Advertisement

Supportive Care in Cancer

, Volume 26, Issue 8, pp 2663–2673 | Cite as

Relationship between sleep and exercise as colorectal cancer survivors transition off treatment

  • Theresa ColesEmail author
  • Antonia V. Bennett
  • Xianming Tan
  • Claudio L. Battaglini
  • Hanna K. Sanoff
  • Ethan Basch
  • Roxanne E. Jensen
  • Bryce B. Reeve
Original Article

Abstract

Purpose

The primary objective of this study was to evaluate the relationship between exercise and sleep disturbance in a sample of individuals diagnosed with stage I, II, and III colorectal cancer (CRC) as patients transitioned off first-line treatment. We also sought to identify heterogeneity in the relationship between sleep disturbance and exercise.

Methods

Data were obtained from the MY-Health study, a community-based observational study of adults diagnosed with cancer. Patient-Reported Outcomes Measurement Information System® (PROMIS) measures (e.g., PROMIS Sleep) were administered, and participants self-reported demographics, comorbidities, cancer treatment, and exercise. Regression mixture and multiple regression models were used to evaluate the relationship between sleep disturbance and exercise cross-sectionally at an average of 10 months after diagnosis, and the change in sleep disturbance over a 7-month period, from approximately 10 to 17 months post-diagnosis.

Results

Patients whose exercise was categorized as likely at or above American College of Sports Medicine’s guidelines did not report statistically better sleep quality compared to patients who were classified as not active. However, retirement (B = − 2.4), anxiety (B = 0.21), and fatigue (B = 0.24) had statistically significant relationships with sleep disturbance (p < 0.05). Increase in exercise was not significantly associated with a decrease in sleep disturbance. No statistical heterogeneity was revealed in the relationship between sleep and exercise.

Conclusions

Further prospective research using an objective measure of exercise is warranted to confirm or refute the nature of the relationship between exercise and sleep disturbance in individuals diagnosed with CRC transitioning off first-line treatment.

Keywords

Cancer Oncology Sleep Quality of life Exercise 

Notes

Funding information

Theresa Coles received funding from the 2016–2017 Alvin R. Tarlov and John E. Ware Jr. Doctoral Dissertation Award in Patient-Reported Outcomes for tuition and conference attendance. Theresa Coles is employed at RTI-Health Solutions, where she received tuition assistance; this manuscript includes key results from her dissertation. Funding for the MY-Health study (Roxanne Jensen) was from the NIAMS U01AR057971 and a general support grant, NCI P30CA051008.

Compliance with ethical standards

Ethical approval

This secondary data analysis was deemed non-human subjects research by the University of North Carolina IRB; formal consent is not required. The MY-Health study was approved through Georgetown University’s IRB (approval 2009-436).

Supplementary material

520_2018_4110_MOESM1_ESM.docx (66 kb)
ESM 1 (DOCX 65 kb)

