Valerie E Rogers1, Shijun Zhu2, Belinda N Mandrell3, Sonia Ancoli-Israel4, Lianqi Liu4, Pamela S Hinds5. 1. University of Maryland, 655 W. Lombard Street, Baltimore, MD, 21201, USA. verogers@umaryland.edu. 2. University of Maryland, 655 W. Lombard Street, Baltimore, MD, 21201, USA. 3. St. Jude Children's Research Hospital, Memphis, TN, USA. 4. University of California, San Diego, CA, USA. 5. Nursing, Children's National Health System and George Washington University, Washington, DC, USA.
Abstract
PURPOSE: Robust circadian rhythms are increasingly recognized as essential to good health. Adult cancer patients with dysregulated circadian activity rhythms (CAR) experience greater fatigue, lower responsiveness to chemotherapy, and shorter time to relapse. There is scant research describing circadian rhythms and associated outcomes in children with cancer. As part of a larger study examining whether a cognitive-behavioral intervention could preserve sleep in children and adolescents with central nervous system cancers hospitalized for high-dose chemotherapy (HDCT), this study aimed to compare CAR of these children to published values and to investigate the relationship between CAR and fatigue. METHODS:Participants aged 4-19 years wore an actigraph throughout their hospitalization (5 days). From activity counts recorded by actigraphy, six CAR variables were calculated: amplitude, 24-h autocorrelation (r24), dichotomy index (I < O), interdaily stability (IS), intradaily variability (IV), and acrophase. Parent-reported child fatigue and child/adolescent self-reported fatigue measures were collected daily. RESULTS:Thirty-three participants were included. Three CAR variables (amplitude, r24, and I < O) showed dysregulation compared to published values. Older age was significantly associated with later acrophase and greater dysregulation of all other CAR variables. Controlling for age, more dysregulated amplitude (p = 0.001), r24 (p = 0.003), IS (p = 0.017), and IV (p = 0.001) were associated with higher parent-reported fatigue; more dysregulated IV (p = 0.003) was associated with higher child-reported fatigue. CONCLUSIONS: Participants demonstrated dysregulated CAR during hospitalization for HDCT. Greater dysregulation was associated with greater fatigue. Research on circadian dysregulation and its relationship to health-related outcomes in children with cancer, and interventions to support circadian rhythmicity, is urgently needed.
RCT Entities:
PURPOSE: Robust circadian rhythms are increasingly recognized as essential to good health. Adult cancerpatients with dysregulated circadian activity rhythms (CAR) experience greater fatigue, lower responsiveness to chemotherapy, and shorter time to relapse. There is scant research describing circadian rhythms and associated outcomes in children with cancer. As part of a larger study examining whether a cognitive-behavioral intervention could preserve sleep in children and adolescents with central nervous system cancers hospitalized for high-dose chemotherapy (HDCT), this study aimed to compare CAR of these children to published values and to investigate the relationship between CAR and fatigue. METHODS:Participants aged 4-19 years wore an actigraph throughout their hospitalization (5 days). From activity counts recorded by actigraphy, six CAR variables were calculated: amplitude, 24-h autocorrelation (r24), dichotomy index (I < O), interdaily stability (IS), intradaily variability (IV), and acrophase. Parent-reported childfatigue and child/adolescent self-reported fatigue measures were collected daily. RESULTS: Thirty-three participants were included. Three CAR variables (amplitude, r24, and I < O) showed dysregulation compared to published values. Older age was significantly associated with later acrophase and greater dysregulation of all other CAR variables. Controlling for age, more dysregulated amplitude (p = 0.001), r24 (p = 0.003), IS (p = 0.017), and IV (p = 0.001) were associated with higher parent-reported fatigue; more dysregulated IV (p = 0.003) was associated with higher child-reported fatigue. CONCLUSIONS:Participants demonstrated dysregulated CAR during hospitalization for HDCT. Greater dysregulation was associated with greater fatigue. Research on circadian dysregulation and its relationship to health-related outcomes in children with cancer, and interventions to support circadian rhythmicity, is urgently needed.
Entities:
Keywords:
Actigraphy; Central nervous system cancer; Chemotherapy; Children; Circadian activity rhythm; Fatigue
Authors: Sonia Ancoli-Israel; Jennifer L Martin; Terri Blackwell; Luis Buenaver; Lianqi Liu; Lisa J Meltzer; Avi Sadeh; Adam P Spira; Daniel J Taylor Journal: Behav Sleep Med Date: 2015 Impact factor: 2.964
Authors: Annabelle Ballesta; Pasquale F Innominato; Robert Dallmann; David A Rand; Francis A Lévi Journal: Pharmacol Rev Date: 2017-04 Impact factor: 25.468
Authors: Pamela S Hinds; Jie Yang; Jami S Gattuso; Marilyn Hockenberry; Heather Jones; Sue Zupanec; Chenghong Li; Valerie McLaughlin Crabtree; Belinda N Mandrell; Robert A Schoumacher; Kelly Vallance; Stacy Sanford; Deo Kumar Srivastava Journal: J Pain Symptom Manage Date: 2010-03 Impact factor: 3.612
Authors: Austin L Brown; Kimberly P Raghubar; Olga A Taylor; Melanie Brooke Bernhardt; Lisa S Kahalley; Wei Pan; Philip J Lupo; Marilyn J Hockenberry; Michael E Scheurer Journal: Support Care Cancer Date: 2020-09-14 Impact factor: 3.603
Authors: Lindsay M H Steur; Gertjan J L Kaspers; Eus J W Van Someren; Natasha K A Van Eijkelenburg; Inge M Van der Sluis; Natasja Dors; Cor Van den Bos; Wim J E Tissing; Martha A Grootenhuis; Raphaële R L Van Litsenburg Journal: Sleep Date: 2020-06-15 Impact factor: 5.849
Authors: L M H Steur; G J L Kaspers; E J W van Someren; N K A van Eijkelenburg; I M van der Sluis; N Dors; C van den Bos; W J E Tissing; M A Grootenhuis; R R L van Litsenburg Journal: Support Care Cancer Date: 2020-04-13 Impact factor: 3.603
Authors: Lauren C Daniel; Raphaele R L van Litsenburg; Valerie E Rogers; Eric S Zhou; Sarah J Ellis; Claire E Wakefield; Robyn Stremler; Lisa Walter; Valerie McLaughlin Crabtree Journal: Psychooncology Date: 2019-11-03 Impact factor: 3.955