.

Original languageEnglish (US)
Pages (from-to)1405-1411
Number of pages7
JournalBone marrow transplantation
Issue number11
StatePublished - Nov 13 2014
Externally publishedYes

Bibliographical note

Funding Information:
This work was supported by Grants R21 CA133343 and K07 CA136966 from the National Cancer Institute to ESC, KL2 RR0205012 from the National Center for Research Resources, P30 CA014520 from the UWCCC, and an award from the Forward Lymphoma Foundation.

Publisher Copyright:
© 2014 Macmillan Publishers Limited.


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