References

  1. 1.
    Palesh O, Peppone L, Innominato PF, Janelsins M, Jeong M, Sprod L, Savard J, Rotatori M, Kesler S, Telli M, Mustian K (2012) Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer. Nat Sci Sleep 4:151–162.  https://doi.org/10.2147/NSS.S18895 CrossRefPubMedPubMedCentralGoogle Scholar
  2. 2.
    Winkelman JW (2015) Clinical practice. Insomnia disorder. N Engl J Med 373(15):1437–1444.  https://doi.org/10.1056/NEJMcp1412740 CrossRefPubMedGoogle Scholar
  3. 3.
    Mota DD, Pimenta CA, Caponero R (2012) Fatigue in colorectal cancer patients: prevalence and associated factors. Rev Lat Am Enfermagem 20(3):495–503CrossRefPubMedGoogle Scholar
  4. 4.
    Manocchia M, Keller S, Ware JE (2001) Sleep problems, health-related quality of life, work functioning and health care utilization among the chronically ill. Qual Life Res 10(4):331–345CrossRefPubMedGoogle Scholar
  5. 5.
    Arndt V, Merx H, Stegmaier C, Ziegler H, Brenner H (2004) Quality of life in patients with colorectal cancer 1 year after diagnosis compared with the general population: a population-based study. J Clin Oncol 22(23):4829–4836.  https://doi.org/10.1200/jco.2004.02.018 CrossRefPubMedGoogle Scholar
  6. 6.
    King AC, Oman RF, Brassington GS, Bliwise DL, Haskell WL (1997) Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. JAMA 277(1):32–37CrossRefPubMedGoogle Scholar
  7. 7.
    Mishra SI, Scherer RW, Geigle PM, Berlanstein DR, Topaloglu O, Gotay CC, Snyder C (2012) Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 8:CD007566.  https://doi.org/10.1002/14651858.CD007566.pub2 CrossRefGoogle Scholar
  8. 8.
    Tran H, Lin C, Yu F, Frederick A, Mieras M, Baccaglini L (2016) A multicenter study on the relative effectiveness of a 12-week physical training program for adults with an oncologic diagnosis. Support Care Cancer 24:3705–3713.  https://doi.org/10.1007/s00520-016-3194-2 CrossRefPubMedGoogle Scholar
  9. 9.
    Spector D, Battaglini C (2015) The feasibility of delivering a home-based motivational exercise program to African-American breast cancer survivors. J Health Disparities Res Pract 8(1):9Google Scholar
  10. 10.
    Wood WA, Phillips B, Smith-Ryan AE, Wilson D, Deal AM, Bailey C, Meeneghan M, Reeve BB, Basch EM, Bennett AV, Shea TC, Battaglini CL (2016) Personalized home-based interval exercise training may improve cardiorespiratory fitness in cancer patients preparing to undergo hematopoietic cell transplantation. Bone Marrow Transplant 51(7):967–972.  https://doi.org/10.1038/bmt.2016.73 Epub 2016 Mar 21CrossRefPubMedPubMedCentralGoogle Scholar
  11. 11.
    Lin KY, Shun SC, Lai YH, Liang JT, Tsauo JY (2014) Comparison of the effects of a supervised exercise program and usual care in patients with colorectal cancer undergoing chemotherapy. Cancer Nurs 37(2):E21–E29.  https://doi.org/10.1097/NCC.0b013e3182791097 CrossRefPubMedGoogle Scholar
  12. 12.
    Cho MH, Dodd MJ, Cooper BA, Miaskowski C (2012) Comparisons of exercise dose and symptom severity between exercisers and nonexercisers in women during and after cancer treatment. J Pain Symptom Manag 43(5):842–854.  https://doi.org/10.1016/j.jpainsymman.2011.05.016 CrossRefGoogle Scholar
  13. 13.
    LeMasters T, Madhavan S, Sambamoorthi U, Kurian S (2013) A population-based study comparing HRQoL among breast, prostate, and colorectal cancer survivors to propensity score matched controls, by cancer type, and gender. Psychooncology 22(10):2270–2282.  https://doi.org/10.1002/pon.3288 PubMedPubMedCentralCrossRefGoogle Scholar
  14. 14.
    Chung JY, Lee DH, Park JH, Lee MK, Kang DW, Min J, Kim DI, Jeong DH, Kim NK, Meyerhardt JA, Jones LW, Jeon JY (2013) Patterns of physical activity participation across the cancer trajectory in colorectal cancer survivors. Support Care Cancer 21(6):1605–1612.  https://doi.org/10.1007/s00520-012-1703-5 CrossRefPubMedGoogle Scholar
  15. 15.
