Alterations of the characteristics of the circadian rest-activity rhythm of cancer in-patients
Alterations of the characteristics of the circadian rest-activity rhythm of cancer in-patients
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DOI：
10.1080/07420520701800868
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发表时间：
2007-01-01
影响因子：
2.8
通讯作者：
Choudhary, Vivek
中科院分区：
文献类型：
--
作者：
Pati, Atanu Kumar;Parganiha, Arti;Choudhary, Vivek
本研究的目的是评估癌症患者的昼夜休息-活动节律特征。31名住院患者，包括19名男性和12名女性，随机选择来自印度赖布尔Pandit Jawaharlal Nehru医学院区域癌症中心。通过无创手腕活动记录仪研究休息-活动节律，并与35名年龄匹配的明显健康受试者（22名男性和13名女性）进行比较。所有受试者至少连续4-7天佩戴Actiwatch （AW64, Mini Mitter Co. Inc.， USA）。采集活动记录仪数据时选取15秒历元长度。此外，还记录了一些睡眠参数，如卧床时间、假设睡眠时间、实际睡眠时间、实际清醒时间、睡眠效率、睡眠潜伏期、睡眠发作、清醒发作和碎片化指数。使用余弦节律法、谱分析、方差分析、邓肯多量程检验和t检验等统计技术对数据进行分析。计算二分类指数（I < 0）和自相关系数（r24）。结果证实，在大多数癌症患者和对照组中，休息-活动的昼夜节律具有统计学意义，其显著周期为24小时。这项研究的结果进一步揭示了癌症患者在昼夜休息-活动节律参数方面确实经历了剧烈的改变。肿瘤患者组的二分指数和r24均有所下降。与年龄和性别匹配的对照组相比，癌症患者的静息-活动节律峰值（峰相，phi）的出现时间更早（p < 0.001）。睡眠参数的结果显示，与对照组相比，癌症患者在床上的时间更长，假设和实际睡眠时间更长，睡眠和醒来次数更多。此外，癌症患者的午睡频率、总午睡时间、平均午睡时间和每1小时清醒时间的总午睡时间均显著高于对照组。综上所述，本研究的结果证明了癌症住院患者的昼夜节律在休息活动中被破坏，表现为振幅减弱，平均活动水平降低，阶段提前。这些昼夜节律特征的改变可以归因于疾病，而不考虑性别、癌症部位和治疗时间的差异。这些结果可能有助于设计针对患者的时间治疗方案。（作者通信：akpati19@gmail.com或akpati19@hotmail.com）。
The aim of the present study was to evaluate the characteristics of the circadian rest-activity rhythm of cancer patients. Thirty-one in-patients, consisting of 19 males and 12 females, were randomly selected from the Regional Cancer Center, Pandit Jawaharlal Nehru Medical College, Raipur, India. The rest-activity rhythm was studied non-invasively by wrist actigraphy, and compared with 35 age-matched apparently healthy subjects (22 males and 13 females). All subjects wore an Actiwatch (AW64, Mini Mitter Co. Inc., USA) for at least 4-7 consecutive days. Fifteen-second epoch length was selected for gathering actigraphy data. In addition, several sleep parameters, such as time in bed, assumed sleep, actual sleep time, actual wake time, sleep efficiency, sleep latency, sleep bouts, wake bouts, and fragmentation index, were also recorded. Data were analyzed using several statistical techniques, such as cosinor rhythmometry, spectral analysis, ANOVA, Duncan's multiple-range test, and t-test. Dichotomy index (I < O) and autocorrelation coefficient (r24) were also computed. The results validated a statistically significant circadian rhythm in rest-activity with a prominent period of 24 h for most cancer patients and control subjects. Results of this study further revealed that cancer patients do experience a drastic alteration in the circadian rest-activity rhythm parameters. Both the dichotomy index and r24 declined in the group of cancer patients. The occurrence of the peak (acrophase, phi) of the rest-activity rhythm was earlier (p < 0.001) in cancer patients than age- and gender-matched control subjects. Results of sleep parameters revealed that cancer patients spent longer time in bed, had longer assumed and actual sleep durations, and a greater number of sleep and wake bouts compared to control subjects. Further, nap frequency, total nap duration, average nap, and total nap duration per 1 h awake span were statistically significantly higher in cancer patients than control subjects. In conclusion, the results of the present study document the disruption of the circadian rhythm in rest-activity of cancer in-patients, with a dampening of amplitude, lowering of mean level of activity, and phase advancement. These alterations of the circadian rhythm characteristics could be attributed to disease, irrespective of variability due to gender, sites of cancer, and timings of therapies. These results might help in designing patient-specific chronotherapeutic protocols. (Author correspondence: akpati19@gmail.com or akpati19@hotmail.com).