Cancer-related Fatigue in Relation to Chronotype and Sleep Quality in (Non-)Hodgkin Lymphoma Survivors

Daniëlle E.J. Starreveld; G. Esther A. Habers; Heiddis B. Valdimarsdottir; Rob Kessels; Laurien A. Daniëls; Flora E. van Leeuwen; Eveline M.A. Bleiker

doi:10.1177/0748730420987327

Cancer-related Fatigue in Relation to Chronotype and Sleep Quality in (Non-)Hodgkin Lymphoma Survivors

Daniëlle E.J. Starreveld, G. Esther A. Habers, Heiddis B. Valdimarsdottir, Rob Kessels, Laurien A. Daniëls, Flora E. van Leeuwen, Eveline M.A. Bleiker

Department of Psychology

Reykjavik University

Research output: Contribution to journal › Article › peer-review

Abstract

Cancer-related fatigue has been related to circadian disruptions and lower levels of sleep quality. However, it is unknown whether the circadian phase, which is associated with chronotype and timing of sleep, is related to fatigue after cancer. The aims of this study were to investigate the associations between (1) chronotype and cancer-related fatigue and (2) sleep quality and cancer-related fatigue. In this cross-sectional questionnaire study, 458 (non-)Hodgkin lymphoma survivors (n = 231 female, mean age 49.7 years) completed a Visual Analogue Scale for fatigue (VAS-fatigue) from 0 (no fatigue) to 10 (worst imaginable fatigue), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI) between October 2018 and July 2019. A hierarchical linear regression analysis was used to evaluate the associations between the dependent variable fatigue and chronotype (based on early, intermediate, or late average midsleep) in Model 1, and fatigue and sleep quality in Model 2. The results showed no indications for an association between chronotype and fatigue (all p values ≥ 0.50). There were associations between two (out of seven) aspects of sleep quality and fatigue: subjective sleep quality (p < 0.001) and daily dysfunctioning (p < 0.001). Therefore, it is more likely that fatigue is associated with self-reported sleep quality rather than with chronotype. However, experimental studies with objective, physiological data on circadian phase and sleep quality are necessary to confirm the conclusions of this cross-sectional study.

Original language	English
Pages (from-to)	71-83
Number of pages	13
Journal	Journal of Biological Rhythms
Volume	36
Issue number	1
DOIs	https://doi.org/10.1177/0748730420987327
Publication status	Published - Feb 2021

Bibliographical note

Funding Information: We would like to thank Eefke Petersen (UMCU), Erik Marijt (LUMC), Lara Böhmer (HagaZiekenhuis), Eva de Jongh (ASZ), Cécile Janus (Erasmus MC), Margreet Houmes (ADRZ), and Marie José Kersten (Amsterdam UMC, location AMC) for the recruitment of participants. We would like to thank Marijke Gordijn (UMCG, Chrono@Work) and Eus van Someren (Amsterdam UMC and Netherlands Institute for Brain Research) for their advice on the MCTQ and PSQI. The Dutch Cancer Society (Grant Number NKI 2015-7909) financially supported this trial. The role of the Dutch Cancer Society is limited to peer review of the grant proposal. The Dutch Cancer Society is not involved in data collection, analyses, and interpretation of the data nor in the writing of the manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request. Funding Information: We would like to thank Eefke Petersen (UMCU), Erik Marijt (LUMC), Lara Böhmer (HagaZiekenhuis), Eva de Jongh (ASZ), Cécile Janus (Erasmus MC), Margreet Houmes (ADRZ), and Marie José Kersten (Amsterdam UMC, location AMC) for the recruitment of participants. We would like to thank Marijke Gordijn (UMCG, Chrono@Work) and Eus van Someren (Amsterdam UMC and Netherlands Institute for Brain Research) for their advice on the MCTQ and PSQI. The Dutch Cancer Society (Grant Number NKI 2015-7909) financially supported this trial. The role of the Dutch Cancer Society is limited to peer review of the grant proposal. The Dutch Cancer Society is not involved in data collection, analyses, and interpretation of the data nor in the writing of the manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request. Publisher Copyright: © 2021 The Author(s).

