Annals of Hematology

, Volume 96, Issue 5, pp 749–755 | Cite as

Reallocating time to sleep, sedentary, and active behaviours in non-Hodgkin lymphoma survivors: associations with patient-reported outcomes

  • Jeff K. VallanceEmail author
  • Matthew P. Buman
  • Brigid M. Lynch
  • Terry Boyle
Original Article


The purpose of this study was to examine potential effects of reallocating time between sleep, sedentary and active behaviours on fatigue symptoms and quality of life in a sample of non-Hodgkin lymphoma survivors. Non-Hodgkin lymphoma survivors identified from the Western Australian Cancer Registry (N = 149) (response rate = 36%; median age = 64 years) wore an Actigraph® GT3X+ accelerometer for 7 days and completed the Fatigue Scale, the Functional Assessment of Cancer Therapy-General and the Pittsburgh Sleep Quality Index. We used isotemporal substitution methods in linear regression models to examine the potential effects of reallocating time between sleep, sedentary and activity behaviours on fatigue and quality of life. Data collection was conducted in Western Australia in 2013. Significant differences were observed for fatigue symptoms when 30 min per day of bouted moderate-to-vigorous physical activity (10 min) was reallocated from 30 min per day of sleep (5.7 points, 95% CI = 1.8, 9.7), sedentary time bouts (20 min) (5.7 points, 95% CI = 1.6, 9.7), sedentary time non-bouts (5.1 points, 95% CI = 1.0, 9.3) or light intensity activity (5.5 points, 95% CI = 1.5, 9.5). Isotemporal substitution effects of reallocating sedentary time, sleep and light physical activity with bouted physical activity was significantly associated with fatigue, but not quality of life. Findings from the present study may aid in the development and delivery of health behaviour interventions that are more likely to influence the health outcome of interest.


Non-Hodgkin lymphoma Physical activity Sedentary time Isotemporal substation modelling 



Jeff Vallance is supported by the Canada Research Chairs program and a Population Health Investigator Award from Alberta Innovates—Health Solutions. Brigid Lynch is supported by an Early Career Fellowship from the National Breast Cancer Foundation. Terry Boyle is supported by an Early Career Fellowship from the Australian National Health and Medical Research Council (#1072266), a Fellowship from the Canadian Institutes of Health Research (#300068), a Postdoctoral Fellowship from the Michael Smith Foundation for Health Research (#5553) and an Honorary Killam Postdoctoral Research Fellowship from Killam Trusts/The University of British Columbia. We would like to thank Emily Ransom for her assistance in data collection and study management and Ms. Jessica Occleston for her assistance in data processing. We also sincerely thank the people who took the time to participate in this study.

Compliance with ethical standards

Human Research Ethics Committees at the WA Department of Health and The University of WA approved this study.


This work was supported by a grant from Cancer Council Western Australia awarded to Terry Boyle.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2017

Authors and Affiliations

  • Jeff K. Vallance
    • 1
    Email author
  • Matthew P. Buman
    • 2
  • Brigid M. Lynch
    • 3
    • 4
    • 5
  • Terry Boyle
    • 6
    • 7
  1. 1.Faculty of Health Disciplines, Centre for Nursing and Health StudiesAthabasca UniversityAthabascaCanada
  2. 2.School of Nutrition and Health PromotionArizona State UniversityPhoenixUSA
  3. 3.Cancer Epidemiology CentreCancer Council VictoriaMelbourneAustralia
  4. 4.Melbourne School of Population and Global HealthThe University of MelbourneMelbourneAustralia
  5. 5.Physical Activity LaboratoryBaker Heart and Diabetes InstituteMelbourneAustralia
  6. 6.British Columbia Cancer AgencyUniversity of British ColumbiaVancouverCanada
  7. 7.School of Public HealthCurtin UniversityPerthAustralia

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