The Relationship between Fatigue and Actigraphy-Derived Sleep and Rest-Activity Patterns in Cancer Survivors

Abstract

Background: Cancer-related fatigue can continue long after curative cancer treatment. The aim of this study was to investigate sleep and rest-activity cycles in fatigued and non-fatigued cancer survivors. We hypothesized that sleep and rest-activity cycles would be more disturbed in people experiencing clinically-relevant fatigue, and that objective measures of sleep would be associated with the severity of fatigue in cancer survivors.Methods: Cancer survivors (n=87) completed a 14-day wrist actigraphy measurement for the estimation of sleep and rest-activity cycles. Fatigue was measured using the Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F). Participants were dichotomised into two groups using a previously validated score (fatigued n=51 and non-fatigued n=36). Perception of sleep was measured using the Insomnia Severity Index (ISI).Results: FACIT-F score was correlated with wake after sleep onset (r =-0.28; p = 0.010), sleep efficiency (r=0.26; p=0.016), sleep onset latency (r=-0.31; p=0.044) and ISI score (r=-0.56; p <0.001). The relative amplitude of the rest-activity cycles was lower in the fatigued vs. non-fatigued group (p=0.017; d=0.58). Conclusions: After treatment for cancer, the severity of cancer-related fatigue is correlated with specific objective measures of sleep, and there is evidence of rest-activity cycle disruption in people experiencing clinically-relevant fatigue.

Can improving quality of sleep reduce the symptoms of cancer‐related fatigue in adults?: A systematic review

“…This suggests that the quality of sleep is more important when trying to treat fatigue. The association between sleep quality and fatigue in cancer survivors has been recently confirmed using actigraphy‐derived sleep quality parameters (Martin et al, 2021). This makes sense when considering that CRF can affect the HPA axis.…”