Kanserden sağ kalanlarda uyku kalitesi ve sedanter davranış: olası bir bağlantı var mı?

Yıl 2024, Cilt: 11 Sayı: 1, 18 - 27, 18.04.2024

Alper Tuğral , Yeşim Bakar , Murat Akyol

https://doi.org/10.15437/jetr.1375131

Öz

Amaç: Kanserden kurtulanlarda yalnızca tedavi sırasında değil, hayatta kalma sırasında da uyku düzeninin bozulması sıklıkla görülebilmektedir. Bu çalışma, kanser hastalarında uyku kalitesi ile sedanter davranış arasındaki olası bağlantıyı analiz etmeyi amaçladı.
Yöntem: Demografik ve klinik bilgiler değerlendirme formu aracılığıyla elde edildi. Uyku kalitesi ve fiziksel inaktivite düzeyi sırasıyla Pittsburgh Uyku Kalitesi İndeksi (PUKİ) ve Sedanter Davranış Anketi (SBA) ile değerlendirildi. Bu kesitsel çalışma İzmir Bakırçay Üniversitesi Tıp Fakültesi Tıbbi Onkoloji ünitesinde Nisan-Haziran 2023 tarihleri arasında gerçekleştirildi.
Bulgular: Bu çalışma, çoğunluğu meme kanseri (n=55) olmak üzere toplam 80 hasta ile tamamlanmıştır. Ortalama PUKİ skoru 7,68±4,02 idi. SDA skorları hafta içi ve hafta sonu sırasıyla 8,16±3,90 ve 6,85±3,86 saat idi. PUKİ ve SDA toplam puanları arasında anlamlı bir ilişki gözlenmedi. (p>0,05). Yaş uyku bozuklukları (r=-,24, p=0,03), gündüz işlev bozukluğu (r=-,34, p=0,002), ve SDA’nın “TV izleme” maddesi ile sırasıyla hem haftaiçinde (r=,35, p=0,001) hem de haftasonunda (r=,38, p=0,001) ilişkili bulundu.
Sonuç: Bu çalışma, kanser hastaları arasında sedanter davranış ile uyku kalitesi arasında anlamlı bir ilişki olmadığını göstermiştir, ancak bu örneklemde önemli derecede kötü uyku kalitesi oranı dikkat çekicidir. Bununla birlikte, ekran süresi ve yaş arasındaki önemli ilişkiler nedeniyle özellikle yaşlı kanser hastaları için artan ekran süresinin iyi yönetilmesi gerektiğini ve daha genç kanserden kurtulanlar arasında ise uyku hijyeni ve gündüz işlev bozukluğunun daha fazla dikkate alınması gerektiğini önermek mantıklı olabilir.

Anahtar Kelimeler

Kanserden sağ kalanlar, Uyku kalitesi, Fiziksel inaktivite

Sleep quality and sedentary behavior among cancer survivors: is there a possible link?

Öz

Purpose: Disrupted sleep patterns can be frequent in cancer survivors not only during treatment but also during survival. This study aimed to analyze the possible link between sleep quality and sedentary behavior among cancer patients.
Methods: Demographic and clinical information was obtained through an assessment form. Sleep quality and physical inactivity level were assessed by the Pittsburgh Sleep Quality Index (PSQI) and Sedentary Behavior Questionnaire (SBQ), respectively. This cross-sectional study was conducted between April and June 2023 in the Medical Oncology unit of Izmir Bakırçay University Faculty of Medicine.
Results: This study was completed with a total of 80 patients with most of the types of cancer being breast (n=55). The mean PSQI score was 7.68±4.02. SBQ scores were 8.16±3.90, and 6.85±3.86 hours on weekdays and weekends, respectively. No significant association was observed between PSQI and SBQ total scores (p>.05). Age was correlated with sleep disturbances (r=-.24, p=0.03), daytime dysfunction (r=-.34, p=0.002), and first item of SBQ (watching TV) both on weekdays (r=.35, p=0.001) and weekends (r=.38, p=0.001), respectively.
Conclusion: This study showed that there was no significant relationship between sedentary behavior and sleep quality among cancer patients, however, the remarkable rate of poor sleep quality was evident in this sample. However, it might be reasonable to suggest that the increased screen time especially for older cancer patients due to significant associations between screen time and age, should be well managed while sleep hygiene and daytime dysfunction should be considered further among younger cancer survivors.

Anahtar Kelimeler

Cancer survivors, Sleep quality, Physical inactivity.

