Journal
SLEEP
Volume 32, Issue 9, Pages 1155-1160Publisher
OXFORD UNIV PRESS INC
DOI: 10.1093/sleep/32.9.1155
Keywords
Cancer; circadian rhythms; sleep-wake activity; chemotherapy
Categories
Funding
- NCI NIH HHS [R01 CA112035, CA112035, R01 CA085264, R01 CA085264-01, CA85264] Funding Source: Medline
- NCRR NIH HHS [M01 RR000827-34, M01 RR000827, M01 RR000827-328456, M01 RR00827] Funding Source: Medline
- NATIONAL CANCER INSTITUTE [R01CA085264, R01CA112035] Funding Source: NIH RePORTER
- NATIONAL CENTER FOR RESEARCH RESOURCES [M01RR000827] Funding Source: NIH RePORTER
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Purpose: Prior cross-sectional studies have shown that cancer patients have sleep-wake activity cycles that show little distinction between daytime and nighttime, a pattern indicative of circadian disruption. This pattern is seen both before and during cancer treatment. Long-term data are needed, however, to assess to what extent circadian rhythm impairments evolve over the course of chemotherapy. The goal of this study was to assess the longitudinal course of sleep-wake activity rhythms before and during chemotherapy for breast cancer. Patients and Methods: Ninety-five women scheduled to receive neoadjuvant or adjuvant anthracycline based chemotherapy for a stage I-III breast cancer participated. The participants wore a wrist actigraph for 72 consecutive hours at baseline (pre-chemotherapy), as well as during the weeks 1, 2 and 3 (W1, W2, W3) of cycle 1 and cycle 4 of chemotherapy. Sleep-wake circadian activity variables were computed based on actigraphic data. Results: Compared to baseline, with the exception of acrophase, all circadian rhythm variables examined, including amplitude, mesor, up-mesor, down-mesor, and rhythmicity were significantly impaired during the first week of both chemotherapy cycles. Although the circadian variables approached baseline values during W2 and W3 of cycle 1, most remained significantly more impaired during W2 and W3 of cycle 4. Conclusion: These data suggest that the first administration of chemotherapy is associated with transient disruption of sleep-wake rhythm, while repeated administration of chemotherapy results in progressively worse and more enduring impairments in sleep-wake activity rhythms.
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