THE IMPACT OF EXERCISE ON THE RELATIONSHIP BETWEEN SLEEP QUALITY AND CANCER-RELATED FATIGUE IN CANCER SURVIVOR

Abstract

Sleep problems have been linked to a variety of factors in cancer survivors (CS), including the disease itself and the treatment. The inability to sleep is strongly associated with cancer-related fatigue (CRF). CRF is a significant concern for CS as it can impair a person's ability to perform their daily life activities. Thus, interventions are needed to improve sleep quality, and thus, reduce CRF. Exercise, has been shown to be an effective non-pharmacologic method for reducing the side effects of cancer treatment, including improving patient-reported sleep quality and reduce CRF independent of one another. However, few studies have studied sleep and CRF together and how this relationship is impacted by exercise. The purpose of this study was to investigate the impact of a 12-week exercise program on the relationship between sleep quality and CRF in CS. The specific objectives were to determine whether the exercise program impacted sleep quality and CRF independently, and whether exercise-induced changes in sleep quality influenced CRF in CS. It was hypothesized that the exercise program would improve sleep quality and thereby decrease CRF. We conducted an analysis of data from the Activating Cancer Communities through an Exercise Strategy for Survivors (ACCESS) study, which included 89 participants that completed the study between September 2018 and March 2020. A paired sample t-test was used to assess the impact of exercise on sleep quality and CRF, while a repeated measure Analysis of Covariance (ANCOVA) was utilized to examine the effect of age and sex on sleep quality and CRF. Additionally, we conducted a correlation analysis to determine if improvements in sleep quality had an impact on CRF and a two-factor mixed ANOVA was conducted to examine the association between PSQI score and change in CRF following the exercise intervention. Study findings indicated that the exercise program had a significant impact in improving sleep quality (p=0.002) and decreasing CRF levels (p=0.001). The two-factor mixed ANOVA results reveal exercise's significant impact on reducing CRF irrespective of sleep quality, although participants with poor sleep quality exhibit higher CRF levels, underscoring the sleep-CRF association. Notably, the exercise intervention proved more effective in lowering CRF for all participants, with a particularly pronounced decrease in those with good sleep quality. These findings underscore the exercise program's efficacy in improving CRF, emphasizing its potential to ameliorate CRF through enhanced sleep quality, particularly for individuals with good sleep patterns. In conclusion, it is crucial to highlight the importance of exercise in improving sleep quality to reduce CRF among CS. It is imperative to conduct further research to explore the lasting effects of exercise on sleep quality and CRF in CS, and to analyze the fundamental mechanisms by which exercise impacts sleep quality and CRF.