 |
| ||
| Abstracts by Number |
| Abstracts by Author |
| Abstracts by Subject |
Congress Abstracts 2006
247
FATIGUE, SLEEP AND CIRCADIAN RHYTHMS AT BASELINE AND AFTER THE FIRST ADJUVANT BREAST CANCER CHEMOTHERAPY TREATMENT WITHIN A RANDOMIZED CONTROL TRIAL. Ann Berger, PhD, RN, AOCN®, FAAN, and Patricia Fischer, BSN, RN, CCRC, University of Nebraska Medical Center, Omaha, NE; Lynne Farr, PhD, retired, Omaha, NE; and Brett Kuhn and Sangeeta Agrawal, MSc, University of Nebraska Medical Center, Omaha, NE.
Interventions to manage fatigue during and after adjuvant breast cancer chemotherapy are needed to control this distressing symptom.
To evaluate the immediate impact of a tailored behavioral sleep intervention (BSI), delivered two days before the first chemotherapy treatment, on fatigue, sleep and circadian rhythms. Managing fatigue is an ONS research priority.
Piper's Integrated Fatigue Model
Randomized control trial comparing a behavioral sleep intervention to a healthy eating control group; N=93, post-operative, with Stage I/II/IIIA breast cancer, receiving adjuvant chemotherapy; mean age =51; most were married and employed. Piper Fatigue Scale (PFS), Pittsburgh Sleep Quality Index (PSQI), wrist actigraphy for 24-hour sleep/wake patterns (2 days baseline plus 7 days after chemotherapy); descriptive statistics, correlations, RM-ANOVA
At baseline, there were no group differences on demographics; nor on PFS [µ=2.44(1.92)] or PSQI [µ=6.66(3.39)]. PSQI score was >5 in 57% and >8 in 26% of subjects. Actigraphy data showed no group differences on total sleep time, percent time awake and number of night awakenings; minutes awake after sleep onset (WASO) [µ=55.4(52.5)] was prolonged. After chemotherapy, mean PFS rose to 4.76(2.53). Actigraphy data showed non-significant increases in the sleep variables; WASO remained prolonged [µ=74.9(70.1)]. Baseline circadian rhythm variables were: mesor [µ=134.08(34.84)], amplitude µ=98.04(33.77)] and measure of robustness [µ=.61(.13)]. After chemotherapy, they dropped 7-17%: mesor [µ=111.26(26.56], amplitude [µ=87.62(24.76), and measure of robustness [µ=0.57(.11)]. The intervention group had significantly higher daily amplitude both at baseline and after chemotherapy and no significant group effect was observed [F(1,81)=2.24, p=.14]. Baseline PFS was related to PSQI (r = .34, p<.001). Day +3 fatigue was inversely correlated with daily amplitude (r= -.30, p=.05) and with goodness of fit (r= -.343, p =.03).Only amplitude was found to be different between the two groups; higher fatigue was associated with poorer subjective sleep. After chemotherapy, higher fatigue is associated with less robust day and night circadian rhythms. Short-term will be compared to long-term results of BSI on reducing fatigue and maintaining quality sleep.