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Actigraphic assessment of daily sleep–activity pattern abnormalities reflects self‐assessed depression and anxiety in outpatients with advanced non‐small cell lung cancer
Author(s) -
DuQuiton Jovelyn,
Wood Patricia A.,
Burch James B.,
Grutsch James F.,
Gupta Digant,
Tyer Kevin,
Lis Christopher G.,
Levin Robert D.,
Quiton Dinah Faith T.,
Reynolds Justin L.,
Hrushesky William J. M.
Publication year - 2010
Publication title -
psycho‐oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.41
H-Index - 137
eISSN - 1099-1611
pISSN - 1057-9249
DOI - 10.1002/pon.1539
Subject(s) - actigraphy , anxiety , depression (economics) , hospital anxiety and depression scale , medicine , lung cancer , mood , copd , circadian rhythm , sleep (system call) , physical therapy , psychiatry , computer science , economics , macroeconomics , operating system
Objectives : We measured subjectively evaluated depression and anxiety, and objectively measured daily sleep–activity patterns in inpatients and outpatients with advanced non‐small cell lung cancer (NSCLC) and determined whether cancer‐associated depression and anxiety are accompanied by characteristic circadian rhythm abnormalities. Methods : Equal numbers of inpatients ( n =42) and outpatients ( n =42) with advanced NSCLC were studied. Baseline depression and anxiety, assessed by the Hospital Anxiety and Depression Scale (HADS), and actigraphy were recorded before chemotherapy initiation. The effects of the presence and severity of chronic obstructive pulmonary disease (COPD) on depression, anxiety, and actigraphy were assessed only among the 42 outpatients. Results : Anxiety occurred in 40% and depression in 25% of these lung cancer patients, equally among inpatients and outpatients. All patients suffer extremely disturbed daily sleep–activity cycles but each patient also maintains some degree of circadian organization. Outpatients maintain more robust daily activity patterns and longer, more consolidated nighttime sleep compared with inpatients. The more disrupted the daily sleep–activity rhythm, the worse the depression and/or anxiety scores for outpatients. These relationships are obscured among inpatients. COPD has no independent measurable effects on the daily organization of sleep–activity, depression, or anxiety. Conclusions : Lung cancer patients whose diurnal activity is disturbed by prolonged and frequent sedentary episodes and whose sleep is disturbed by frequent and prolonged waking are most anxious and depressed. These findings and relationships are masked by hospitalization. Since diurnal exercise improves both sleep and mood, it is reasonable to test whether enhancing daytime activity and nighttime sleep can diminish cancer‐associated depression. Copyright © 2009 John Wiley & Sons, Ltd.