Sleep quality, fatigue and physical activity following a cancer diagnosis
N. HUMPEL
phd
,
D.C. IVERSON
phd
,
Corresponding Author
N. HUMPEL phd
Faculty of Health Sciences, University of Sydney, Sydney
Dr Nancy Humpel, Faculty of Health Sciences, University of Sydney, Sydney, NSW 2141, Australia (e-mail: [email protected]).Search for more papers by this authorD.C. IVERSON phd
Faculty of Health & Behavioural Sciences, University of Wollongong, Wollongong, NSW, Australia
Search for more papers by this authorN. HUMPEL
phd
,
D.C. IVERSON
phd
,
Corresponding Author
N. HUMPEL phd
Faculty of Health Sciences, University of Sydney, Sydney
Dr Nancy Humpel, Faculty of Health Sciences, University of Sydney, Sydney, NSW 2141, Australia (e-mail: [email protected]).Search for more papers by this authorD.C. IVERSON phd
Faculty of Health & Behavioural Sciences, University of Wollongong, Wollongong, NSW, Australia
Search for more papers by this authorThis study was funded by the Australian Research Council.
Abstract
HUMPEL N. & IVERSON D.C. (2010) European Journal of Cancer Care19, 761–768Sleep quality, fatigue and physical activity following a cancer diagnosis
Research on physical activity for cancer survivors suggests a relationship with improved quality of life. The aim of this study was to explore if there was also a relationship of physical activity with sleep difficulties and fatigue, common effects of cancer and its treatments. Recruitment was by posters and flyers in medical waiting rooms and by letter of invitation. Thirty-two breast and 59 prostate cancer survivors completed the questionnaire. Poor sleep quality was reported by 57.8%. A greater proportion of breast cancer (36.7%) than prostate cancer survivors (15.5%) reported poor sleep latency, and sleep disturbance (48.4% vs. 17.2%). The mean minutes of moderate physical activity was lower among participants reporting poor sleep quality [F(1,89) = 11.36, P < 0.001]. A greater proportion of breast cancer (65.7%) than prostate cancer survivors (43.1%) reported high fatigue. Participants who reported no physical activity had significantly greater fatigue (M = 31) than those reporting high physical activity levels (M = 42). While at an early stage of research, results are suggestive of a relationship of physical activity with sleep problems among cancer survivors. Findings have implications for improving quality of life as poor sleep was associated with greater fatigue and regular physical activity shows promise as an aid to alleviating these problems.
REFERENCES
- Ancoli-Israel S., Moore P.J. & Jones V. (2001) The relationship between fatigue and sleep in cancer patients: a review. European Journal of Cancer Care 10, 245–255.
- Ancoli-Israel S., Liu L., Marler M., Parker B.A., Jones V., Robins Sadler G., Dimsdale J., Cohen-Zion M. & Fiorentino L. (2006) Fatigue, sleep, and circadian rhythms prior to chemotherapy for breast cancer. Supportive Care in Cancer 14, 201–209.
- Anderson K.O., Getto C.J., Mendoza T.R., Palmer S.N., Wang S.X., Reyes-Gibby C.C. & Cleeland C.S. (2003) Fatigue and sleep disturbance in patients with cancer, patients with clinical depression, and community-dwelling adults. Journal of Pain and Symptom Management 25, 307–318.
- Beck S., Schwartz A., Towsley G., Dudley W. & Barsevick A. (2004) Psychometric evaluation of the Pittsburgh Sleep Quality Index in cancer patients. Journal of Pain and Symptom Management 27, 140–148.
- Bellizzi K.M., Rowland J.H., Jeffery D.D. & McNeel T. (2005) Health behaviors of cancer survivors: Examining opportunities for cancer control intervention. Journal of Clinical Oncology 23, 8884–8893.
- Bennett B., Goldstein D., Lloyd A., Davenport T. & Hickie I. (2004) Fatigue and psychological distress – exploring the relationship in women treated for breast cancer. European Journal of Cancer 40, 1689–1695.
- Berger A.M., Sankaranayanan J. & Watanabe-Galloway S. (2007) Current methodological approaches to the study of sleep disturbances and quality of life in adults with cancer: a systematic review. Psycho-Oncology 16, 401–420.