Kaynakça

• Soerjomataram I, Bray F. Planning for tomorrow: global cancer incidence and the role of prevention 2020-2070. Nat Rev Clin Oncol.2021;18:663-672.
• Wang L, Li J, Wang T, et al. Long-term recurrence rate and survival in different aged patients with breast cancer undergoing breast conserving therapy. Zhonghua Wai Ke Za Zhi. 2021;59:127-133.
• Lowery-Allison AE, Passik SD, Cribbet MR, et al. Sleep problems in breast cancer survivors 1–10 years posttreatment. Palliat Support Care. 2018;16:325-334.
• Innominato PF, Spiegel D, Ulusakarya A, et al. Subjective sleep and overall survival in chemotherapy-naïve patients with metastatic colorectal cancer. Sleep Med. 2015;16:391-398.
• Chen D, Yin Z, Fang B. Measurements and status of sleep quality in patients with cancers. Support Care Cancer. 2018;26:405-414.
• Lin S, Chen Y, Yang L,et al.Pain, fatigue, disturbed sleep and distress comprised a symptom cluster that related to quality of life and functional status of lung cancer surgery patients. J Clin Nurs. 2013;22:1281-1290.
• Sanford SD, Wagner LI, Beaumont JL, et al. Longitudinal prospective assessment of sleep quality: before, during, and after adjuvant chemotherapy for breast cancer. Support Care Cancer. 2013;21:959-967.
• López E, de la Torre-Luque A, Lazo A, et al. Assessment of sleep disturbances in patients with cancer: Cross-sectional study in a radiotherapy department. Eur J Oncol Nurs. 2016;20:71-76.
• Fox RS, Ancoli-Israel S, Roesch SC, et al. Sleep disturbance and cancer-related fatigue symptom cluster in breast cancer patients undergoing chemotherapy. Support Care Cancer. 2020;28:845-855.
• Otte JL, Carpenter JS, Manchanda S, et al. Systematic review of sleep disorders in cancer patients: can the prevalence of sleep disorders be ascertained? Cancer Med. 2015;4:183-200.
• Mogavero MP, DelRosso LM, Fanfulla F, Bruni O, Ferri R. Sleep disorders and cancer: State of the art and future perspectives. Sleep Med Rev. 2021;56:101409.
• Fang YY, Hung CT, Chan JC, Huang SM, Lee YH. Meta‐analysis: Exercise intervention for sleep problems in cancer patients. Eur J Cancer Care. 2019; 28:e13131.
• Huang B-H, Duncan MJ, Cistulli PA, et al. Sleep and physical activity in relation to all-cause, cardiovascular disease and cancer mortality risk. Br J Sports Med. 2022;56:718-724.
• Yonenaga Y, Naito T, Okayama T, et al. Impact of physical inactivity on the risk of disability and hospitalization in older patients with advanced lung cancer. J Multidiscip Healthc. 2021;14:1521-1532.
• Tabaczynski A, Courneya KS, Trinh L. Replacing sedentary time with physical activity and sleep: associations with quality of life in kidney cancer survivors. Cancer Causes Control. 2020;31:669-681.
• Boyle T, Vallance JK, Ransom EK, et al. How sedentary and physically active are breast cancer survivors, and which population subgroups have higher or lower levels of these behaviors? Support Care Cancer. 2016;24:2181-2190.
• Frikkel J, Götte M, Beckmann M, et al. Fatigue, barriers to physical activity and predictors for motivation to exercise in advanced Cancer patients. BMC Palliat Care. 2020;19:43.
• Courneya KS, Katzmarzyk PT, Bacon E. Physical activity and obesity in Canadian cancer survivors: population‐based estimates from the 2005 Canadian Community Health Survey. Cancer. 2008;112:2475-2482.
• Beck SL, Schwartz AL, Towsley G, et al. Psychometric evaluation of the Pittsburgh Sleep Quality Index in cancer patients. J Pain Symptom Manage. 2004;27:140-148.
• Bakar Y, Tugral A, Ozel A, et al. Reliability and Validity of Sedentary Behavior Questionnaire in Turkish Population: Evaluation of Psychometric Properties. Middle East J Rehabil Health Stud. 2018;5:e63576.
• Faul F, Erdfelder E, Lang A-G, et al. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Method. 2007;39:175-191.
• Divani A, Heidari ME, Ghavampour N, et al. Effect of cancer treatment on sleep quality in cancer patients: A systematic review and meta-analysis of Pittsburgh Sleep Quality Index. Support Care Cancer. 2022;30:4687-4697.
• Courneya KS, Segal RJ, Mackey JR, et al. Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial. Breast Cancer Res Treat. 2014;144:361-369.
