Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial

Courneya, Kerry S.; Segal, Roanne; Mackey, John R.; Gelmon, Karen A.; Friedenreich, Christine M.; Yasui, Yutaka; Reid, Robert D.; Jespersen, D. K.; Cook, Diane J.; Proulx, Carolyn; Trinh, Linda; Dolan, Lianne B.; Wooding, Evyanne; Forbes, Cynthia C.; McKenzie, Donald C.

doi:10.1007/s10549-014-2883-0

Cited by 75 publications

(77 citation statements)

References 23 publications

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“…61 Exercise-induced maintenance or improvements in circadian rhythm may result in decreases in sleep disturbance and morning fatigue. 58,59,62,63 While the association between altered circadian rhythms and morning fatigue severity has not been studied in oncology patients, it was found to be associated with more severe morning fatigue in mothers with an infant in the ICU 64 and in women with HIV disease. 65 …”

Section: Discussionmentioning

confidence: 99%

Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue

Wright

Melkus

Hammer

et al. 2015

Journal of Pain and Symptom Management

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Context Fatigue is the most common symptom in oncology patients during chemotherapy (CTX). Little is known about the predictors of interindividual variability in initial levels and trajectories of morning fatigue severity in these patients. Objectives An evaluation was done to determine which demographic, clinical, and symptom characteristics were associated with initial levels as well as the trajectories of morning fatigue and to compare findings with our companion paper on evening fatigue. Methods A sample of outpatients with breast, gastrointestinal, gynecological, and lung cancer (N=586) completed demographic and symptom questionnaires a total of six times over two cycles of CTX. Fatigue severity was evaluated using the Lee Fatigue Scale. Hierarchical linear modeling (HLM) was used to answer the study objectives. Results A large amount of interindividual variability was found in the morning fatigue trajectories. A piecewise model fit the data best. Patients with higher body mass index (BMI), who did not exercise regularly, with a lower functional status, and who had higher levels of state anxiety, sleep disturbance and depressive symptoms, reported higher levels of morning fatigue at enrollment. Variations in the trajectories of morning fatigue were predicted by the patients’ ethnicity and younger age. Conclusion The modifiable risk factors that were associated with only morning fatigue were BMI, exercise, and state anxiety. Modifiable risk factors that were associated with both morning and evening fatigue included functional status, depressive symptoms, and sleep disturbance. Using this information, clinicians can identify patients at higher risk for more severe morning fatigue and evening fatigue, provide individualized patient education, and tailor interventions to address the modifiable risk factors.

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Section: Discussionmentioning

confidence: 99%

Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue

Wright

Melkus

Hammer

et al. 2015

Journal of Pain and Symptom Management

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“…But, what intervention could be used to solve the sleep trouble? Besides pharmacological therapy [26, 27], behavioral therapy [28, 29], exercise [30], and even Yoga [31] have been tested to be effective to manage sleep dysfunction in cancer patients. We will test these therapeutic methods in our future studies.…”

Section: Discussionmentioning

confidence: 99%

Sleep Quality of Patients with Differentiated Thyroid Cancer

Meng

Jia

et al. 2015

PLoS ONE

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ObjectiveWe aimed to measure prevalence of sleep disturbance in patients with differentiated thyroid cancer (DTC) by calculating Pittsburgh Sleep Quality Index (PSQI), and compare these data with patients with benign thyroid nodules or normal participants.MethodsThree groups of patients participated in this cross-sectional study. In the first group, 162 patients with DTC received total thyroidectomy, and then 131I therapy. The second group consisted of 84 patients with benign thyroid nodules, who received partial thyroidectomy. The third group was 78 normal healthy control cases. PSQI was used to assess the sleep quality. Inter-group differences were analyzed by Kruskal-Wallis test or independent samples T test. χ2 test was also used to check prevalence differences of poor sleep quality among the groups. Differences of PSQI score and poor sleep quality prevalence before and after 131I therapy in the same group of DTC participants were analyzed by paired T test and Mcnemar's test.ResultsHigher PSQI score (7.59 ± 4.21) and higher rate of poor sleep quality (54.32%) were shown in DTC patients than in any other group. After 131I therapy, PSQI score and prevalence of poor sleep quality in DTC patients increased significantly to 8.78 ± 4.72 and 70.99%. Then DTC patients were divided into two subgroups based on their metastatic status. DTC patients with metastasis (87/162 cases, 53.70%) had significantly higher PSQI score (10.87 ± 5.18) and higher prevalence of poor sleep quality (79.31%).ConclusionDTC patients suffer from sleep disturbance, 131I therapy and awareness of metastatic status could worsen sleep problem. Psychological fear of cancer, nuclear medicine therapy and metastasis could be one major underlying reason. Longitude and interventional studies are necessary for further investigations.