- Blanchard C., Denniston M., Baker F., Ainsworth S.A., Courneya K., Hann D.M. & Gesme D.H. (2003) Do adults change their lifestyle behaviors after a cancer diagnosis? American Journal of Health Behavior 27, 246–256.
- Buysse D.J., Reynolds I., Charles F., Monk T.H., Berman S.R. & Kupfer D.J. (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Research 28, 193–213.
- Carpenter J.S. & Andrykowski M.A. (1998) Psychometric evaluation of the Pittsburgh Sleep Quality Index. Journal of Psychosomatic Research 45, 5–13.
- Cella D. (1997) The Functional Assessment of Cancer Therapy-Anemia (FACT-An) Scale: a new tool for the assessment of outcomes in cancer anemia and fatigue. Seminars in Hematology 34, 13–19.
- Cella D., Eton D., Lai J., Peterman A.H. & Merkel D.E. (2002a) Combining anchor and distribution-based methods to derive minimally clinically important differences on the Functional Assessment of Cancer Therapy (FACT) Anemia and Fatigue Scales. Journal of Pain and Symptom Management 24, 547–561.
- Cella D., Lai J., Chang C., Peterman A. & Slavin M. (2002b) Fatigue in cancer patients compared with fatigue in the general United States population. American Cancer Society 94, 528–538.
- Cella D., Zagari M., Vandoros C., Gagnon D.D., Hurtz H.J. & Nortier J.W.R. (2003) Epoetin Alfa treatment results in clinically significant improvements in quality of life in anemic cancer patients when referenced to the general population. Journal of Clinical Oncology 21, 366–373.
- Commonwealth Department of Health and Aged Care (1999) National Physical Activity Guidelines for Australians. Australian Government Publishing Service, Canberra, Australia.
-
Courneya K.S.,
Keats M. &
Turner A. (2000) Physical exercise and quality of life in cancer patients following high dose chemotherapy and autologous bone marrow transplantation.
Psycho-Oncology
9, 127–136.
10.1002/(SICI)1099-1611(200003/04)9:2<127::AID-PON438>3.0.CO;2-L PubMed Web of Science® Google Scholar
- Courneya K.S., Friedenreich C., Quinney H.A., Fields A., Jones L.W. & Fairey A. (2003) A randomized trial of exercise and quality of life in colorectal cancer survivors. European Journal of Cancer Care 12, 347–357.
- Curt G. (2000) Cancer fatigue: diagnosis, treatment and economic impact. Oncology Economics 1, 29–33.
- Davidson J.R., MacLean A.W., Brundage M.D. & Schuktze K. (2002) Sleep disturbance in cancer patients. Social Science & Medicine 54, 1309–1321.
- Godin G. & Shephard R.J. (1985) A simple method to assess exercise behavior in the community. Canadian Journal of Applied Sport Science 10, 141–146.
- Godin G., Jobin J. & Bouillon J. (1986) Assessment of leisure time exercise behavior by self report: a concurrent validity study. Canadian Journal of Public Health 77, 359–362.
- Holtzman J., Schmitz K., Babes G., Kane R.L., Duval S., Wilt T.J., MacDonald R.M. & Rutks I. (2004) Effectiveness of Behavioral Interventions to Modify Physical Activity Behaviors in General Populations and Cancer Patients and Survivors. Evidence Report/Technology Assessment No.102. AHRQ Publication No. 04-E027-2. Agency for Healthcare Research and Quality, Rockville, MD, USA.
- Humpel N. & Iverson D.C. (2005) Review and critique of the quality of exercise recommendations for cancer patients and survivors. Supportive Care in Cancer 13, 493–502.
- Humpel N. & Iverson D.C. (2007) Depression and quality of life in cancer survivors: is there a relationship with physical activity? International Journal of Behavioural Nutrition and Physical Activity 4, 65.
- Jacobs D., Ainsworth B.E., Hartman T. & Leon A.S. (1993) A simultaneous evaluation of 10 commonly used physical activity questionnaires. Medicine and Science in Sports and Exercise 25, 81–91.
- Jones L.W., Courneya K.S., Peddle C. & Mackay J.R. (2005) Oncologists' opinions towards recommending exercise to patients with cancer: a Canadian national survey. Supportive Care in Cancer 13, 929–937.
