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Table 3 Longitudinal associations of diurnal rest-activity rhythm parameters with fatigue, insomnia, and health-related quality of life in the study population of survivors of colorectal cancer between 6 weeks and 60 months post-treatment

From: Longitudinal associations of diurnal rest-activity rhythms with fatigue, insomnia, and health-related quality of life in survivors of colorectal cancer up to 5 years post-treatment

  

Checklist Individual Strength (CIS)

EORTC-QLQ-C30

Diurnal rest-activity rhythm parameters per SD

Total fatigue

(20 – 140)

Subjective

Fatigue

(8 – 56)

Activity

Fatigue

(3 – 21)

Fatigue

(0 – 100)

Insomnia

(0 – 100)

Global QoL

(0 – 100)

Physical Functioning

(0 – 100)

  

Βa (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

Mesor

(reflects mean activity level)

Adjustedb,c

-5.3 (-6.9, -3.6)

-2.2 (-3.0, -1.4)

-1.5 (-1.8, -1.1)

-3.4 (-5.0, -1.8)

-2.0 (-4.0, 0.0)

3.7 (2.5, 4.9)

3.2 (2.1, 4.4)

Intrad

-4.8 (-6.8, -2.8)

-2.0 (-3.0, -1.0)

-1.3 (-1.8, -0.9)

-3.8 (-5.7, -1.9)

-3.2 (-6.0, -0.5)

3.5 (1.9, 5.0)

2.3 (1.0, 3.5)

Intere

-6.3 (-9.1, -3.4)

-2.6 (-4.0, -1.3)

-1.7 (-2.3, -1.2)

-3.2 (-5.5, -0.9)

-0.7 (-3.5, 2.1)

4.5 (2.7, 6.3)

6.5 (4.7, 8.3)

Amplitude

(reflects difference between peak- and mean activity levels)

Adjustedb,c

-5.5 (-7.1, -3.9)

-2.5 (-3.3, -1.6)

-1.3 (-1.7, -1.0)

-4.7 (-6.2, -3.1)

-2.4 (-4.3, -0.4)

4.1 (3.0, 5.2)

4.7 (3.7, 5.7)

Intrad

-4.9 (-6.8, -3.0)

-2.3 (-3.2, -1.3)

-1.2 (-1.6, -0.7)

-5.4 (-7.2, -3.6)

-2.9 (-5.5, -0.2)

3.7 (2.2, 5.2)

3.7 (2.5, 4.9)

Intere

-6.8 (-9.7, -3.9)

-3.0 (-4.4, -1.7)

-1.6 (-2.2, -1.1)

-4.3 (-6.6, -2.1)

-1.9 (-4.7, 0.9)

5.4 (3.7, 7.2)

8.3 (6.5, 10.0)

Circadian Quotient

(reflects peak activity adjusted for mean activity levels)

Adjustedb,c

-5.1 (-6.6, -3.6)

-2.3 (-3.1, -1.5)

-1.2 (-1.5, -0.9)

-4.5 (-6.0, -3.0)

-2.3 (-4.2, -0.4)

3.9 (2.7, 5.0)

4.6 (3.6, 5.6)

Intrad

-4.5 (-6.3, -2.7)

-2.1 (-3.0, -1.2)

-1.0 (-1.4, -0.6)

-5.1 (-6.8, -3.4)

-2.5 (-5.0, 0.1)

3.4 (2.0, 4.8)

3.5 (2.4, 4.6)

Intere

-6.6 (-9.4, -3.8)

-3.0 (-4.3, -1.7)

-1.6 (-2.1, -1.0)

-4.3 (-6.6, -2.1)

-2.1 (-4.9, 0.7)

5.4 (3.6, 7.1)

8.3 (6.5, 10.0)

Dichotomy Index

(reflects difference between daytime and nighttime activity)

Adjustedb,c

-3.1 (-4.2, -2.1)

-1.0 (-1.4, -0.5)

-1.0 (-1.2, -0.7)

-2.9 (-4.0, -1.8)

-1.0 (-2.2, 0.3)

1.7 (0.7, 2.6)

2.3 (1.5, 3.1)

Intrad

-2.5 (-3.5, -1.4)

-1.1 (-1.6, -0.5)

-0.7 (-0.9, -0.4)

-2.0 (-3.0, -1.0)

-1.1 (-2.6, 0.4)

0.7 (-0.2, 1.5)

1.0 (0.3, 1.7)

Intere

-1.8 (-4.2, 0.5)

-0.5 (-1.6, 0.6)

-0.8 (-1.3, -0.4)

-1.0 (-2.9, 0.8)

