{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,29]],"date-time":"2026-03-29T08:07:58Z","timestamp":1774771678433,"version":"3.50.1"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,2,9]],"date-time":"2025-02-09T00:00:00Z","timestamp":1739059200000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012524","name":"American Lebanese Syrian Associated Charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100012524","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100007737","name":"St. Jude Children's Research Hospital","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100007737","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2025,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Young adult survivors of childhood cancer exhibit rates of frailty similar to adults several decades older without a cancer history. Frailty has been associated with sleep disturbances in non\u2010cancer populations, but the relationship has not been examined in childhood cancer survivors who are known to exhibit elevated rates of sleep problems.<\/jats:p><\/jats:sec><jats:sec><jats:title>Aims<\/jats:title><jats:p>Examine associations between frailty and poor sleep quality in long\u2010term survivors of childhood cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study utilized data from 9044 participants (&gt; 5\u00a0years from diagnosis, <jats:italic>M<\/jats:italic><jats:sub>age<\/jats:sub>\u00a0=\u00a040.8\u00a0years [SD\u00a0=\u00a09.5]) in the Childhood Cancer Survivor Study. Survivors' frailty status, chronic health conditions (CHC), health behaviors, mental health, and pain were collected in 2014\u20132016, and self\u2010reported sleep quality in 2017\u20132019. Multivariable logistic regression models examined frailty status as a predictor of clinically significant poor sleep. All models were adjusted for age at diagnosis, age at survey, sex, race\/ethnicity, smoking, risky\/heavy alcohol use, and physical inactivity. Separate models included treatment\u2010related variables, CHC burden (number\/severity), and emotional health\/pain as co\u2010variates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Frail survivors had 6\u2010fold (95% CI 4.48\u20137.96) increased odds of future poor sleep quality. Little attenuation of this association was observed when accounting for cancer diagnosis (Odds Ratio [OR] 5.80, 95% CI 4.47\u20137.52), treatment exposures (OR 5.80, 95% CI 4.43\u20137.71), or chronic health condition burden (OR 5.12, 95% CI 3.98\u20136.59), but adjustment for emotional health\/pain (OR 2.88, 95% CI 2.18\u20133.82) attenuated the association appreciably.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Frail childhood cancer survivors have a higher prevalence of clinically significant poor sleep quality. Addressing poor physiologic reserve may impact sleep in frail childhood cancer survivors.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.70098","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T04:05:34Z","timestamp":1739246734000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Frailty and Sleep in Adult Survivors of Childhood Cancer: A Childhood Cancer Survivor Study Report"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8637-2424","authenticated-orcid":false,"given":"Lauren C.","family":"Daniel","sequence":"first","affiliation":[{"name":"Department of Psychology Rutgers University Camden  Camden New Jersey USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margaret M.","family":"Lubas","sequence":"additional","affiliation":[{"name":"Children's Hospital of the King's Daughters  Norfolk Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huiqi","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Szklo\u2010Coxe","sequence":"additional","affiliation":[{"name":"Joint School of Public Health, Macon &amp; Joan Brock Virginia Health Sciences Old Dominion University  Norfolk Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kirsten K.","family":"Ness","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"AnnaLynn M.","family":"Williams","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Division of Supportive Care in Cancer Department of Surgery, James P. Wilmot Cancer Institute, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel A.","family":"Mulrooney","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee USA"},{"name":"Department of Oncology St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Howell","sequence":"additional","affiliation":[{"name":"Department of Radiation Physics MD Anderson  Houston Texas USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wendy","family":"Leisenring","sequence":"additional","affiliation":[{"name":"Clinical Research and Public Health Sciences Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Yasui","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leslie L.","family":"Robison","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gregory T.","family":"Armstrong","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric J.","family":"Chow","sequence":"additional","affiliation":[{"name":"Clinical Research and Public Health Sciences Division Fred Hutchinson Cancer Center  Seattle Washington USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin R.","family":"Krull","sequence":"additional","affiliation":[{"name":"Psychology and Biobehavioral Sciences Department St. Jude Children's Research Hospital  Memphis Tennessee USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4250-6160","authenticated-orcid":false,"given":"Tara M.","family":"Brinkman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Cancer Control St. Jude Children's Research Hospital  Memphis Tennessee 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