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

Abstract

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.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2

References

  1. 1.

    American Cancer Society (2016) Cancer facts & figures 2016. American Cancer Society, Atlanta

    Google Scholar 

  2. 2.

    Oerlemans S et al (2011) The impact of treatment, socio-demographic and clinical characteristics on health-related quality of life among Hodgkin’s and non-Hodgkin’s lymphoma survivors: a systematic review. Ann Hemat 90(9):993–1004

    Article  Google Scholar 

  3. 3.

    Oerlemans S et al (2013) A high level of fatigue among long-term survivors of non-Hodgkin’s lymphoma: results from the longitudinal population-based PROFILES registry in the south of the Netherlands. Haematologica 98(3):479–486

    Article  PubMed  PubMed Central  Google Scholar 

  4. 4.

    Mols F et al (2007) Quality of life among long-term non-Hodgkin lymphoma survivors. Cancer 109(8):1659–1667

    Article  PubMed  Google Scholar 

  5. 5.

    Arden-Close E, Pacey A, Eiser C (2010) Health-related quality of life in survivors of lymphoma: a systematic review and methodological critique. Leuk Lymphoma 51(4):628–640

    Article  PubMed  Google Scholar 

  6. 6.

    Jensen RE et al (2013) Health-related quality of life among survivors of aggressive non-Hodgkin lymphoma. Cancer 119(3):672–680

    Article  PubMed  Google Scholar 

  7. 7.

    Bergenthal N et al (2014) Aerobic physical exercise for adult patients with haematological malignancies. Cochrane Database Syst Rev 11:Cd009075

    Google Scholar 

  8. 8.

    Husson O et al (2015) High levels of physical activity are associated with lower levels of fatigue among lymphoma patients: results from the longitudinal PROFILES registry. Acta Oncol 54(5):678–684

    Article  PubMed  Google Scholar 

  9. 9.

    Spector DJ et al (2015) Are lifestyle behavioral factors associated with health-related quality of life in long-term survivors of non-Hodgkin lymphoma? Cancer 121(18):3343–3351

    Article  PubMed  PubMed Central  Google Scholar 

  10. 10.

    Vallance JK et al (2005) Differences in quality of life between non-Hodgkin’s lymphoma survivors meeting and not meeting public health exercise guidelines. Psychooncology 14(11):979–991

    Article  PubMed  Google Scholar 

  11. 11.

    Bellizzi KM et al (2009) Physical activity and quality of life in adult survivors of non-Hodgkin’s lymphoma. J Clin Oncol 27(6):960–966

    Article  PubMed  PubMed Central  Google Scholar 

  12. 12.

    Boyle T et al (2015) Volume and correlates of objectively measured physical activity and sedentary time in non-Hodgkin lymphoma survivors. Psychooncology. doi:10.1002/pon.4027

  13. 13.

    Lynch BM et al (2013) Don’t take cancer sitting down: a new survivorship research agenda. Cancer 119(11):1928–1935

    Article  PubMed  Google Scholar 

  14. 14.

    Owen N (2012) Ambulatory monitoring and sedentary behaviour: a population-health perspective. Physiol Meas 33(11):1801–1810

    Article  PubMed  Google Scholar 

  15. 15.

    Owen N (2012) Sedentary behavior: understanding and influencing adults’ prolonged sitting time. Prev Med 55(6):535–539

    Article  PubMed  Google Scholar 

  16. 16.

    Mekary RA et al (2009) Isotemporal substitution paradigm for physical activity epidemiology and weight change. Am J Epidemiol 170(4):519–527

    Article  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Buman MP et al (2014) Reallocating time to sleep, sedentary behaviors, or active behaviors: associations with cardiovascular disease risk biomarkers, NHANES 2005-2006. Am J Epidemiol 179(3):323–334

    Article  PubMed  Google Scholar 

  18. 18.

    van Roekel EH, et al.(2016) Modeling how substitution of sedentary behavior with standing or physical activity is associated with health-related quality of life in colorectal cancer survivors. Cancer Causes Control

  19. 19.