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“…The inability of this meta-analysis to detect sleep quality benefits is not unexpected given that currently published randomized controlled trials (RCTs) of aerobic exercise (e.g., home-based walking, supervised aerobic exercise) in breast cancer survivors specifically have not consistently reported beneficial intervention effects on sleep (10,22,27,30–32,34,37). In the seven trials measuring self-report, significant intervention effects were reported for overall sleep quality in four studies (two occurred during chemotherapy/radiation) (10,22,27,37), efficiency in one study (during chemotherapy) (10), latency in two studies (one during chemotherapy) (10,31), and sleep duration in one (post-chemotherapy/radiation) (30).…”

Section: Introductionmentioning

confidence: 94%

“…In the seven trials measuring self-report, significant intervention effects were reported for overall sleep quality in four studies (two occurred during chemotherapy/radiation) (10,22,27,37), efficiency in one study (during chemotherapy) (10), latency in two studies (one during chemotherapy) (10,31), and sleep duration in one (post-chemotherapy/radiation) (30). Another post chemotherapy/radiation trial reported beneficial effects on accelerometer measured efficiency, latency, and awake time (34).…”

Section: Introductionmentioning

confidence: 99%

Physical Activity and Sleep Quality in Breast Cancer Survivors

Rogers

Courneya

Oster

et al. 2017

Medicine &Amp; Science in Sports &Amp; Exercise

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Purpose Data from large randomized controlled trials confirming sleep quality improvements with aerobic physical activity have heretofore been lacking for post-primary treatment breast cancer survivors. Our primary purpose for this report was to determine the effects of a physical activity behavior change intervention, previously reported to significantly increase physical activity behavior, on sleep quality in post-primary treatment breast cancer survivors. Methods Post-primary treatment breast cancer survivors (n=222) were randomized to a 3-month physical activity behavior change intervention (BEAT Cancer) or usual care. Self-report (Pittsburgh Sleep Quality Index [PSQI]) and actigraphy (latency and efficiency) sleep outcomes were measured at baseline, 3 months (M3), and 6 months (M6). Results After adjusting for covariates, BEAT Cancer significantly improved PSQI global sleep quality when compared with usual care at M3 (mean between group difference [M] = −1.4; 95% CI = −2.1 to −0.7; p < .001) and M6 (M = −1.0; 95% CI = −1.7 to −0.2; P = .01). BEAT Cancer improved several PSQI subscales at M3 (sleep quality M = −0.3; 95% CI = −0.4 to −0.1; P = .002; sleep disturbances M = −0.2; 95% CI = −0.3 to −0.03; P = .016; daytime dysfunction M = −0.2; 95% CI = −0.4 to −0.02; P = .027) but not M6. A non-significant increase in percent of participants classified as good sleepers occurred. No significant between group difference was noted for accelerometer latency or efficiency. Conclusion A physical activity intervention significantly reduced perceived global sleep dysfunction at 3 and 6 months, primarily due to improvements in sleep quality aspects not detected with accelerometer.

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Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial

Cited by 75 publications

References 23 publications

Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue

Predictors and Trajectories of Morning Fatigue Are Distinct From Evening Fatigue

Sleep Quality of Patients with Differentiated Thyroid Cancer

Physical Activity and Sleep Quality in Breast Cancer Survivors

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