Department of Psychiatry, Harvard Medical School/Massachusetts General Hospital, MA, USA.
Department of Health Outcomes and Behavior, Moffitt Cancer Center, Tampa, FL, USA.
Ann Behav Med. 2021 Aug 23;55(9):870-878. doi: 10.1093/abm/kaaa110.
Fatigue is a prominent quality of life concern among recipients of hematopoietic cell transplantation (HCT).
The present study investigated whether objectively measured sleep efficiency and sedentary behavior are related to greater reports of fatigue.
Eighty-two allogeneic HCT recipients who were 1-5 years post-transplant and returning for a follow-up visit participated (age M = 56, 52% female, 56% leukemia). They wore an actigraph assessing sleep efficiency and sedentary behavior for one week and completed an electronic log assessing fatigue each evening during the same period.
Twenty-six percent of patients reported clinically meaningful fatigue. On average, fatigue was mild (M = 2.5 on 0-10 scale, SD = 2.0), sleep was disturbed (sleep efficiency M = 78.9%, SD = 8.9), and patients spent the majority of time in sedentary (M = 55.4%, SD = 10.2) or light (M = 35.9%, SD = 8.6) activity. Multilevel model analysis of between-person differences indicated that patients who experienced less efficient sleep the previous evening provided greater evening reports of average fatigue, b = -0.06, 95% CI (-0.11, -0.01). Similarly, within-person analyses indicated that when patients experienced less efficient sleep the previous evening or were more sedentary as compared to their average, they provided greater evening reports of average fatigue, b = -0.02, 95% CI (-0.05, -0.004); b = 4.46, 95% CI (1.95, 6.97), respectively.
Findings demonstrate that poor sleep and daily sedentary behavior are related to evening reports of fatigue and should be considered modifiable targets for intervention.
疲劳是造血细胞移植（HCT）受者生活质量的一个突出问题。
本研究旨在调查客观测量的睡眠效率和久坐行为是否与更大的疲劳报告相关。
82 名异基因 HCT 受者在移植后 1-5 年返回进行随访（年龄 M = 56，52%为女性，56%为白血病）。他们佩戴一个活动记录仪来评估一周的睡眠效率和久坐行为，并在同一期间的每晚完成一份电子日志来评估疲劳。
26%的患者报告存在有临床意义的疲劳。平均而言，疲劳程度较轻（M = 2.5，0-10 分制，SD = 2.0），睡眠受到干扰（睡眠效率 M = 78.9%，SD = 8.9），并且患者大部分时间处于久坐（M = 55.4%，SD = 10.2）或轻度活动（M = 35.9%，SD = 8.6）状态。个体间差异的多层次模型分析表明，前一天晚上睡眠效率较低的患者，当晚报告的平均疲劳程度更大，b = -0.06，95%置信区间（-0.11，-0.01）。同样，个体内分析表明，当患者前一天晚上睡眠效率较低或与平均水平相比更久坐时，他们当晚报告的平均疲劳程度更大，b = -0.02，95%置信区间（-0.05，-0.004）；b = 4.46，95%置信区间（1.95，6.97）。
研究结果表明，睡眠质量差和日常久坐行为与晚上疲劳报告有关，应将其视为干预的可调节目标。
