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Randomized Controlled Trial
. 2016 Nov 22;115(11):1304-1312.
doi: 10.1038/bjc.2016.356. Epub 2016 Nov 3.

Effect of walking on circadian rhythms and sleep quality of patients with lung cancer: a randomised controlled trial

Hui-Mei Chen  1   2 , Chun-Ming Tsai  3   4 , Yu-Chung Wu  4   5 , Kuan-Chia Lin  6 , Chia-Chin Lin  2
Affiliations
Randomized Controlled Trial

Effect of walking on circadian rhythms and sleep quality of patients with lung cancer: a randomised controlled trial

Hui-Mei Chen et al. Br J Cancer. .

Abstract

Background: Sleep disturbances and poor rest-activity rhythms, which can reduce the quality of life, are highly prevalent among patients with lung cancer.

Methods: This trial investigated the effects of a 12-week exercise intervention including home-based walking exercise training and weekly exercise counseling on 111 lung cancer patients. Participants were randomly allocated to receive the intervention or usual-care. Outcomes included objective sleep (total sleep time, TST; sleep efficiency, SE; sleep onset latency, SOL; and wake after sleep onset, WASO), subjective sleep (Pittsburgh Sleep Quality Index, PSQI), and rest-activity rhythms (r24 and I<O). Outcomes were assessed at baseline and 3 and 6 months after intervention.

Results: The PSQI (Wald χ2=15.16, P=0.001) and TST (Wald χ2=7.59, P=0.023) of the patients in the exercise group significantly improved 3 and 6 months after intervention. The moderating effect of I<O on TST was significant (β of group × I<O=3.70, P=0.032).

Conclusions: The walking program is an effective intervention for improving the subjective and objective sleep quality of lung cancer patients and can be considered an optional component of lung cancer rehabilitation.

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Figures

Figure 1
Figure 1
Consolidated standards of reporting trials (CONSORT) diagram showing the flow of participants through the trial.
Figure 2
Figure 2
Effects of walking exercise on subjective and objective sleep quality in both groups. (A) PSQI scores decreased and (B) TST increased in the walking exercise group over time. PSQI, Pittsburgh Sleep Quality Index; TST, total sleep time.
Figure 3
Figure 3
Subjective and objective sleep quality in the r24 and I<O subgroups. The trends of changes in (A) the PSQI and (B) TST in the poor r24 subgroup and in (C) the PSQI and (D) TST in the poor I<O subgroup. I<O, in-bed less than out-of-bed dichotomy index; PSQI, Pittsburgh Sleep Quality Index; r24, 24-h autocorrelation coefficient; TST, total sleep time.
See this image and copyright information in PMC

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