0860 A Comparison of Circadian Activity Rhythms, Sleep and Fatigue Between Adolescent Cancer Survivors and Healthy Peers. (27th April 2018)

• Record Type: Journal Article
• Authors: Rogers, V E; Mowbray, C; Hinds, P S; Zhu, S; Lianqi, L; Ancoli-Israel, S
• Is Part Of: Sleep. Volume 41(2018)Supplement 1
• Page Start: A319
• Page End: A319
• Publication Date: 2018-04-27
• Subjects: Sleep -- Physiological aspects -- Periodicals; Sleep disorders -- Periodicals; Sommeil -- Aspect physiologique -- Périodiques; Sommeil, Troubles du -- Périodiques; Sleep disorders; Sleep -- Physiological aspects; Sleep -- physiological aspects; Sleep Wake Disorders; Psychophysiology; Electronic journals; Periodicals; 616.8498
• DOI: 10.1093/sleep/zsy061.859
• Languages: English
• ISSNs: 0161-8105

Abstract

Abstract: Introduction: Cancer and its treatment are known to disrupt sleep and circadian rhythms. Dysregulated circadian activity rhythms (CAR) in adults with cancer are common and have been associated with adverse outcomes including fatigue, poor responsiveness to treatment, decreased time to relapse and death. Little is known about disturbed CAR in adolescents treated for cancer ('survivors') or their resolution post-treatment. This 2-phase ongoing study aims to compare CAR and fatigue of survivors to those of healthy peers, and pilots a morning bright light intervention to test its feasibility and effectiveness in improving CAR in survivors. Phase 1 results are reported. Methods: Participants are survivors aged 13–18 years within 5 years of treatment and age-matched healthy controls. During phase 1, participants complete questionnaires (parent- and child-reported PROMIS Pediatric Fatigue and Epworth Sleepiness scales) and wear an actigraph and keep a sleep diary for 7 days. CAR variables calculated from cosine-transformed activity counts include amplitude (maximum minus minimum), mesor (average), acrophase (clock time of maximum), upmesor (time switch from low to high activity), downmesor (reverse of upmesor), widthratio (fraction of day activity above mesor) and F-statistic. Group comparisons (survivor vs. controls) were by Chi-square and t-tests. Results: Seventeen survivors and nineteen controls have completed phase 1. Mean age is 15.3 years, and 58% are female. Parent-reported (but not child-reported) fatigue was higher in survivors than controls (p=0.055). Sleep onset latency of survivors was nearly double that of controls (17.9min vs. 9.3min, p<0.01). Differences in bedtime between school and non-school nights were significantly greater (1.2h vs. 0.2h, p=0.019) and differences in wake times were greater (2.8h vs. 1.8h, p=0.07) for controls than survivors. Amplitude of CAR was significantly greater (p=0.022) and widthratio was higher (p=0.052) for controls, suggesting more robust CAR compared to survivors. Conclusion: Preliminary results suggest survivors of pediatric cancer have long-term decrements in fatigue, sleep and CAR in, although healthy adolescents also manifest signs of dysregulated circadian rhythms. Support (If Any): Alex's Lemonade Stand Foundation Discovery Grant: Independent Nurse Researcher