Other keywords

circadian rhythms
fatigue
neoplasms
sleep
survivorship

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10.1177/0748730420987327

Cite this

@article{bb00a012c4c444fb8531ba0bfbb827c7,

title = "Cancer-related Fatigue in Relation to Chronotype and Sleep Quality in (Non-)Hodgkin Lymphoma Survivors",

abstract = "Cancer-related fatigue has been related to circadian disruptions and lower levels of sleep quality. However, it is unknown whether the circadian phase, which is associated with chronotype and timing of sleep, is related to fatigue after cancer. The aims of this study were to investigate the associations between (1) chronotype and cancer-related fatigue and (2) sleep quality and cancer-related fatigue. In this cross-sectional questionnaire study, 458 (non-)Hodgkin lymphoma survivors (n = 231 female, mean age 49.7 years) completed a Visual Analogue Scale for fatigue (VAS-fatigue) from 0 (no fatigue) to 10 (worst imaginable fatigue), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI) between October 2018 and July 2019. A hierarchical linear regression analysis was used to evaluate the associations between the dependent variable fatigue and chronotype (based on early, intermediate, or late average midsleep) in Model 1, and fatigue and sleep quality in Model 2. The results showed no indications for an association between chronotype and fatigue (all p values ≥ 0.50). There were associations between two (out of seven) aspects of sleep quality and fatigue: subjective sleep quality (p < 0.001) and daily dysfunctioning (p < 0.001). Therefore, it is more likely that fatigue is associated with self-reported sleep quality rather than with chronotype. However, experimental studies with objective, physiological data on circadian phase and sleep quality are necessary to confirm the conclusions of this cross-sectional study.",

keywords = "circadian rhythms, fatigue, neoplasms, sleep, survivorship",

author = "Starreveld, \{Dani{\"e}lle E.J.\} and Habers, \{G. Esther A.\} and Valdimarsdottir, \{Heiddis B.\} and Rob Kessels and Dani{\"e}ls, \{Laurien A.\} and \{van Leeuwen\}, \{Flora E.\} and Bleiker, \{Eveline M.A.\}",

note = "Funding Information: We would like to thank Eefke Petersen (UMCU), Erik Marijt (LUMC), Lara B{\"o}hmer (HagaZiekenhuis), Eva de Jongh (ASZ), C{\'e}cile Janus (Erasmus MC), Margreet Houmes (ADRZ), and Marie Jos{\'e} Kersten (Amsterdam UMC, location AMC) for the recruitment of participants. We would like to thank Marijke Gordijn (UMCG, Chrono@Work) and Eus van Someren (Amsterdam UMC and Netherlands Institute for Brain Research) for their advice on the MCTQ and PSQI. The Dutch Cancer Society (Grant Number NKI 2015-7909) financially supported this trial. The role of the Dutch Cancer Society is limited to peer review of the grant proposal. The Dutch Cancer Society is not involved in data collection, analyses, and interpretation of the data nor in the writing of the manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request. Funding Information: We would like to thank Eefke Petersen (UMCU), Erik Marijt (LUMC), Lara B{\"o}hmer (HagaZiekenhuis), Eva de Jongh (ASZ), C{\'e}cile Janus (Erasmus MC), Margreet Houmes (ADRZ), and Marie Jos{\'e} Kersten (Amsterdam UMC, location AMC) for the recruitment of participants. We would like to thank Marijke Gordijn (UMCG, Chrono@Work) and Eus van Someren (Amsterdam UMC and Netherlands Institute for Brain Research) for their advice on the MCTQ and PSQI. The Dutch Cancer Society (Grant Number NKI 2015-7909) financially supported this trial. The role of the Dutch Cancer Society is limited to peer review of the grant proposal. The Dutch Cancer Society is not involved in data collection, analyses, and interpretation of the data nor in the writing of the manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request. Publisher Copyright: {\textcopyright} 2021 The Author(s).",

year = "2021",

month = feb,

doi = "10.1177/0748730420987327",

language = "English",

volume = "36",

pages = "71--83",

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T1 - Cancer-related Fatigue in Relation to Chronotype and Sleep Quality in (Non-)Hodgkin Lymphoma Survivors

AU - Starreveld, Daniëlle E.J.

AU - Habers, G. Esther A.

AU - Valdimarsdottir, Heiddis B.

AU - Kessels, Rob

AU - Daniëls, Laurien A.

AU - van Leeuwen, Flora E.

AU - Bleiker, Eveline M.A.

