 Comparison between fatigue, sleep disturbance, and circadian rhythm in cancer inpatients and healthy volunteers: Evaluation of diagnostic criteria for cancer-related fatigue The aim of this study was to evaluate whether diagnostic criteria for cancer-related
fatigue syndrome (CRFS) could be rigorously applied to cancer inpatients, and
to explore the relationship between subjective fatigue and objective measures
of physical activity, sleep, and circadian rhythm. Female cancer patients (n=25)
and a comparison group of subjects without cancer (n=25) were studied. Study
participants completed a structured interview for CRFS and questionnaires relating
to fatigue, psychological symptoms, and quality of life (QoL). Wrist actigraphs
worn for 72 hours were used as an objective measure of activity, sleep, and
circadian rhythm. Compared to controls, cancer patients were more fatigued,
had worse sleep quality, more disrupted circadian rhythms, lower daytime activity
levels, and worse QoL. After exclusion of subjects with "probable" mood disorders,
the prevalence of CRFS was 56%. Fatigue severity among the cancer patients was
significantly correlated with low QoL, depression, constipation, and decreased
self-reported physical functioning. It can be concluded that the diagnostic
criteria for CRFS can be applied to cancer inpatients but strict application
requires a rigorous assessment of psychiatric comorbidity. Despite cancer inpatients
having greater impairments of sleep and circadian rhythm, it was found that
fatigue severity did not appear to be related to these impairments. Fernandes
R, Stone P, Andrews P, Morgan R, Sharma S. From J
Pain Symptom Manage. J Pain Symptom Manage. 2006 Sep;32(3):245-54. |
| Department of Pain Medicine and Palliative Care Beth Israel Medical Center, New York City ©2005 Continuum Health Partners, Inc. www.stoppain.org/palliative_care |
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