-0.6 (-3.0, 1.7)

1.1 (-0.4, 2.7)

3.9 (2.4, 5.4)

24-h autocorrelation coefficient

(rhythm consistency across days)

Adjustedb,c

-1.1 (-2.9, 0.7)

-1.3 (-2.1, -0.4)

-0.1 (-0.4, 0.3)

-3.0 (-4.6, -1.4)

-1.2 (-3.4, 1.1)

1.5 (0.1, 2.9)

4.1 (2.9, 5.4)

Intrad

0.3 (-1.8, 2.4)

-0.2 (-1.3, 0.9)

0.2 (-0.3, 0.7)

-1.3 (-3.5, 0.8)

-2.0 (-5.1, 1.2)

0.1 (-1.7, 1.9)

1.9 (0.5, 3.4)

Intere

-4.5 (-7.7, -1.3)

-2.7 (-4.2, -1.2)

-0.4 (-1.1, 0.2)

-4.5 (-7.0, -2.0)

-0.4 (-3.4, 2.7)

2.9 (0.9, 4.9)

5.7 (3.8, 7.7)

Acrophase, per tertilef

Total fatigue

(20 – 140)

Subjective

Fatigue

(8 – 56)

Activity

Fatigue

(3 – 21)

Fatigue

(0 -100)

Insomnia

(0–100)

Global QoL(0-100)

Physical Functioning (0-100)

  

βa (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

β (95% CI)

Acrophase

(reflects clock-time of peak activity)

Adjusted, tertile 1

REF

REF

REF

REF

REF

REF

REF

Adjusted, tertile 2

-0.2 (-3.2, 2.9)

0.2 (-1.4, 1.7)

-0.2 (-0.8, 0.5)

-0.5 (-3.3, 2.3)

1.1 (-2.9, 5.0)

-0.6 (-2.9, 1.7)

-1.2 (-3.1, 0.7)

Adjusted, tertile 3

0.4 (-3.2, 4.0)

0.3 (-1.5, 2.1)

0.2 (-0.6, 1.0)

-0.7 (-3.9, 2.6)

3.0 (-1.5, 7.5)

-0.9 (-3.6, 1.8)

-1.4 (-3.7, 0.8)

  1. Values in bold are statistically significant (P < 0.05)
  2. Abbreviations: CIS Checklist Individual Strength, EORTC QLQ-C30 European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire
  3. aThe β-coefficients indicate the overall longitudinal difference in the outcome score using linear mixed models per standard deviation (SD) increase in diurnal rest-activity rhythms parameter. This SD was calculated by summing the SDs of each diurnal rest-activity rhythm parameter at each time point, and then dividing this number by 5 (number of time points). The SDs were as follows: mesor 0.175, amplitude 0.180, circadian quotient 0.042, dichotomy index 0.114, and 24-h autocorrelation coefficient 0.107
  4. bLinear mixed-models adjusted for sex (male/female), age at enrollment (years), weeks since end of treatment (weeks), neo-adjuvant therapy (yes/no), adjuvant therapy (yes/no), comorbidities (0, 1, ≥ 2), BMI (kg/m2), stoma (yes/no), smoking (former, current, never), employment status (yes/no), and alcohol intake (g/day)
  5. cA random slope was added to the model when the model improved statistically significantly using a likelihood-ratio test
  6. dThe β-coefficients indicate the average change in the outcome score over time when exposure increases with 1 SD between time points from 6 weeks to 60 months post-treatment within individuals
  7. eThe β-coefficients indicate the average difference in the outcome score between individuals differing by 1 SD in average exposure across all time points from 6 weeks to 60 months post-treatment
  8. fTertiles were calculated based on the distribution of values at each individual post-treatment time point. Ranges (clock-hours) were as follows: 6 weeks post-treatment, tertile 1 01:24 – 13:46, tertile 2 13:47 – 14:42, tertile 3 14:43 – 20:10; 6 months post-treatment, tertile 1 08:19 – 13:54, tertile 2 13:55 – 14:43, tertile 3 14:44 – 19:05; 12 months post-treatment, tertile 1 10:45 – 13:56, tertile 2 13:57 – 14:44, tertile 3 14:45 – 17:48; 24 months post-treatment, tertile 1 10:35 – 13:47, tertile 2 13:48 – 14:40, tertile 3 14:41 – 17:47; 60 months post-treatment, tertile 1 08:02 – 14:01, tertile 2 14:02 – 14:38, tertile 3 14:39 – 17:13
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International Journal of Behavioral Nutrition and Physical Activity

ISSN: 1479-5868

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