Efficacy of an Intervention for Fatigue and Sleep Disturbance During Cancer Chemotherapy

Abstract

Context-Multiple complex symptoms from cancer treatment can interfere with functioning.Objectives-To evaluate the efficacy of an "energy and sleep enhancement" (EASE) intervention to relieve fatigue and sleep disturbance and improve health-related functional status.Methods-Individuals receiving chemotherapy were randomized to the EASE (n = 153) or a control intervention (n = 139). The EASE intervention included information and behavioral skills taught by an oncology nurse in three telephone sessions. The primary outcomes of fatigue, sleep disturbance and functional status were measured before chemotherapy, Day 4 after first treatment (baseline) and 43-46 or 57-60 days later (follow-up) depending on chemotherapy cycle length.Results-The sample was primarily female (82%) and non-Hispanic white (89%) with mean age of 53.9 years. Fatigue and patient-reported sleep disturbance were elevated in both groups at baseline and follow-up. Actigraphy revealed total sleep time was almost eight hours and sleep percent was over 85% for both groups at both time points (normal range). Physical functioning was diminished and at the same level as a sample with serious illness. Mental functioning was in normal range. A repeated measures analysis of variance revealed no statistically significant groupby-time effects for fatigue, sleep disturbance, or functional status. Unemployed individuals showed greater benefit from the EASE intervention, reporting less pain and symptom interference.Conclusion-Potential explanations include high variability and/or floor effect for fatigue; incorrect timing of measures; insufficient amount or dose of the intervention; and confounding effects of gender. Future research should consider screening for symptom severity and tailoring interventions.

Actigraphy for measurements of sleep in relation to oncological treatment of patients with cancer: A systematic review

“…It should be noted that the article published by Liu et al [27] is a combination of unpublished data from two studies [30,40]. Likewise, the data presented in [34] represents secondary data from two sleep intervention studies [41,42].…”

“…Five of the studies [42e46] were performed in patients with breast cancer and one study [41] in a mixed population with cancer (55% breast cancer). The studies were performed between 2002 and 2010, and had a study population between 20 and 219 patients.…”

“…The studies were performed between 2002 and 2010, and had a study population between 20 and 219 patients. One study was a quasi experimental feasibility study [43], one was an open label intervention study [46], and four studies [41,42,44,45] were randomized clinical trials without any form of blinding.…”

“…In the most recent study [41] an energy and sleep enhancement (EASE) non-pharmacological self-help strategy was applied to test its sleep improving effect during chemotherapy. The study was performed on a mixed cancer population, with 153 patients receiving EASE and 139 receiving control treatment.…”

Avaliação da qualidade de sono em pacientes com câncer de mama em quimioterapia

“…Pacientes com câncer de mama submetidos à quimioterapia muitas vezes têm que lidar com inúmeras complicações durante o tratamento, o que pode interferir no desempenho das atividades habituais 1 . O sono, nessas circunstâncias, é afetado por vários fatores, desde alterações bioquímicas aos tratamentos antineoplásicos até sintomas que acompanham o câncer, tais como dor, fadiga e depressão 2 .…”