Circadian rhythms measured by actigraphy during oncological treatments: a systematic review

During oncological treatment patients often suffer from fatigue, insomnia, and daytime inactivity. This cluster of symptoms and overall survival are linked with circadian rhythm disruptions in rest-activity, which can be objectively characterized using actigraphy. We systematically reviewed the body of literature using actigraphy to characterize the circadian rhythm disruption in patients during oncological treatments and studies that introduced interventions to deal with this disruption. Thirteen observational and two interventional studies were included in this review. These mainly described patients with breast cancer undergoing chemotherapy, and the disruptions were persistent among these patients, and the disruptions peaked at the start of chemotherapy cycles and decreased during the periods in between. Light and behavioral therapy showed some alleviating effects in patients with breast cancer. We also found that circadian rhythm disruptions were prevalent in patients during other cancer therapies. Effective cancer therapy controls cancer growth and improves circadian organization. Cancer therapy itself, however, also contributes to cancer associated circadian dys-synchrony. Interrupting this vicious cycle represents an important opportunity for diminishing cancer patients’ suffering and improving or even prolonging their useful and enjoyable lives.