    Matthews CE et al (2008) Amount of time spent in sedentary behaviors in the United States, 2003-2004. Am J Epidem 167(7):875–881

    Article  Google Scholar 

  20. 20.

    Freedson PS, Melanson E, Sirard J (1998) Calibration of the Computer Science and Applications, Inc. accelerometer. Med Sci Sports Exerc 30(5):777–781

    CAS  Article  PubMed  Google Scholar 

  21. 21.

    Dunstan DW et al (2012) Breaking up prolonged sitting reduces postprandial glucose and insulin responses. Diab Care 35(5):976–983

    Article  Google Scholar 

  22. 22.

    United States Government (2008) 2008 physical activity guidelines for Americans. Department of Health and Human Services, Washington, DC

  23. 23.

    Buysse DJ et al (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28(2):193–213

    CAS  Article  PubMed  Google Scholar 

  24. 24.

    Cella D (1997) The Functional Assessment of Cancer Therapy-Anemia (FACT-An) scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Semin Hematol 34(3 Suppl 2):13–19

    CAS  PubMed  Google Scholar 

  25. 25.

    Cella DF et al (1993) The functional assessment of cancer therapy scale: development and validation of the general measure. J Clin Oncol 11(3):570–579

    CAS  Article  PubMed  Google Scholar 

  26. 26.

    Yost KJ et al (2013) The Functional Assessment of Cancer Therapy-General (FACT-G) is valid for monitoring quality of life in patients with non-Hodgkin lymphoma. Leuk Lymph 54(2):290–297

    Article  Google Scholar 

  27. 27.

    Cella D et al (2002) Combining anchor and distribution-based methods to derive minimal clinically important differences on the Functional Assessment of Cancer Therapy (FACT) Anemia and Fatigue Scales. J Pain Sympt Manag 24(6):547–561

    Article  Google Scholar 

  28. 28.

    Osoba D et al (1998) Interpreting the significance of changes in health-related quality-of-life scores. J Clin Oncol 16(1):139–144

    CAS  Article  PubMed  Google Scholar 

  29. 29.

    Phillips SM et al (2015) Objectively measured physical activity and sedentary behavior and quality of life indicators in survivors of breast cancer. Cancer 121(22):4044–4052

    Article  PubMed  PubMed Central  Google Scholar 

  30. 30.

    Vallance JK et al (2014) Associations of objectively-assessed physical activity and sedentary time with health-related quality of life among colon cancer survivors. Cancer 120(18):2919–2926

    Article  PubMed  Google Scholar 

  31. 31.

    George SM et al (2014) Objectively measured sedentary time is related to quality of life among cancer survivors. PLoS One 9(2):e87937

    Article  PubMed  PubMed Central  Google Scholar 

  32. 32.

    Kozey-Keadle S et al (2011) Validation of wearable monitors for assessing sedentary behavior. Med Sci Sports Exerc 43(8):1561–1567

    Article  PubMed  Google Scholar 

  33. 33.

    Mekary RA et al (2013) Isotemporal substitution analysis for physical activity, television watching, and risk of depression. Am J Epidemiol 178(3):474–483

    Article  PubMed  PubMed Central  Google Scholar 

  34. 34.

    Stamatakis E et al (2015) All-cause mortality effects of replacing sedentary time with physical activity and sleeping using an isotemporal substitution model: a prospective study of 201,129 mid-aged and older adults. Int J Behav Nutr Phys Act 12:12

    Article  Google Scholar 

Download references

Acknowledgements

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.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Jeff K. Vallance.

Ethics declarations

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

Funding

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.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Vallance, J.K., Buman, M.P., Lynch, B.M. et al. Reallocating time to sleep, sedentary, and active behaviours in non-Hodgkin lymphoma survivors: associations with patient-reported outcomes. Ann Hematol 96, 749–755 (2017). https://doi.org/10.1007/s00277-017-2942-9

Download citation

Keywords

  • Non-Hodgkin lymphoma
  • Physical activity
  • Sedentary time
  • Isotemporal substation modelling