Relationship of subjective and objective sleep measures with physical performance in advanced-stage lung cancer patients

Naomi Takemura,Chia-Chin Lin,Tai-Chung Lam,Denise Shuk Ting Cheung,Tsz Yeung Kam,Anne Wing Mui Lee,James Chung-Man Ho,Daniel Yee Tak Fong,Jeannie Yin Kwan Chik

doi:10.1038/s41598-021-96481-7

Abstract

Advanced lung cancer patients suffer from deteriorated physical function, which negatively impacts physical and psychological health. As little is known about sleep and physical function in this population, this study aimed to examine the association between subjective and objective sleep parameters and physical function among them. 164 advanced lung cancer patients were included. Objective sleep was measured by actigraphy (measured on non-dominant wrist for 72 h), and subjective sleep quality was assessed by the Pittsburgh Sleep Quality Index (PSQI). Performance-based physical function was measured by Timed Up and Go Test (TUGT), 6-Minute Walk Test (6MWT), Sit-to-Stand Test, and One-leg Standing Test. Univariable and multivariable regression analyses were employed to examine the association between sleep and physical function. Total sleep time (TST) was significantly associated with the 6MWT (β = 0.259; 95% CI 0.120, 0.398; P < 0.001), TUGT (β = − 0.012; 95% CI = − 0.017, − 0.008; P < 0.001) and Sit-to-Stand Test (β = 0.027; 95% CI = 0.018, 0.035; P < 0.001) after adjustment for multiple covariates. PSQI global score was only significantly associated with TUGT (β = 0.140; 95% CI = 0.000, 0.280; P = 0.050) after adjustment for multiple covariates. Shorter sleep duration significantly predicted poorer physical performance in advanced lung cancer patients, and more attention is required for those with less than 4.3 h of sleep on average.Trial registration: ClinicalTrials.gov, NCT03482323. Registered 29 March 2018, https://clinicaltrials.gov/ct2/show/NCT03482323; ClinicalTrials.gov, NCT04119778. Registered 8 October 2019, https://clinicaltrials.gov/ct2/show/NCT04119778.

Highlights

Background characteristicsSociodemographic variables, cancer-related information, and lifestyle factors were collected via a self-designed questionnaire
Data were collected via questionnaires, objective physical performance tests, and actigraphy
The current study showed that shorter sleep duration as measured by actigraphy was independently associated with lower physical function as measured by the 6-Minute Walk Test (6MWT), Sit-to-Stand Test, and Timed Up and Go Test

Summary

Introduction

Sociodemographic variables, cancer-related information, and lifestyle factors were collected via a self-designed questionnaire. Sociodemographic variables included age, gender, marital status, and education level. Cancer-related information comprised current treatment modalities (chemotherapy or nonchemotherapy), time since diagnosis, and lifestyle factors consisting of smoking (smoker or nonsmoker) and drinking (drinker or nondrinker) habits. Body mass index (BMI) was calculated as weight in kilograms divided by height in metres squared. The Karnofsky Performance Status (KPS) score, which measures the level of patient activity and patient independence, was assessed by nurses[34]. Psychological distress (i.e., anxiety and depression symptoms) was measured using the Chinese version of the Hospital Anxiety and Depression Score (HADS), with a score of 8 or more on either subscale representing clinical cases of anxiety or depression[35]

Methods

Results

Discussion

Conclusion