title: Sleep-wake circadian activity rhythms and fatigue in family caregivers of oncology patients.
abstract: BACKGROUND
  Little is known about the relationships between sleep/wake circadian activity rhythms and fatigue in family caregivers (FCs) of oncology patients.
  
  
  OBJECTIVE
  The objectives of this study were to describe values for nocturnal sleep/rest, daytime wake/activity, and circadian activity rhythm parameters measured using actigraphy and to evaluate the relationships between these subjective and objective measures of sleep disturbance and self-reported fatigue severity, in a sample of FCs of oncology patients.
  
  
  METHODS
  Family caregivers (n = 103) completed self-report measures for sleep disturbance (ie, Pittsburgh Sleep Quality Index, General Sleep Disturbance Scale) and fatigue (Lee Fatigue Scale) and wore wrist actigraphs for 48 hours prior to beginning radiation therapy. Spearman rank correlations were calculated between variables.
  
  
  RESULTS
  Approximately 40% to 60% of FCs experienced sleep disturbance depending on whether clinically significant cutoffs for the subjective or objective measures were used to calculate occurrence rates. In addition, these FCs reported moderate levels of fatigue. Only a limited number of significant correlations were found between the subjective and objective measures of sleep disturbance. Significant positive correlations were found between fatigue and subjective, but not objective measures of sleep disturbance. The amplitude of circadian activity rhythm was not related to any objective sleep measure but was correlated with self-report of longer sleep-onset latency.
  
  
  CONCLUSIONS
  A significant percentage of FCs experience clinically meaningful disturbances in sleep-wake circadian activity rhythms. These disturbances occur primarily in sleep maintenance.
  
  
  CONCLUSIONS
  Family caregivers need to be assessed, along with patients, for sleep disturbance, and appropriate interventions initiated for them and for the patient.
authors.affiliation: Schools of Nursing and Medicine, Department of Physiological Nursing, University of California-San Francisco, 2 Koret Way, San Francisco, CA 94143-0610, USA.
authors.forename: Anand
authors.initials: A
authors.lastname: Dhruva
authors.forename: Kathryn
authors.initials: K
authors.lastname: Lee
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
authors.forename: Claudia
authors.initials: C
authors.lastname: West
authors.forename: Laura
authors.initials: L
authors.lastname: Dunn
authors.forename: Marylin
authors.initials: M
authors.lastname: Dodd
authors.forename: Bradley E
authors.initials: BE
authors.lastname: Aouizerat
authors.forename: Bruce
authors.initials: B
authors.lastname: Cooper
authors.forename: Patrick
authors.initials: P
authors.lastname: Swift
authors.forename: Christine
authors.initials: C
authors.lastname: Miaskowski
mesh_terms: D056044:Actigraphy; D000204:Activity Cycles / Q000502:physiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology* / Q000706:statistics & numerical data; D005221:Fatigue / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy*; D057566:Self Report; D012720:Severity of Illness Index; D012890:Sleep / Q000502:physiology*; D012893:Sleep Wake Disorders / Q000503:physiopathology*; D014851:Wakefulness / Q000502:physiology*