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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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WRAP-tele-monitoring-cancer-patients-rhythms during-daily-life-identifies-actionable-determinants-circadian-sleep disruption-Levi-2020.pdf - Published Version - Requires a PDF viewer. Available under License Creative Commons Attribution 4.0. Download (3077Kb) | Preview |
Official URL: https://doi.org/10.3390/cancers12071938
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 | |||||||||
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| Subjects: | Q Science > QP Physiology R Medicine > R Medicine (General) |
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| 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 |
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| 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: |
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| 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: |
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