Actigraphic assessment of daily sleep-activity pattern abnormalities reflects self-assessed depression and anxiety in outpatients with advanced non-small cell lung cancer
Actigraphic assessment of daily sleep-activity pattern abnormalities reflects self-assessed depression and anxiety in outpatients with advanced non-small cell lung cancer
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DOI：
10.1002/pon.1539
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发表时间：
2010-02-01
期刊：
影响因子：
3.6
通讯作者：
Hrushesky, William J. M.
中科院分区：
文献类型：
--
作者：
Du-Quiton, Jovelyn;Wood, Patricia A.;Hrushesky, William J. M.
目的：我们测量主观评估抑郁和焦虑，并客观地测量每日睡眠活动模式的住院患者和门诊晚期非小细胞肺癌（NSCLC），并确定是否癌症相关的抑郁和焦虑伴随着特征性昼夜节律aberrations.Methods：同等数量的住院患者（n = 42）和门诊患者（n = 42）与晚期NSCLC进行了研究。基线抑郁和焦虑，评估医院焦虑和抑郁量表（HADS）和体动记录化疗开始前。慢性阻塞性肺疾病（COPD）的存在和严重程度对抑郁，焦虑和体动仪的影响进行了评估，只有在42个outpatients.Results：焦虑发生在40%和抑郁症的25%，这些肺癌患者，同样在住院和门诊。所有患者的日常睡眠活动周期都受到严重干扰，但每个患者也保持一定程度的昼夜节律组织。与住院患者相比，门诊患者保持更强健的日常活动模式和更长、更稳定的夜间睡眠。日常睡眠活动节律越紊乱，门诊患者的抑郁和/或焦虑评分越差。这些关系在住院病人中是模糊的。COPD对睡眠活动、抑郁或焦虑的日常组织没有独立的可测量的影响。结论：昼夜活动因长时间和频繁的久坐而受到干扰以及睡眠因频繁和长时间醒来而受到干扰的肺癌患者最焦虑和抑郁。这些发现和关系被住院治疗掩盖。既然日间运动可以改善睡眠和情绪，那么测试增强日间活动和夜间睡眠是否可以减少癌症相关的抑郁症是合理的。版权所有（C）2009约翰威利父子有限公司
Objectives: We measured subjectively evaluated depression and anxiety, and objectively measured daily sleep-activity patterns in inpatients and outpatients with advanced non-small cell lung cancer (NSCLC) and determined whether cancer-associated depression and anxiety are accompanied by characteristic circadian rhythm abnormalities.Methods: Equal numbers of inpatients (n = 42) and outpatients (n = 42) with advanced NSCLC were studied. Baseline depression and anxiety, assessed by the Hospital Anxiety and Depression Scale (HADS), and actigraphy were recorded before chemotherapy initiation. The effects of the presence and severity of chronic obstructive pulmonary disease (COPD) on depression, anxiety, and actigraphy were assessed only among the 42 outpatients.Results: Anxiety occurred in 40% and depression in 25% of these lung cancer patients, equally among inpatients and outpatients. All patients suffer extremely disturbed daily sleep-activity cycles but each patient also maintains some degree of circadian organization. Outpatients maintain more robust daily activity patterns and longer, more consolidated nighttime sleep compared with inpatients. The more disrupted the daily sleep-activity rhythm, the worse the depression and/or anxiety scores for outpatients. These relationships are obscured among inpatients. COPD has no independent measurable effects on the daily organization of sleep-activity, depression, or anxiety.Conclusions: Lung cancer patients whose diurnal activity is disturbed by prolonged and frequent sedentary episodes and whose sleep is disturbed by frequent and prolonged waking are most anxious and depressed. These findings and relationships are masked by hospitalization. Since diurnal exercise improves both sleep and mood, it is reasonable to test whether enhancing daytime activity and nighttime sleep can diminish cancer-associated depression. Copyright (C) 2009 John Wiley & Sons, Ltd.