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The day after : correlates of patient-reported outcomes with actigraphy-assessed sleep in cancer patients at home (inCASA project)

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Komarzynski, Sandra, Huang, Qi, Lévi, Francis A., Palesh, Oxana G., Ulusakarya, Ayhan, Bouchahda, Mohamed, Haydar, Mazen, Wreglesworth, Nicholas I, Morère, Jean-François, Adam, René and Innominato, Pasquale F. (2019) The day after : correlates of patient-reported outcomes with actigraphy-assessed sleep in cancer patients at home (inCASA project). Sleep, 42 (10). zsz146. doi:10.1093/sleep/zsz146 ISSN 0161-8105.

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Official URL: http://dx.doi.org/10.1093/sleep/zsz146

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Abstract

Subjective sleep assessment in cancer patients poorly correlates with actigraphy parameters that usually encompass multiple nights. We aimed to determine the objective actigraphy measures that best correlated with subjective sleep ratings on a night-by-night basis in cancer patients. Thirty-one cancer patients daily self-rated sleep disturbances using the single dedicated item of the MD Anderson Symptom Inventory (0–10 scale) with 18 other items, and continuously wore a wrist actigraph for 30 days. Objective sleep parameters were computed from the actigraphy nighttime series, and correlated with subjective sleep disturbances reported on the following day, using repeated measures correlations. Multilevel Poisson regression analysis was performed to identify the objective and subjective parameters that affected subjective sleep rating. Poor subjective sleep score was correlated with poor sleep efficiency (rrm = −0.13, p = 0.002) and large number of wake episodes (rrm = 0.12, p = 0.005) on the rated night. Multilevel analysis demonstrated that the expected sleep disturbance score was affected by the joint contribution of the wake episodes (exp(β) = 1.01, 95% confidence interval = 1.00 to 1.02, p = 0.016), fatigue (exp(β) = 1.35, 95% confidence interval = 1.15 to 1.55, p < 0.001) and drowsiness (exp(β) = 1.70, 95% confidence interval = 1.19 to 2.62, p = 0.018), self-rated the following evening, and sleep disturbance experienced one night before (exp(β) = 1.77, 95% confidence interval = 1.41 to 2.22, p < 0.001). The night-by-night approach within a multidimensional home tele-monitoring framework mainly identified the objective number of wake episodes computed from actigraphy records as the main determinant of the severity of sleep complaint in cancer patients on chemotherapy. This quantitative information remotely obtained in real time from cancer patients provides a novel framework for streamlining and evaluating interventions toward sleep improvement in cancer patients.

Item Type: Journal Article
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Journal or Publication Title: Sleep
Publisher: American Academy of Sleep Medicine
ISSN: 0161-8105
Official Date: October 2019
Dates:
DateEvent
October 2019Published
19 July 2019Available
19 July 2019Accepted
Volume: 42
Number: 10
Article Number: zsz146
DOI: 10.1093/sleep/zsz146
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Restricted or Subscription Access

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