Association between Daytime Activity, Fatigue, Sleep, Anxiety, Depression, and Symptom Burden in Advanced Cancer Patients: A Preliminary Report

Abstract

Background: There is limited research in advanced cancer patients (ACP) regarding association between objectively measured daytime activity and sleep (as measured by actigraphy), patient characteristics, and cancer symptoms (fatigue, sleep, anxiety, depression, cachexia, and symptom distress scores [SDSs]). Objectives: Our aim of the study was to determine the association between mean daytime activity (MDTA) and the following items: fatigue (FACIT-F), SDSs (Edmonton Symptom Assessment Scale [ESAS]), sleep quality (Pittsburg Sleep Quality Index [PSQI]), objective sleep variables (OSV) (sleep onset, sleep efficacy, wake after sleep onset, total sleep time), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), body composition scores, and overall survival (OS). We also examined the association between sleep [PSQI and OSV scores] and FACIT-F, HADS, and ESAS. Methods: Secondary analysis of a recent clinical trial of cancer-related fatigue in advanced cancer (NCT00424099). Association between MDTA and OSV (measured by actigraphy) during the first week of the study and patient characteristics, symptoms (FACIT-F, ESAS, HADS, and PSQI), and OS were analyzed. Results: Seventy-nine eligible patients were evaluable. The median age was 57 years. Median MDTA was 248.43 counts/minute. Multivariate analysis shows that low MDTA was significantly associated with age, gender, Functional Assessment of Cancer Therapy (FACT)-Functional Well-Being (FWB), ESAS dyspnea, HADS-anxiety, and total sleep time. MDTA was not associated with FACIT-F ( p = 0.997) and OS ( p = 0.18). Sleep quality (PSQI) was significantly associated with FACIT-F, HADS, ESAS anxiety, and depression, but none of these variables was associated with OSV. Conclusion: In ACP, lower MDTA was significantly associated with age, gender, FACT-FWB, ESAS dyspnea, HADS-anxiety, and total sleep time. Both sleep quality and cancer-related fatigue scores were strongly associated with depression and anxiety. More research is needed.

Cranial Electrotherapy Stimulation for the Management of Depression, Anxiety, Sleep Disturbance, and Pain in Patients With Advanced Cancer: A Preliminary Study

“…27,58,69e71 Prior studies also found that anxiety, depression, and pain was associated with disturbance in sleep. 72,73 In our study, we also found improvement of PSQI total sleep score by two points, P ¼ 0.055 (which is better than most pharmacological trials). We also found significant improvement of PSQI daytime dysfunction, sedative medication use, anxiety, depression, and pain scores.…”

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

“…Two independent datasets were used to test this hypothesis. Based on the convenience of its noninvasive methodology and previous reports in smaller cohorts showing an association with fatigue and sleep problems, [19][20][21][22][23][24][25] we selected the circadian rest-activity rhythm as measured by wrist actigraphy. 26,27 Wrist actigraphy has been validated as an objective biomarker of circadian function.…”

Application of doctor-patient communication skills in clinical teaching of postgraduates of tumour radiotherapy

“…If the treatment is only symptomatic and ignores the patient's psychological needs, it may aggravate the condition and seriously affect the quality of life and survival of the patient [8]. Therefore, good communication between doctors and patients can ease the patient's anxiety, make the patient treat the disease more actively, and improve the quality of life of patients with advanced cancer [9][10].…”