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Relationship between subjective and actigraphy-measured sleep in 237 patients with metastatic colorectal cancer

Quality of Life Research volume 26, pages 2783–2791 (2017)Cite this article

Abstract

Objective

Patients with cancers frequently experience sleep and circadian dysfunction. To date, only a few studies have used both a questionnaire and actigraphy for concomitant evaluation of sleep and circadian function in patients with cancer. We sought to evaluate objective sleep and circadian parameters in metastatic colon cancer (MCC) patients and their associations with symptoms and quality of life (QOL).

Methods

Patients reported subjective sleep problems on the EORTC QLQ-C30. Sleep and circadian parameters were calculated using a wrist-actigraph that patients wore for 72 h.

Results

237 Patients with MCC (mean age: 60.4 years; range: 20.7–77.6; Male/Female ratio: 1.66) participated in this cross-sectional study. Subjective sleep problems were reported by 63.4% of patients (S+). No differences in any sleep parameters (sleep efficiency, sleep latency, total sleep time, total time in bed, wake after sleep onset, activity bathyphase) were observed between S+ and S− patients. However, S+ patients displayed a significantly worse circadian function than S− patients (96.4 vs 98.1%; p = 0.005). The presence of poor subjective sleep and objective circadian dysfunction negatively affected symptoms and QOL domains (p = 0.038).

Conclusions

Subjective report of sleep problems was not associated with worse objectively measured sleep parameters in patients with MCC although it was associated with disrupted circadian rest-activity rhythm and poorer QOL. These findings coincide with prior research in cancer patients in that an inconsistent relationship exists between subjective and objective sleep measurements on some sleep domains. This study supports the value of coupled evaluation of self-reported and objective measures of sleep and circadian function in cancer patients.

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Funding

Funded by National Cancer Institute (Grant Nos. NCI R01CA181659, NCI R21CA185678).

Author information

Affiliations

  1. Department of Psychiatry and Behavioral Sciences, Stanford University, 401 Quarry Road, Stanford, CA, 94305, USA

    Oxana Palesh, Karyn Haitz, Carl Deguzman, Igbal Alizeh & Mary Melissa Packer

  2. Stanford Cancer Institute, Stanford School of Medicine, Stanford, CA, USA

    Oxana Palesh & Mary Melissa Packer

  3. INSERM U935 and AP-HP, Chronotherapy Unit, Department of Medical Oncology, Paul Brousse Hospital, Villejuif, France

    Francis Lévi & Ayhan Ulusakarya

  4. Cancer Chronotherapy Unit, Cancer Research Centre, Warwick Medical School, Coventry, Warwickshire, UK

    Francis Lévi & Pasquale F. Innominato

  5. Department of Oncology, Queen Elizabeth Hospital Birmingham NHS Foundation Trust, Birmingham, UK

    Francis Lévi & Pasquale F. Innominato

  6. Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada

    Georg A. Bjarnason

Authors
  1. Oxana Palesh
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  2. Karyn Haitz
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  3. Francis Lévi
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  4. Georg A. Bjarnason
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  7. Ayhan Ulusakarya
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  8. Mary Melissa Packer
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  9. Pasquale F. Innominato
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Corresponding author

Correspondence to Oxana Palesh.

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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.

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

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Palesh, O., Haitz, K., Lévi, F. et al. Relationship between subjective and actigraphy-measured sleep in 237 patients with metastatic colorectal cancer. Qual Life Res 26, 2783–2791 (2017). https://doi.org/10.1007/s11136-017-1617-2

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  • DOI: https://doi.org/10.1007/s11136-017-1617-2

Keywords

  • Cancer
  • Oncology
  • Sleep
  • Actigraphy
  • Metastatic colorectal cancer
  • Circadian