Fatigue is described as a major complaint in patients undergoing chemotherapy. Yet it is unknown whether the fatigue has any relationship to the quality or quantity of sleep or to the sleep/wake circadian rhythm cycle. One of the easiest circadian rhythms to measure is sleep/wake activity. Sleep may also play an important role in the quality of life of these patients. If patients with synchronized rhythms show better tolerance to treatment, then synchronizing the rhythms with light therapy before the start of therapy would be encouraged. Before treatment studies or synchronization studies can be implemented however, more understanding is needed about the relationship between fatigue and sleep, about the normal circadian rhythms in cancer patients and what happens to rhythms during traditional therapy. Current technology allows for non-invasive, ambulatory measurements of circadian rhythms and sleep/wake activity. We propose to study sleep/wake activity cycles in outpatients with breast cancer to examine the relationship between fatigue experienced during the day with sleep/wake cycles and with the quality and quantity of sleep recorded at night; to examine the effect of fatigue and desynchronized sleep/wake rhythms on quality of life and mood (e.g., depression) during multiple cycles of treatment; to examine whether sleep/wake rhythms influence a patient's tolerance to treatment; to examine the effect of chemotherapy on sleep/wake rhythms and quality and quantity of sleep, over the time course of multiple cycles of chemotherapy; to examine the relationship between light exposure and circadian rhythms. This will be accomplished by placing Actillumes on patients for 72-hour periods each week of cycle one and cycle four of chemotherapy. At each visit questionnaires evaluating sleep, fatigue, depression and quality of life will be administered. In addition, since many of these women will be older, each woman will have a complete polysomnogram to rule out sleep disordered breathing and periodic limb movements in sleep. Results will provide a scientific basis for future intervention studies, particularly studies with light therapy which can re-synchronize rhythms.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA085264-05
Application #
6706933
Study Section
Special Emphasis Panel (ZRG1-RPHB-2 (01))
Program Officer
Nelson, Wendy
Project Start
2000-04-01
Project End
2006-03-31
Budget Start
2004-05-01
Budget End
2006-03-31
Support Year
5
Fiscal Year
2004
Total Cost
$309,358
Indirect Cost
Name
University of California San Diego
Department
Psychiatry
Type
Schools of Medicine
DUNS #
804355790
City
La Jolla
State
CA
Country
United States
Zip Code
92093
Ancoli-Israel, Sonia; Liu, Lianqi; Rissling, Michelle et al. (2014) Sleep, fatigue, depression, and circadian activity rhythms in women with breast cancer before and after treatment: a 1-year longitudinal study. Support Care Cancer 22:2535-45
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Jeste, Neelum; Liu, Lianqi; Rissling, Michelle et al. (2013) Prevention of quality-of-life deterioration with light therapy is associated with changes in fatigue in women with breast cancer undergoing chemotherapy. Qual Life Res 22:1239-44
Rissling, Michelle B; Liu, Lianqi; Natarajan, Loki et al. (2011) Relationship of menopausal status and climacteric symptoms to sleep in women undergoing chemotherapy. Support Care Cancer 19:1107-15
Savard, Josée; Liu, Lianqi; Natarajan, Loki et al. (2009) Breast cancer patients have progressively impaired sleep-wake activity rhythms during chemotherapy. Sleep 32:1155-60
Liu, Lianqi; Fiorentino, Lavinia; Natarajan, Loki et al. (2009) Pre-treatment symptom cluster in breast cancer patients is associated with worse sleep, fatigue and depression during chemotherapy. Psychooncology 18:187-94
Fiorentino, Lavinia; McQuaid, John R; Liu, Lianqi et al. (2009) Individual cognitive behavioral therapy for insomnia in breast cancer survivors: a randomized controlled crossover pilot study. Nat Sci Sleep 2010:1-8
Ancoli-Israel, Sonia (2009) Recognition and treatment of sleep disturbances in cancer. J Clin Oncol 27:5864-6
Goldman, Suzanne E; Hall, Martica; Boudreau, Robert et al. (2008) Association between nighttime sleep and napping in older adults. Sleep 31:733-40
Mills, Paul J; Ancoli-Israel, Sonia; Parker, Barbara et al. (2008) Predictors of inflammation in response to anthracycline-based chemotherapy for breast cancer. Brain Behav Immun 22:98-104

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