- Koopman C., Nouriani B., Erickson V., Anupindi R., Butler L.D. & Bachmann M.H. (2002) Sleep disturbances in women with metastatic breast cancer. The Breast Journal 8, 362–370.
- McTiernan A. (2004) Physical activity after cancer: physiologic outcomes. Cancer Investigation 22, 68–81.
- Mock V., Hassey Dow K., Meares C., Grimm P., Dienemann J.A. & Haisfield-Wolf M.E. (1997) Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncology Nursing Forum 24, 991–1000.
- Mock V., Pickett M., Ropka M., Lin E.M., Stewart K.J. & Rhodes V.A. (2001) Fatigue and quality of life outcomes of exercise during cancer treatment. Cancer Practice 9, 119–127.
- Mock V., Frangakis C., Davidson N.E., Ropka M.E., Pickett M., Poniatowski B., Stewart K.J., Cameron L., Zawacki K., Podewils L.J., Cohen G. & McCorkle R. (2005) Exercise manages fatigue during breast cancer treatment: a randomised controlled trial. Psycho-Oncology 14, 464–477.
- Oldervoll L.M., Kaasa S., Knobel H., Lin E.M., Stewart K.J. & Rhodes V.A. (2003) Exercise reduces fatigue in chronic fatigued Hodgkins disease survivors-results from a pilot study. European Journal of Cancer 39, 57–63.
- Patterson R.E., Neuhouser M.L., Hedderson M.M., Schwartz S.M., Standish L.J. & Bowen D.J. (2003) Changes in diet, physical activity, and supplement use among adults diagnosed with cancer. Journal of the American Dietetic Association 103, 323–328.
-
Pinto B. &
Maruyama N. (1999) Exercise in the rehabilitation of breast cancer survivors.
Psycho-Oncology
8, 191–206.
10.1002/(SICI)1099-1611(199905/06)8:3<191::AID-PON355>3.0.CO;2-T CAS PubMed Web of Science® Google Scholar
- Savard J. & Morin C. (2001) Insomnia in the context of cancer: a review of a neglected problem. Journal of Clinical Oncology 19, 895–908.
- Savard J., Simard S., Hervouet S., Ivers H., Lacombe L. & Fradet Y. (2005) Insomnia in men treated with radical prostatectomy for prostate cancer. Psycho-Oncology 14, 147–156.
- Schmitz K.H., Holtzman J., Courneya K.S., Masse L.C., Duval S. & Kane R. (2005) Controlled physical activity trials in cancer survivors: a systematic review and meta-analysis. Cancer Epidemiology Biomarkers & Prevention 14, 1588–1595.
- Schwartz A. (1998) Patterns of exercise and fatigue in physically active cancer survivors. Oncology Nursing Forum 25, 485–491.
- Schwartz A. (1999) Fatigue mediates the effects of exercise on quality of life. Quality of Life Research 8, 529–538.
- Segal R.J., Reid R.D., Courneya K.S., Malone S.C., Parliament M.B., Scott C.G., Venner P.M., Quinney H.A. & Jones L.W. (2003) Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. Journal of Clinical Oncology 21, 1653–1659.
- Smythe C. (1999) The Pittsburgh Sleep Quality Index (PSQI). The Journal of Gerontological Nursing 25, 10–11.
- US Department of Health and Human Services (1996) Physical Activity and Health: A Report of the Surgeon General. USDHHS, Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Atlanta, GA, USA.
- Watson T. (2003) Exercise and cancer-related fatigue: a review of current literature. Rehabilitation Oncology 2, 23–30.
- Winningham M. (2001) Strategies for managing cancer-related fatigue. Cancer 92, 988–997.
- Yellen S., Cella D., Webster K., Blendowski C. & Kaplan E. (1997) Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. Journal of Pain and Symptom Management 13, 63–74.
- Young-McCaughan S., Mays M., Arzola S., Yoder L.H., Dramiga S.A., Leclerc K.M., Caton J.R. & Nowlin M.U. (2003) Change in exercise tolerance, activity and sleep patterns, and quality of life in patients with cancer participating in a structured exercise program. Oncology Nursing Forum 30, 441–454.