• Berger AM, Parker KP, Young-McCaughan S, et al. Sleep/wake disturbances in people with cancer and their caregivers: state of the science. Oncol Nurs Forum. 2005;32:E98-126.
• Cleeland CS, Zhao F, Chang VT, et al. The symptom burden of cancer: evidence for a core set of cancer‐related and treatment‐related symptoms from the Eastern Cooperative Oncology Group Symptom Outcomes and Practice Patterns study. Cancer. 2013;119:4333-4340.
• Vena C, Parker K, Cunningham M, et al. Sleep-wake disturbances in people with cancer part I: an overview of sleep, sleep regulation, and effects of disease and treatment. Oncol Nurs Forum. 2004;31:735-746.
• Collins KP, Geller DA, Antoni M, et al. Sleep duration is associated with survival in advanced cancer patients. Sleep Med. 2017; 32:208-212.
• Jim HS, Small B, Faul LA, et al. Fatigue, depression, sleep, and activity during chemotherapy: daily and intraday variation and relationships among symptom changes. Ann Behav Med. 2011;42:321-333.
• Chang W-P, Chang Y-P. Meta-analysis of changes in sleep quality of women with breast cancer before and after therapy. Breast Care (Basel). 2020;15:227-235.
• Souza RCdS, Dos Santos MR, das Chagas Valota IA, et al. Factors associated with sleep quality during chemotherapy: An integrative review. Nurs Open. 2020;7:1274-1284.
• Demiralp M, Oflaz F, Komurcu S. Effects of relaxation training on sleep quality and fatigue in patients with breast cancer undergoing adjuvant chemotherapy. J Clin Nurs. 2010;19:1073-1083.
• Roscoe JA, Morrow GR, Hickok JT, et al. Temporal interrelationships among fatigue, circadian rhythm and depression in breast cancer patients undergoing chemotherapy treatment. Support Care Cancer. 2002;10:329-336.
• Fleming L, Randell K, Stewart E, et al. Insomnia in breast cancer: a prospective observational study. Sleep. 2019;42:1-10.
• Smith HS, Barkin RL, Barkin SJ. Personalized pharmacotherapy for treatment approaches focused at primary insomnia. Am J Ther. 2011;18:227-240.
• Rowland JH, Bellizzi KM. Cancer survivorship issues: life after treatment and implications for an aging population. J Clin Oncol. 2014;32:2662-2668.
• Ferlay J, Colombet M, Soerjomataram I, et al. Cancer statistics for the year 2020: An overview. Int J Cancer. 2021;149:778-789.
• McTiernan A, Friedenreich CM, Katzmarzyk PT, et al. Physical activity in cancer prevention and survival: a systematic review. Med Sci Sports Exerc. 2019;51:1252-1261.
• Masala G, Bendinelli B, Assedi M, et al. Up to one-third of breast cancer cases in post-menopausal Mediterranean women might be avoided by modifying lifestyle habits: the EPIC Italy study. Breast Cancer Res Treat. 2017;161:311-320.
• Friedenreich CM, Stone CR, Cheung WY, et al. Physical activity and mortality in cancer survivors: a systematic review and meta-analysis. JNCI Cancer Spectr. 2019;4(1):pkz080.
• Ottenbacher AJ, Day RS, Taylor WC, et al. Exercise among breast and prostate cancer survivors-what are their barriers? J Cancer Surviv. 2011;5:413-419.
• Chan A, Ports K, Neo P, et al. Barriers and facilitators to exercise among adult cancer survivors in Singapore. Support Care Cancer. 2022;30:4867-4878.
• Speed‐Andrews A, Rhodes R, Blanchard C, et al. Medical, demographic and social cognitive correlates of physical activity in a population‐based sample of colorectal cancer survivors. Eur J Cancer Care (Engl). 2012;21:187-196.
• Romero SA, Li QS, Mao JJ. Factors and barriers associated with changes in physical activity after cancer diagnosis. J Clin Oncol, 2017;35:5162-5162.
• Fernandez S, Franklin J, Amlani N, et al. Physical activity and cancer: a cross-sectional study on the barriers and facilitators to exercise during cancer treatment. Can Oncol Nurs J. 2015;25:37-48.
• Mac Carthaigh S, Griffin C, Perry J. The relationship between sleep and problematic smartphone use among adolescents: A systematic review. Dev Rev. 2020;55:100897.
• Zhang MX, Wu AM. Effects of smartphone addiction on sleep quality among Chinese university students: The mediating role of self-regulation and bedtime procrastination. Addict Behav. 2020;111:106552.
• Metin G, Topuz S, Yagci G. Smartphone use Affects gait performance, spinal kinematics and Causes spinal musculoskeletal discomfort in young adults. Musculoskelet Sci Pract. 2023;66:102819.