Department of Physiological Nursing, University of California, San Francisco, California 94143-0610, USA.
Cancer Nurs. 2011 Jul-Aug;34(4):255-68. doi: 10.1097/NCC.0b013e3181f65d9b.
Little is known about the relationships between sleep parameters and fatigue in patients at the initiation of radiation therapy (RT).
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 objective parameters and subjective ratings of sleep disturbance and fatigue severity, in a sample of patients at the initiation of RT.
Patients (n = 185) with breast, prostate, lung, or brain cancer 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 a total of 48 hours prior to beginning RT. Actigraphy data were analyzed using the Cole-Kripke algorithm. Spearman rank correlations were calculated between variables.
Approximately 30% to 50% of patients experienced sleep disturbance, depending on whether clinically significant cutoffs for the subjective or objective measures were used to calculate occurrence rates. In addition, these patients 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 the subjective, but not the objective measures of sleep disturbance and fatigue.
A significant percentage of oncology patients experience significant disturbances in sleep-wake circadian activity rhythms at the initiation of RT. The disturbances occur in both sleep initiation and sleep maintenance.
Patients need to be assessed at the initiation of RT for sleep disturbance, so appropriate treatment is initiated.
在开始放射治疗（RT）时，人们对睡眠参数与疲劳之间的关系知之甚少。
本研究的目的是描述使用活动记录仪测量的夜间睡眠/休息、白天清醒/活动以及昼夜活动节律参数的值，并评估这些客观参数与睡眠障碍和疲劳严重程度的主观评分之间的关系，在开始 RT 的患者样本中。
患有乳腺癌、前列腺癌、肺癌或脑癌的患者（n=185）完成了睡眠障碍（即匹兹堡睡眠质量指数、一般睡眠障碍量表）和疲劳（李疲劳量表）的自我报告测量，并在开始 RT 前总共佩戴腕部活动记录仪 48 小时。使用 Cole-Kripke 算法分析活动记录仪数据。计算变量之间的 Spearman 秩相关系数。
根据使用主观或客观测量的临床显著截止值来计算发生率，约 30%至 50%的患者经历了睡眠障碍。此外，这些患者报告了中度疲劳水平。仅发现睡眠障碍的主观和客观测量之间存在有限数量的显著相关性。在主观但不是客观的睡眠障碍和疲劳测量之间发现了显著的正相关。
在开始 RT 时，相当比例的肿瘤患者出现睡眠-觉醒昼夜节律活动的明显紊乱。这些紊乱发生在睡眠开始和维持两个阶段。
在开始 RT 时，患者需要评估睡眠障碍，以便开始适当的治疗。
