Association between daytime activity, sleep, and symptom burden in patients with advanced cancer: A preliminary report.

Abstract

101 Background: There is limited research in advanced cancer patients (ACP) regarding association between objective daytime activity, sleep variables and symptom burden. Our primary aim was to determine the association between mean daytime activity (MDTA) and objective sleep variables, cancer related fatigue (FACIT-F), symptom burden (ESAS), Anxiety and Depression (HADS), Sleep Quality (PSQI) and overall survival (OS). Methods: Secondary analysis of a recent clinical trial of cancer related fatigue in advanced cancer (NCT00424099). Association between MDTA and sleep variables (measured by actigraphy) during the first week of the study and patient characteristics, symptoms (FACIT-F, ESAS, HADS, and PSQI) and OS were analyzed using Spearman correlation, multivariate analysis and survival analysis. Results: 79 eligible patients were evaluable. The median age was 57 years. Median MDTA was 248.43 counts/min. MDTA was significantly associated with (r, p-value) age (-.379, ≤ .001), serum albumin (.328, .006), FACT-Functional well-being (FWB) (.248, .028), ESAS dyspnea (-.300, .008), HADS-Anxiety (.262, P = .019) and total sleep time (-.323, .004). MDTA was not associated with FACIT-F subscale (p = .997) and OS (p = .18). PSQI was significantly associated with FACIT-F, HADS, ESAS anxiety and depression, but none of these variables were associated with sleep measured by actigraphy. Conclusions: In ACP, lower MDTA was not correlated with patient reported fatigue, and sleep measured by actigraphy was not associated with patient reported sleep disturbance. Both fatigue and sleep disturbance were strongly associated with depression and anxiety. More research is needed to characterize the association between objective and patient reported daytime activity, fatigue and sleep. Clinical trial information: NCT00424099.