1. Longitudinal associations of diurnal rest-activity rhythms with fatigue, insomnia, and health-related quality of life in survivors of colorectal cancer up to 5 years post-treatment
- Author
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Chong, Marvin Y., Frenken, Koen G., Eussen, Simone J. P. M., Koster, Annemarie, Pot, Gerda K., Breukink, Stephanie O., Janssen-Heijnen, Maryska, Keulen, Eric T. P., Bijnens, Wouter, Buffart, Laurien M., Meijer, Kenneth, Scheer, Frank A. J. L., Steindorf, Karen, de Vos-Geelen, Judith, Weijenberg, Matty P., van Roekel, Eline H., Bours, Martijn J. L., Chong, Marvin Y., Frenken, Koen G., Eussen, Simone J. P. M., Koster, Annemarie, Pot, Gerda K., Breukink, Stephanie O., Janssen-Heijnen, Maryska, Keulen, Eric T. P., Bijnens, Wouter, Buffart, Laurien M., Meijer, Kenneth, Scheer, Frank A. J. L., Steindorf, Karen, de Vos-Geelen, Judith, Weijenberg, Matty P., van Roekel, Eline H., and Bours, Martijn J. L.
- Abstract
Background There is a growing population of survivors of colorectal cancer (CRC). Fatigue and insomnia are common symptoms after CRC, negatively influencing health-related quality of life (HRQoL). Besides increasing physical activity and decreasing sedentary behavior, the timing and patterns of physical activity and rest over the 24-h day (i.e. diurnal rest-activity rhythms) could also play a role in alleviating these symptoms and improving HRQoL. We investigated longitudinal associations of the diurnal rest-activity rhythm (RAR) with fatigue, insomnia, and HRQoL in survivors of CRC.Methods In a prospective cohort study among survivors of stage I-III CRC, 5 repeated measurements were performed from 6 weeks up to 5 years post-treatment. Parameters of RAR, including mesor, amplitude, acrophase, circadian quotient, dichotomy index, and 24-h autocorrelation coefficient, were assessed by a custom MATLAB program using data from tri-axial accelerometers worn on the upper thigh for 7 consecutive days. Fatigue, insomnia, and HRQoL were measured by validated questionnaires. Confounder-adjusted linear mixed models were applied to analyze longitudinal associations of RAR with fatigue, insomnia, and HRQoL from 6 weeks until 5 years post-treatment. Additionally, intra-individual and inter-individual associations over time were separated.Results Data were available from 289 survivors of CRC. All RAR parameters except for 24-h autocorrelation increased from 6 weeks to 6 months post-treatment, after which they remained relatively stable. A higher mesor, amplitude, circadian quotient, dichotomy index, and 24-h autocorrelation were statistically significantly associated with less fatigue and better HRQoL over time. A higher amplitude and circadian quotient were associated with lower insomnia. Most of these associations appeared driven by both within-person changes over time and between-person differences in RAR parameters. No significant associations were observed for acrophase.Conclu
- Published
- 2024