    Jensen RE, Moinpour CM, Keegan TH, Cress RD, Wu X-C, Paddock LE, Stroup AM, Potosky AL (2016) The measuring your health study: leveraging community-based cancer registry recruitment to establish a large, diverse cohort of cancer survivors for analyses of measurement equivalence and validity of the patient reported outcomes measurement information system®(PROMIS®) short form items. Psychol Test Assess Model 58(1):99Google Scholar
  16. 16.
    PROMIS 2 MY Health (2016) Harvard Dataverse.  https://doi.org/10.7910/DVN/XD1A6B
  17. 17.
    Patient-reported outcomes measurement information system (2015) PROMIS Sleep Disturbance Scoring Manual. https://www.assessmentcenter.net/documents/PROMIS%20Sleep%20Disturbance%20Scoring%20Manual.pdf. Accessed 11 Nov 2016
  18. 18.
    Jensen R, King-Kallimanis B, Sexton E, Reeve B, Moinpour C, Potosky A, Lobo T, Teresi J (2016) Measurement properties of PROMIS sleep disturbance short forms in a large, ethnically diverse cancer cohort. Psychol Test Assess Model 58(2):353–370Google Scholar
  19. 19.
    Health Measures (2016) Interpret scores: PROMIS. http://www.healthmeasures.net/score-and-interpret/interpret-scores/promis. Accessed 31 Aug 2016
  20. 20.
    Jensen RE, Moinpour CM, Potosky AL, Lobo T, Hahn EA, Hays RD, Cella D, Smith AW, Wu XC, Keegan TH, Paddock LE, Stroup AM, Eton DT (2016) Responsiveness of 8 patient-reported outcomes measurement information system (PROMIS) measures in a large, community-based cancer study cohort. Cancer 123(2):327–335.  https://doi.org/10.1002/cncr.30354 CrossRefPubMedPubMedCentralGoogle Scholar
  21. 21.
    Schmitz KH, Courneya KS, Matthews C, Demark-Wahnefried W, Galvão DA, Pinto BM, Irwin ML, Wolin KY, Segal RJ, Lucia A, Schneider CM, von Gruenigen VE, Schwartz AL, Medicine ACS (2010) American College of Sports Medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42(7):1409–1426.  https://doi.org/10.1249/MSS.0b013e3181e0c112 CrossRefPubMedGoogle Scholar
  22. 22.
    Savard J, Villa J, Ivers H, Simard S, Morin CM (2009) Prevalence, natural course, and risk factors of insomnia comorbid with cancer over a 2-month period. J Clin Oncol 27(31):5233–5239.  https://doi.org/10.1200/jco.2008.21.6333 CrossRefPubMedGoogle Scholar
  23. 23.
    Alfano CM, Lichstein KL, Vander Wal GS, Smith AW, Reeve BB, McTiernan A, Bernstein L, Baumgartner KB, Ballard-Barbash R (2011) Sleep duration change across breast cancer survivorship: associations with symptoms and health-related quality of life. Breast Cancer Res Treat 130(1):243–254.  https://doi.org/10.1007/s10549-011-1530-2 CrossRefPubMedPubMedCentralGoogle Scholar
  24. 24.
    Bliwise D, Scullin M (2017) Normal aging. Principles and practice of sleep medicine, Sixth edn. Elsevier, PhiladelphiaGoogle Scholar
  25. 25.
    Reeve BB, Pinheiro LC, Jensen RE, Teresi JA, Potosky AL, McFatrich MK, Ramirez M, Chen W-H (2016) Psychometric evaluation of the PROMIS® fatigue measure in an ethnically and racially diverse population-based sample of cancer patients. Psychol Test Assess Model 58(1)Google Scholar
  26. 26.
    Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, Cook K, Devellis R, DeWalt D, Fries JF, Gershon R, Hahn EA, Lai JS, Pilkonis P, Revicki D, Rose M, Weinfurt K, Hays R, Group PC (2010) The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. J Clin Epidemiol 63(11):1179–1194.  https://doi.org/10.1016/j.jclinepi.2010.04.011 CrossRefPubMedPubMedCentralGoogle Scholar
  27. 27.
    Savard J, Savard M-H, Ancoli-Israel S (2017) Principles and practice of sleep medicine, Sixth edn. Elsevier, PhiladelphiaGoogle Scholar
  28. 28.
    Cella DF, Tulsky DS, Gray G, Sarafian B, Linn E, Bonomi A, Silberman M, Yellen SB, Winicour P, Brannon J (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579CrossRefPubMedGoogle Scholar
  29. 29.
    Colten HR, Altevogt BM, Institute of Medicine (U.S.). Committee on Sleep Medicine and Research (2006) Sleep disorders and sleep deprivation : an unmet public health problem. Institute of Medicine : National Academies Press, Washington, DCGoogle Scholar
  30. 30.
    Mystakidou K, Parpa E, Tsilika E, Gennatas C, Galanos A, Vlahos L (2009) How is sleep quality affected by the psychological and symptom distress of advanced cancer patients? Palliat Med 23(1):46–53.  https://doi.org/10.1177/0269216308098088 CrossRefPubMedGoogle Scholar
