Defense Date


Document Type


Degree Name

Doctor of Philosophy



First Advisor

Dr. Marcia Winter

Second Advisor

Dr. Joshua Langberg


Craniopharyngiomas are among the most common brain tumors in children and are associated with greater rates of sleep problems compared to other pediatric cancers. However, research examining sleep among youth with craniopharyngioma has been limited by a reliance on retrospective reports or sleep studies. Families also play a crucial role in children’s adjustment following a pediatric cancer diagnosis, yet remarkably little is known about transactional associations between family functioning and sleep in pediatric cancer. This study examined cross-sectional and daily associations among family functioning, affect, and sleep difficulties for youth with pediatric craniopharyngioma using retrospective reports and ecological momentary assessment (EMA). Thirty-nine youth who underwent partial resection and proton therapy and their primary caregivers completed retrospective reports, and youth completed daily electronic surveys over a one-week period. At the end of the week, youth were asked for feedback about their overall experiences using EMA surveys. Ordinal least squares regression suggested significant associations between youth-reported but not parent-reported family functioning, excessive daytime sleepiness, and insomnia. Multilevel modeling did not suggest significant associations between daily family functioning, negative affect, and sleep efficiency. Youth reported overall satisfaction and minimal burden from completing EMA surveys. Findings inform clinical recommendations for systematic screening efforts to acknowledge youth perceptions of family functioning and excessive daytime sleepiness at routine follow-up visits. Results highlight the importance of using a multifaceted approach to assess and treat sleep difficulties in pediatric oncology and of identifying potential pathways explaining associations between family functioning and sleep.


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