Actigraphy for measurements of sleep in relation to oncological treatment of patients with cancer: A systematic review

Madsen, Michael Tvilling; Huang, Chenxi; Gögenur, Ismail

doi:10.1016/j.smrv.2014.07.002

Cited by 40 publications

(38 citation statements)

References 60 publications

(148 reference statements)

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“…This observation, particularly when taking into account the time difference between the two data group collection, as well as complementary subgroup and intrasubject dynamic analyses, further supported the reliability of the findings. However, circadian rhythm alterations were only weakly associated with subjective sleep complaints, in line with prior reports . This underscores the importance of obtaining objective as well as subjective reports of sleep quality and quantity …”

Section: Discussionsupporting

confidence: 89%

“…However, circadian rhythm alterations were only weakly associated with subjective sleep complaints, in line with prior reports. 43,44 This underscores the importance of obtaining objective as well as subjective reports of sleep quality and quantity. 45,46 One of our study's limitations is that it does not provide definitive evidence as to whether circadian rhythm disruption is a cause, a consequence, or a correlate of fatigue and anorexia.…”

Section: Discussionmentioning

confidence: 99%

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Circadian rest‐activity rhythm as an objective biomarker of patient‐reported outcomes in patients with advanced cancer

et al. 2018

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BackgroundPsychosocial symptoms often cluster together, are refractory to treatment, and impair health‐related quality of life (HR‐QoL) in cancer patients. The contribution of circadian rhythm alterations to systemic symptoms has been overlooked in cancer, despite a causal link shown under jet lag and shift work conditions. We investigated whether the circadian rest‐activity rhythm provides a reliable and objective estimate of the most frequent patient‐reported outcome measures (PROMs).MethodsTwo datasets were used, each involving concomitant 3‐day time series of wrist actigraphy and HR‐QoL questionnaires: EORTC QLQ‐C30 was completed once by 237 patients with metastatic colorectal cancer; MD Anderson Symptom Inventory (MDASI) was completed daily by 31 patients with advanced cancer on continuous actigraphy monitoring, providing 1015 paired data points. Circadian function was assessed using the clinically validated dichotomy index I < O. Nonparametric tests compared PROMs and I < O. Effect sizes were computed. Sensitivity subgroup and temporal dynamics analyses were also performed.Results I < O values were significantly lower with increasing symptom severity and worsening HR‐QoL domains. Fatigue and anorexia were worse in patients with circadian disruption. The differences were both statistically and clinically significant (P < 0.001; d ≥ 0.33). Physical and social functioning, and global quality/enjoyment of life were significantly better in patients with robust circadian rhythm (P < 0.001; d ≥ 0.26). Sensitivity analyses validated these findings.ConclusionObjectively determined circadian disruption was consistently and robustly associated with clinically meaningfully severe fatigue, anorexia, and interference with physical and social functioning. This supports an important role of the circadian system in the determination of cancer patients’ HR‐QoL and symptoms that deserves therapeutic exploitation.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Circadian rest‐activity rhythm as an objective biomarker of patient‐reported outcomes in patients with advanced cancer

et al. 2018

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“…Longitudinal wrist-actigraphy monitoring in individual cancer patients has indeed demonstrated its validity for prognosis prediction and for association with patient-reported outcome measures (Mormont and Waterhouse, 2002; Payne, 2011; Lévi et al, 2014). Actigraphy is particularly useful as it allows assessment of both locomotor activity and sleep, which are relevant biomarkers for many diseases (Broderick et al, 2014; Madsen et al, 2015). …”

Section: The Circadian Timing System and Its Multilevel Intersubjmentioning

confidence: 99%

Systems Chronotherapeutics

et al. 2017

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Chronotherapeutics aim at treating illnesses according to the endogenous biologic rhythms, which moderate xenobiotic metabolism and cellular drug response. The molecular clocks present in individual cells involve approximately fifteen clock genes interconnected in regulatory feedback loops. They are coordinated by the suprachiasmatic nuclei, a hypothalamic pacemaker, which also adjusts the circadian rhythms to environmental cycles. As a result, many mechanisms of diseases and drug effects are controlled by the circadian timing system. Thus, the tolerability of nearly 500 medications varies by up to fivefold according to circadian scheduling, both in experimental models and/or patients. Moreover, treatment itself disrupted, maintained, or improved the circadian timing system as a function of drug timing. Improved patient outcomes on circadian-based treatments (chronotherapy) have been demonstrated in randomized clinical trials, especially for cancer and inflammatory diseases. However, recent technological advances have highlighted large interpatient differences in circadian functions resulting in significant variability in chronotherapy response. Such findings advocate for the advancement of personalized chronotherapeutics through interdisciplinary systems approaches. Thus, the combination of mathematical, statistical, technological, experimental, and clinical expertise is now shaping the development of dedicated devices and diagnostic and delivery algorithms enabling treatment individualization. In particular, multiscale systems chronopharmacology approaches currently combine mathematical modeling based on cellular and whole-body physiology to preclinical and clinical investigations toward the design of patient-tailored chronotherapies. We review recent systems research works aiming to the individualization of disease treatment, with emphasis on both cancer management and circadian timing system–resetting strategies for improving chronic disease control and patient outcomes.

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“…Actigraphy can be used for continuous measurement of activity. It has previously been used in the ICU setting to assess agitation and sedation and in ICU and non‐ICU populations to assess sleep and activity . It is easy to use, noninvasive, and inexpensive.…”

Section: Introductionmentioning

confidence: 99%

“…It is easy to use, noninvasive, and inexpensive. It is worn like a bracelet and does not impair the patient's mobility or ambulation …”

Section: Introductionmentioning

confidence: 99%

Physical function and actigraphy in intensive care survivors—A prospective 3‐month follow‐up cohort study

Estrup

Kjer

Vilhelmsen

et al. 2019

Acta Anaesthesiol Scand

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Funding informationDepartmental funding only.Background: Impaired physical function after intensive care unit (ICU) stay is common. We aimed to study the association between activity levels in the ward after discharge from ICU and physical function at 3-month follow-up.Methods: Prospective cohort study of adult patients admitted to the ICU for more than 24 hours. Patients wore an accelerometer for up to 7 days at the ward. At discharge from ICU and at 3-month follow-up, patients were tested with the Chelsea Critical Care Physical Assessment Tool (CPAx). Results:We screened 66 consecutive, eligible patients; 41 completed actigraphy and 19 patients were visited at 3 months. The median CPAx increased from 31 (IQR 23-41) at discharge from ICU to 47 (IQR 44-49) at follow-up (P < 0.0001). Mean daily activity for the first week was correlated with CPAx at ICU discharge (R 2 = 0.14, P = 0.017; all 41 patients). For the 19 visited patients, we found no significant correlation for activity levels with CPAx at ICU discharge (R 2 = 0.12, P = 0.14) nor at visit (R 2 = 0.2, P = 0.058). Conclusion:We found improved physical function for most patients 3 months after ICU treatment. Activity levels for 1 week after ICU discharge at the ward were not associated with better physical function at 3-month follow-up.

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Actigraphy for measurements of sleep in relation to oncological treatment of patients with cancer: A systematic review

Cited by 40 publications

References 60 publications

Circadian rest‐activity rhythm as an objective biomarker of patient‐reported outcomes in patients with advanced cancer

Circadian rest‐activity rhythm as an objective biomarker of patient‐reported outcomes in patients with advanced cancer

Systems Chronotherapeutics

Physical function and actigraphy in intensive care survivors—A prospective 3‐month follow‐up cohort study

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