Table 1.
Key findings of sleep and rhythm studies in cancer patients
| Number and type of patient | Fatigue measurement | Sleep/Rhythm measurements | Results | |
|---|---|---|---|---|
| Berger (1998) | 17 breast CA | Piper Fatigue Scale | Actigraphy | Fatigue and night-time restlessness ↑during chemotherapy |
| Berger & Farr (1999) | 72 breast CA | Piper Fatigue Scale | Actigraphy | Those less active during the day (i.e. had lower peak activity scores) had ↑awakenings, ↑levels of fatigue |
| Beszterczey & Lipowski (1977) | 47 radiotherapy | None | Self-report questionnaire | Insomnia was positively correlated with depression and anxiety but not with pain. |
| Cimprich (1999) | 74 breast CA | Symptom Distress Scale; POMS | None | High levels of distress related to insomnia, fatigue (tiredness) and loss of concentration. Insomnia most common complaint (88%) with >50% indicating high levels of distress owing to insomnia |
| Engstrom et al. (1999) | 150 CA – Phase I 42 CA – Phase II |
None | Telephone interviews | Phase I: 44% reported sleep difficulty; Phase II: 45% reported sleep difficulty, with half as severe; most frequent problems were mid-night awakenings, sleeping fewer hours, trouble getting back to sleep |
| Kaye et al. (1983) | 30 CA 28 cardiac 24 controls |
None | Sleep habits questionnaire | CA patients had more difficulty staying asleep compared with controls |
| Miaskowski & Lee (1999) | 24 bone metastases patients | Lee Fatigue Scale | Actigraphy | Fatigue ratings ↑ in evening and ↓in morning; SE ↓; fatigue associated with periods of greater inactivity; sleep fragmented |
| Mormont et al. (1996) | 30 colorectal CA | None | Actigraphy | Patients had less differentiation in rest/activity between night and day |
| Mormont et al. (2000) | 200 colorectal CA | None | Actigraphy | Survival at 2 years was fivefold higher in those with marked activity rhythms |
| Morrow et al. (1999) | 78 breast CA | Multidimensional Assessment of Fatigue; Fatigue Symptom Checklist; POMS | Actigraphy | More robust and consistent circadian rhythm patterns associated with ↓fatigue scores, even after controlling for depression |
| Owen et al. (1999) | 15 CA | None | Self-report; Pittsburgh Sleep Quality Inventory | Cancer patients reported significantly ↓sleep quality, ↓SE, ↑SOL |
| Silberfarb et al. (1993) | 15 breast CA 17 lung CA 32 insomniacs 32 Controls |
None | PSG measures of SE, SOL, WASO | Lung CA patients had ↓SE, ↑SOL and WASO compared with breast CA patients and controls |
CA, cancer; PSG, polysomnogram; SE, sleep efficiency; SOL, sleep onset latency; WASO, wake after sleep onset or the total time spent awake during the night.