Sleep Patterns Across the Transfusion Cycle in Children with Transfusion-Dependent β-Thalassemia: A 14-Day Prospective Controlled Study Using Sleep Diaries and Repeated Questionnaires

Background/Objectives: Sleep across the transfusion cycle remains understudied in children with transfusion-dependent β-thalassemia (TDT). We assessed sleep patterns and hematologic correlates before and after transfusion.

Methods

This prospective, controlled, repeated-measures study included 27 children with TDT and 30 controls who had been frequency-matched at recruitment on age, sex, and school-attendance category; no fixed one-to-one patient–control pairs were formed. Participants completed 14-day sleep diaries spanning the pre- and post-transfusion weeks and repeated Children’s Sleep Habits Questionnaire (CSHQ) and Pittsburgh Sleep Quality Index (PSQI) assessments. The three primary outcome domains were sleep-diary measures (including sleep regularity, daytime nap frequency, sleep-duration variability, and nocturnal awakenings), continuous CSHQ total and subscale scores, and the continuous modified PSQI global score. Threshold classifications, individual questionnaire items, and laboratory/MRI associations were exploratory. Multiplicity was controlled within the diary and questionnaire families using the Benjamini–Hochberg false discovery rate (FDR).