To determine how induction chemotherapy affects sleep
for school-age children and adolescents with ALL, baseline
data about sleep patterns before cancer diagnosis are needed.
Obtaining this information is a methodological challenge
because children and adolescents experience symptoms prior
to diagnosis. The symptoms they experience vary from tiring
easily to pain and are present from weeks to months prior to
their diagnosis (Gedaly-Duff et al., 2008). Because diagnosis
of leukemia is a life-altering experience for children and their
families, an assessment of “normal” or baseline is not possible
once the diagnosis is made. Therefore, although sleep
characteristics during induction chemotherapy can be measured
with objective methods such as actigraphy, clinicians
and researchers must rely on retrospective reports from the
parent or child to ascertain the child's sleep–wake pattern
prior to diagnosis.