Patterns of circadian activity rhythms and their relationships with fatigue and anxiety/depression in women treated with breast cancer adjuvant chemotherapy

Ann Malone Berger, Kimberly Wielgus, Melody Hertzog, Patricia Fischer, Lynne Farr

Research output: Contribution to journalArticle

71 Citations (Scopus)

Abstract

Purpose: The purpose of this study was to examine patterns of circadian activity rhythms and their relationship with fatigue, anxiety/depression, and demographic/medical variables in women receiving breast cancer adjuvant therapy treatments (Tx) at three times within a randomized clinical trial (RCT) designed to improve sleep and modify fatigue. Methods: A RCT enrolled 219 women with stage I-IIIA breast cancer who were randomized 2 days prior to starting chemotherapy to a behavioral therapy sleep intervention or healthy eating control group. All cases with available data (n∈=∈190) were included in a descriptive, correlational, repeated measures analysis. Activity data were collected continuously by wrist actigraphy for 7 days at three times: the start (Tx 1), continuation (Tx 3), and recovery (30 days after last Tx) of chemotherapy. Circadian activity rhythm parameters were generated using Action4 software (Ambulatory Monitoring, Inc.). Measures collected simultaneously included Piper Fatigue Scale, Hospital Anxiety and Depression Scale, and demographic/medical variables. Results: Circadian activity rhythm parameters at three times in both groups were disrupted compared to healthy adults, but similar to values of cancer patients. Significant changes in mesor, amplitude, peak activity, and 24 h autocorrelation values were found over time in both groups. The intervention group's amplitude and circadian quotient values were significantly more robust. More robust activity rhythms were associated with lower fatigue, depressive symptoms, body mass index, and higher performance status in both groups. Conclusions: Disrupted patterns of circadian activity rhythms were prevalent and associated with distressing fatigue and depressive symptoms during chemotherapy and at recovery. The intervention resulted in more robust rhythms.

Original languageEnglish (US)
Pages (from-to)105-114
Number of pages10
JournalSupportive Care in Cancer
Volume18
Issue number1
DOIs
StatePublished - Jan 1 2010

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Adjuvant Chemotherapy
Circadian Rhythm
Fatigue
Anxiety
Depression
Breast Neoplasms
Drug Therapy
Sleep
Randomized Controlled Trials
Demography
Actigraphy
Piper
Ambulatory Monitoring
Wrist
Body Mass Index
Therapeutics
Software
Control Groups
Neoplasms

Keywords

  • Actigraph
  • Activity
  • Breast cancer
  • Chemotherapy
  • Circadian rhythms

ASJC Scopus subject areas

  • Oncology

Cite this

Patterns of circadian activity rhythms and their relationships with fatigue and anxiety/depression in women treated with breast cancer adjuvant chemotherapy. / Berger, Ann Malone; Wielgus, Kimberly; Hertzog, Melody; Fischer, Patricia; Farr, Lynne.

In: Supportive Care in Cancer, Vol. 18, No. 1, 01.01.2010, p. 105-114.

Research output: Contribution to journalArticle

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