  31. 31.
    Strine TW, Chapman DP (2005) Associations of frequent sleep insufficiency with health-related quality of life and health behaviors. Sleep Med 6(1):23–27.  https://doi.org/10.1016/j.sleep.2004.06.003 CrossRefPubMedGoogle Scholar
  32. 32.
    Sherwood NE, Jeffery RW (2000) The behavioral determinants of exercise: implications for physical activity interventions. Annu Rev Nutr 20:21–44.  https://doi.org/10.1146/annurev.nutr.20.1.21 CrossRefPubMedGoogle Scholar
  33. 33.
    Bauman AE, Sallis JF, Dzewaltowski DA, Owen N (2002) Toward a better understanding of the influences on physical activity: the role of determinants, correlates, causal variables, mediators, moderators, and confounders. Am J Prev Med 23(2 Suppl):5–14CrossRefPubMedGoogle Scholar
  34. 34.
    Sallis JF, Hovell MF (1990) Determinants of exercise behavior. Exerc Sport Sci Rev 18:307-330CrossRefGoogle Scholar
  35. 35.
    Schlattmann P (2009) Medical applications of finite mixture models [electronic resource]. Statistics for biology and health. Springer-Verlag, [Berlin]Google Scholar
  36. 36.
  37. 37.
    Kessler D, McDowell A (2012) Introducing the FMM procedure for finite mixture models. https://support.sas.com/resources/papers/proceedings12/328-2012.pdf. Accessed 15 July 2016
  38. 38.
    Colagiuri B, Christensen S, Jensen AB, Price MA, Butow PN, Zachariae R (2011) Prevalence and predictors of sleep difficulty in a national cohort of women with primary breast cancer three to four months postsurgery. J Pain Symptom Manag 42(5):710–720.  https://doi.org/10.1016/j.jpainsymman.2011.02.012 CrossRefGoogle Scholar
  39. 39.
    Cheville AL, Kollasch J, Vandenberg J, Shen T, Grothey A, Gamble G, Basford JR (2013) A home-based exercise program to improve function, fatigue, and sleep quality in patients with stage IV lung and colorectal cancer: a randomized controlled trial. J Pain Symptom Manag 45(5):811–821.  https://doi.org/10.1016/j.jpainsymman.2012.05.006 CrossRefGoogle Scholar
  40. 40.
    Courneya KS, Friedenreich CM (1997) Relationship between exercise pattern across the cancer experience and current quality of life in colorectal cancer survivors. J Altern Complement Med 3(3):215–226CrossRefPubMedGoogle Scholar
  41. 41.
    Savard J, Morin CM (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19(3):895–908CrossRefPubMedGoogle Scholar
  42. 42.
    Shuman AG, Duffy SA, Ronis DL, Garetz SL, McLean SA, Fowler KE, Terrell JE (2010) Predictors of poor sleep quality among head and neck cancer patients. Laryngoscope 120(6):1166–1172.  https://doi.org/10.1002/lary.20924 PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Adams SA, Matthews CE, Ebbeling CB, Moore CG, Cunningham JE, Fulton J, Hebert JR (2005) The effect of social desirability and social approval on self-reports of physical activity. Am J Epidemiol 161(4):389–398.  https://doi.org/10.1093/aje/kwi054 CrossRefPubMedPubMedCentralGoogle Scholar
  44. 44.
    Irwin MR (2015) Why sleep is important for health: a psychoneuroimmunology perspective. Annu Rev Psychol 66:143–172.  https://doi.org/10.1146/annurev-psych-010213-115205 CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.RTI-Health SolutionsResearch Triangle ParkUSA
  2. 2.University of North Carolina at Chapel Hill Department of Health Policy and ManagementChapel HillUSA
  3. 3.University of North Carolina at Chapel Hill, Lineberger Comprehensive Cancer CenterChapel HillUSA
  4. 4.Department of BiostatisticsUniversity of North Carolina at Chapel HillChapel HillUSA
  5. 5.Department of Exercise and Sport ScienceUniversity of North Carolina at Chapel HillChapel HillUSA
  6. 6.Division of Hematology/Oncology, Department of MedicineUniversity of North Carolina at Chapel HillChapel HillUSA
  7. 7.Department of OncologyGeorgetown UniversityWashingtonUSA
  8. 8.Department of Population Health SciencesDuke University School of MedicineDurhamUSA

Personalised recommendations