title: Fatigue, sleep, and circadian rhythms prior to chemotherapy for breast cancer.
abstract: OBJECTIVE
  Previous investigations have shown that women undergoing chemotherapy for breast cancer experience both disturbed sleep and fatigue. However, most of the previous research examined women either during or after chemotherapy. This study examined sleep, fatigue, and circadian rhythms in women with breast cancer before the start of chemotherapy.
  
  
  METHODS
  Eighty five women with Stages I-IIIA breast cancer who were scheduled to begin adjuvant or neoadjuvant anthracycline-based chemotherapy participated. Each had sleep/wake activity recorded with actigraphy for 72 consecutive hours and filled out questionnaires on sleep, fatigue, depression, and functional outcome.
  
  
  RESULTS
  On average, the women slept for about 6 h a night and napped for over an hour during the day. Sleep was reported to be disturbed and fatigue levels were high. Circadian rhythms were robust, but women who were more phase-delayed reported more daily dysfunction (p<0.01).
  
  
  CONCLUSIONS
  The data from the current study suggest that the women with breast cancer likely experience both disturbed sleep and fatigue before the beginning of chemotherapy. Although their circadian rhythms are robust, breast cancer patients with more delayed rhythms experience more daily dysfunction secondary to fatigue. These data suggest that strategies to improve disturbed sleep and to phase-advance circadian rhythms prior to initiation of chemotherapy may be beneficial in improving daily function in breast cancer patients.
authors: Department of Psychiatry, University of California, San Diego, CA 92161, USA. sancoliisrael@ucsd.edu
authors: Sonia
authors: S
authors: Ancoli-Israel
authors: Lianqi
authors: L
authors: Liu
authors: Matthew R
authors: MR
authors: Marler
authors: Barbara A
authors: BA
authors: Parker
authors: Vicky
authors: V
authors: Jones
authors: Georgia Robins
authors: GR
authors: Sadler
authors: Joel
authors: J
authors: Dimsdale
authors: Mairav
authors: M
authors: Cohen-Zion
authors: Lavinia
authors: L
authors: Fiorentino
mesh_terms: D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D001943:Breast Neoplasms / Q000188:drug therapy*; D002140:California; D002940:Circadian Rhythm; D005221:Fatigue; D005260:Female; D006801:Humans; D008875:Middle Aged; D011788:Quality of Life; D012890:Sleep; D011795:Surveys and Questionnaires; D014861:Washington
chemical_list: D000970:Antineoplastic Agents