Physical Activity, Sleep, Cognitive Function, and Fatigue in Head and Neck Cancer Survivors

Abstract

Physical activity associations with multiple dimensions of sleep, cognitive function, and fatigue have not been studied in head and neck cancer (HNCa) survivors. PURPOSE: To explore associations between physical activity, sleep, cognitive function, and fatigue among HNCa survivors. METHODS: A cross-sectional study enrolled 55 HNCa out-patients (response rate = 80%). Mean age was 60 ± 13. The majority were men (71%), Caucasian (98%), off treatment (89%) with cancer of the oral cavity or oropharnyx 66%). Self-administered survey included leisure physical activity, Functional Assessment of Cancer Treatment-Cognitive, Pittsburgh Sleep Quality Index, and Fatigue Symptom Inventory. RESULTS: Mean weekly minutes of moderate + vigorous physical activity was 89 ± 216 with no moderate or vigorous activity reported by 73%. Higher weekly minutes of moderate + vigorous physical activity demonstrated small associations with longer sleep latency (r =.21, p =.14), sleep medication use (r =.12, p =.41), lower sleep efficiency (r = −.18, p =.22), and shorter sleep duration (r = −.13, p =.34) but no association was noted for daytime or overall sleep dysfunction. Higher activity was weakly associated with better memory (r = 0.20, p =.15), higher verbal fluency (r =. 10, p =.47) and less frequent notice of cognitive deficit by others (r = −. 11, p =.42) with no association noted for mental acuity, concentration, functioning interference, and change from previous cognitive function. No associations with activity were found for fatigue amount, intensity, or interference. Greater sleep dysfunction was associated with poorer cognitive function for all dimensions (e.g., r = −.33, p =.02 for verbal fluency) and greater fatigue (e.g., r =.46, p =.001 for fatigue intensity). Fatigue intensity and interference were strongly associated with poorer cognitive function (e.g., r = −.54, p <.001 for fatigue intensity and mental acuity). CONCLUSIONS: With few HNCa survivors reporting any moderate or vigorous activity, the influence of physical activity on sleep, cognitive function, and fatigue in HNCa survivors cannot be fully assessed but appears small and variable based on domain measured. Prospective studies assessing these activity outcomes (and possible interactions) should include adequate sample sizes and multi-dimensional measures.