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Tele-monitoring of cancer patients’ rhythms during daily life identifies actionable determinants of circadian and sleep disruption

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Lévi, Francis A., Komarzynski, Sandra, Huang, Qi, Young, Teresa, Ang, Yeng, Fuller, Claire, Bolborea, Matei, Brettschneider, Julia, Fursse, Joanna, Finkenstädt, Bärbel, White, David Pollard and Innominato, Pasquale F. (2020) Tele-monitoring of cancer patients’ rhythms during daily life identifies actionable determinants of circadian and sleep disruption. Cancers, 12 (7). 1938. doi:10.3390/cancers12071938

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Official URL: https://doi.org/10.3390/cancers12071938

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Abstract

The dichotomy index (I < O), a quantitative estimate of the circadian regulation of daytime activity and sleep, predicted overall cancer survival and emergency hospitalization, supporting its integration in a mHealth platform. Modifiable causes of I < O deterioration below 97.5%—(I < O)low—were sought in 25 gastrointestinal cancer patients and 33 age- and sex-stratified controls. Rest-activity and temperature were tele-monitored with a wireless chest sensor, while daily activities, meals, and sleep were self-reported for one week. Salivary cortisol rhythm and dim light melatonin onset (DLMO) were determined. Circadian parameters were estimated using Hidden Markov modelling, and spectral analysis. Actionable predictors of (I < O)low were identified through correlation and regression analyses. Median compliance with protocol exceeded 95%. Circadian disruption—(I < O)low—was identified in 13 (52%) patients and four (12%) controls (p = 0.002). Cancer patients with (I < O)low had lower median activity counts, worse fragmented sleep, and an abnormal or no circadian temperature rhythm compared to patients with I < O exceeding 97.5%—(I < O)high—(p < 0.012). Six (I < O)low patients had newly-diagnosed sleep conditions. Altered circadian coordination of rest-activity and chest surface temperature, physical inactivity, and irregular sleep were identified as modifiable determinants of (I < O)low. Circadian rhythm and sleep tele-monitoring results support the design of specific interventions to improve outcomes within a patient-centered systems approach to health care.

Item Type: Journal Article
Subjects: Q Science > QP Physiology
R Medicine > R Medicine (General)
Divisions: Faculty of Medicine > Warwick Medical School > Biomedical Sciences
Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Science > Statistics
Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Circadian rhythms -- Health aspects, Biochemical markers, Cancer -- Treatment
Journal or Publication Title: Cancers
Publisher: MDPI
ISSN: 2072-6694
Official Date: 17 July 2020
Dates:
DateEvent
17 July 2020Published
14 July 2020Accepted
Date of first compliant deposit: 8 September 2020
Volume: 12
Number: 7
Article Number: 1938
DOI: 10.3390/cancers12071938
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDPhilipshttp://dx.doi.org/10.13039/100004320
UNSPECIFIEDUniversity of Warwickhttp://dx.doi.org/10.13039/501100000741

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