N1 - Funding Information: We would like to thank Eefke Petersen (UMCU), Erik Marijt (LUMC), Lara Böhmer (HagaZiekenhuis), Eva de Jongh (ASZ), Cécile Janus (Erasmus MC), Margreet Houmes (ADRZ), and Marie José Kersten (Amsterdam UMC, location AMC) for the recruitment of participants. We would like to thank Marijke Gordijn (UMCG, Chrono@Work) and Eus van Someren (Amsterdam UMC and Netherlands Institute for Brain Research) for their advice on the MCTQ and PSQI. The Dutch Cancer Society (Grant Number NKI 2015-7909) financially supported this trial. The role of the Dutch Cancer Society is limited to peer review of the grant proposal. The Dutch Cancer Society is not involved in data collection, analyses, and interpretation of the data nor in the writing of the manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request. Funding Information: We would like to thank Eefke Petersen (UMCU), Erik Marijt (LUMC), Lara Böhmer (HagaZiekenhuis), Eva de Jongh (ASZ), Cécile Janus (Erasmus MC), Margreet Houmes (ADRZ), and Marie José Kersten (Amsterdam UMC, location AMC) for the recruitment of participants. We would like to thank Marijke Gordijn (UMCG, Chrono@Work) and Eus van Someren (Amsterdam UMC and Netherlands Institute for Brain Research) for their advice on the MCTQ and PSQI. The Dutch Cancer Society (Grant Number NKI 2015-7909) financially supported this trial. The role of the Dutch Cancer Society is limited to peer review of the grant proposal. The Dutch Cancer Society is not involved in data collection, analyses, and interpretation of the data nor in the writing of the manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request. Publisher Copyright: © 2021 The Author(s).

PY - 2021/2

Y1 - 2021/2

N2 - Cancer-related fatigue has been related to circadian disruptions and lower levels of sleep quality. However, it is unknown whether the circadian phase, which is associated with chronotype and timing of sleep, is related to fatigue after cancer. The aims of this study were to investigate the associations between (1) chronotype and cancer-related fatigue and (2) sleep quality and cancer-related fatigue. In this cross-sectional questionnaire study, 458 (non-)Hodgkin lymphoma survivors (n = 231 female, mean age 49.7 years) completed a Visual Analogue Scale for fatigue (VAS-fatigue) from 0 (no fatigue) to 10 (worst imaginable fatigue), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI) between October 2018 and July 2019. A hierarchical linear regression analysis was used to evaluate the associations between the dependent variable fatigue and chronotype (based on early, intermediate, or late average midsleep) in Model 1, and fatigue and sleep quality in Model 2. The results showed no indications for an association between chronotype and fatigue (all p values ≥ 0.50). There were associations between two (out of seven) aspects of sleep quality and fatigue: subjective sleep quality (p < 0.001) and daily dysfunctioning (p < 0.001). Therefore, it is more likely that fatigue is associated with self-reported sleep quality rather than with chronotype. However, experimental studies with objective, physiological data on circadian phase and sleep quality are necessary to confirm the conclusions of this cross-sectional study.

AB - Cancer-related fatigue has been related to circadian disruptions and lower levels of sleep quality. However, it is unknown whether the circadian phase, which is associated with chronotype and timing of sleep, is related to fatigue after cancer. The aims of this study were to investigate the associations between (1) chronotype and cancer-related fatigue and (2) sleep quality and cancer-related fatigue. In this cross-sectional questionnaire study, 458 (non-)Hodgkin lymphoma survivors (n = 231 female, mean age 49.7 years) completed a Visual Analogue Scale for fatigue (VAS-fatigue) from 0 (no fatigue) to 10 (worst imaginable fatigue), the Munich Chronotype Questionnaire (MCTQ), and the Pittsburgh Sleep Quality Index (PSQI) between October 2018 and July 2019. A hierarchical linear regression analysis was used to evaluate the associations between the dependent variable fatigue and chronotype (based on early, intermediate, or late average midsleep) in Model 1, and fatigue and sleep quality in Model 2. The results showed no indications for an association between chronotype and fatigue (all p values ≥ 0.50). There were associations between two (out of seven) aspects of sleep quality and fatigue: subjective sleep quality (p < 0.001) and daily dysfunctioning (p < 0.001). Therefore, it is more likely that fatigue is associated with self-reported sleep quality rather than with chronotype. However, experimental studies with objective, physiological data on circadian phase and sleep quality are necessary to confirm the conclusions of this cross-sectional study.

KW - circadian rhythms

KW - fatigue

KW - neoplasms

KW - sleep

KW - survivorship

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JO - Journal of Biological Rhythms

JF - Journal of Biological Rhythms

IS - 1

ER -

Cancer-related Fatigue in Relation to Chronotype and Sleep Quality in (Non-)Hodgkin Lymphoma Survivors

Abstract

Bibliographical note

Other keywords

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