title: Association between Daytime Activity, Fatigue, Sleep, Anxiety, Depression, and Symptom Burden in Advanced Cancer Patients: A Preliminary Report.
abstract: There is limited research in advanced cancer patients (ACP) regarding association between objectively measured daytime activity and sleep (as measured by actigraphy), patient characteristics, and cancer symptoms (fatigue, sleep, anxiety, depression, cachexia, and symptom distress scores [SDSs]).
  
  
  
  Our aim of the study was to determine the association between mean daytime activity (MDTA) and the following items: fatigue (FACIT-F), SDSs (Edmonton Symptom Assessment Scale [ESAS]), sleep quality (Pittsburg Sleep Quality Index [PSQI]), objective sleep variables (OSV) (sleep onset, sleep efficacy, wake after sleep onset, total sleep time), anxiety and depression (Hospital Anxiety and Depression Scale [HADS]), body composition scores, and overall survival (OS). We also examined the association between sleep [PSQI and OSV scores] and FACIT-F, HADS, and ESAS.
  
  
  
  Secondary analysis of a recent clinical trial of cancer-related fatigue in advanced cancer (NCT00424099). Association between MDTA and OSV (measured by actigraphy) during the first week of the study and patient characteristics, symptoms (FACIT-F, ESAS, HADS, and PSQI), and OS were analyzed.
  
  
  
  Seventy-nine eligible patients were evaluable. The median age was 57 years. Median MDTA was 248.43 counts/minute. Multivariate analysis shows that low MDTA was significantly associated with age, gender, Functional Assessment of Cancer Therapy (FACT)-Functional Well-Being (FWB), ESAS dyspnea, HADS-anxiety, and total sleep time. MDTA was not associated with FACIT-F (p = 0.997) and OS (p = 0.18). Sleep quality (PSQI) was significantly associated with FACIT-F, HADS, ESAS anxiety, and depression, but none of these variables was associated with OSV.
  
  
  
  In ACP, lower MDTA was significantly associated with age, gender, FACT-FWB, ESAS dyspnea, HADS-anxiety, and total sleep time. Both sleep quality and cancer-related fatigue scores were strongly associated with depression and anxiety. More research is needed.
authors.affiliation: 1 Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors.forename: Sriram
authors.initials: S
authors.lastname: Yennurajalingam
authors.affiliation: 1 Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center , Houston, Texas.|2 Siriraj Palliative Care Center, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok, Thailand .
authors.forename: Supakarn
authors.initials: S
authors.lastname: Tayjasanant
authors.affiliation: 4 Department of Pulmonary Medicine, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors.forename: Dave
authors.initials: D
authors.lastname: Balachandran
authors.affiliation: 5 Research Center for Nursing Research, University of Texas Health School of Nursing, Houston, Texas.
authors.forename: Nikhil S
authors.initials: NS
authors.lastname: Padhye
authors.affiliation: 1 Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors.forename: Janet L
authors.initials: JL
authors.lastname: Williams
authors.affiliation: 3 Department of Biostatistics, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors.forename: Diane D
authors.initials: DD
authors.lastname: Liu
authors.affiliation: 1 Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors.forename: Susan
authors.initials: S
authors.lastname: Frisbee-Hume
authors.affiliation: 1 Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center , Houston, Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000203:Activities of Daily Living; D001007:Anxiety; D003863:Depression; D005221:Fatigue; D006801:Humans; D008875:Middle Aged; D009369:Neoplasms; D012890:Sleep