Sleep-wake circadian activity rhythm parameters and fatigue in oncology patients before the initiation of radiation therapy.
Sleep-wake circadian activity rhythm parameters and fatigue in oncology patients before the initiation of radiation therapy.
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DOI：
10.1097/ncc.0b013e3181f65d9b
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发表时间：
2011-07
期刊：
影响因子：
2.6
通讯作者：
Swift P
中科院分区：
文献类型：
--
作者：
Miaskowski C;Lee K;Dunn L;Dodd M;Aouizerat BE;West C;Paul SM;Cooper B;Wara W;Swift P
在放射治疗(RT)开始时，患者的睡眠参数与疲劳之间的关系知之甚少。在启动RT的患者样本中，描述使用活动记录仪测量的夜间睡眠/休息、日间觉醒/活动和昼夜活动节律参数的值，并评估这些客观参数与睡眠障碍和疲劳严重程度的主观评级之间的关系。185名乳腺癌、前列腺癌、肺癌或脑癌患者在开始放疗前完成了睡眠障碍(即匹兹堡睡眠质量指数、一般睡眠障碍量表)和疲劳(Lee疲劳量表)的自我报告，并总共戴了48小时的腕部活动记录仪。采用科尔-克里普克算法对动作图数据进行分析。计算变量间的Spearman等级相关。大约30%到50%的患者经历了睡眠障碍，这取决于是否使用了主观或客观指标的临床显著临界值来计算发生率。此外，这些患者报告了中等程度的疲劳。在睡眠障碍的主观和客观测量之间只发现了有限数量的显著相关性。睡眠障碍与疲劳的主观指标呈显著正相关，而客观指标与疲劳无显著正相关。相当大比例的肿瘤科患者在放疗开始时经历了睡眠-觉醒昼夜活动节律的显著紊乱。这种干扰既发生在睡眠启动阶段，也发生在睡眠维持阶段。需要在RT开始时评估患者的睡眠障碍，并开始适当的治疗。
Little is known about the relationships between sleep parameters and fatigue in patients at the initiation of radiation therapy (RT). In a sample of patients at the initiation of RT, to describe values for nocturnal sleep/rest, daytime wake/activity, and circadian activity rhythm parameters measured using actigraphy and to evaluate the relationships between these objective parameters and subjective ratings of sleep disturbance and fatigue severity. Patients (n=185) with breast, prostate, lung, or brain cancer completed self-report measures for sleep disturbance (i.e., Pittsburgh Sleep Quality Index, General Sleep Disturbance Scale) and fatigue (Lee Fatigue Scale) and wore wrist actigraphs for a total of 48 hours prior to beginning RT. Actigraphy data were analyzed using the Cole-Kripke algorithm. Spearman rank correlations were calculated between variables. Approximately 30% to 50% of patients experienced sleep disturbance depending on whether clinically significant cutoffs for the subjective or objective measures were used to calculate occurrence rates. In addition, these patients reported moderate levels of fatigue. Only a limited number of significant correlations were found between the subjective and objective measures of sleep disturbance. Significant positive correlations were found between the subjective, but not the objective measures of sleep disturbance and fatigue. A significant percentage of oncology patients experience significant disturbances in sleep-wake circadian activity rhythms at the initiation of RT. The disturbances occur in both sleep initiation and sleep maintenance. Patients need to be assessed at the initiation of RT for sleep disturbance and appropriate treatment initiated.