Effect of Increased Light Exposure on Fatigue in Breast Cancer
| Status: | Completed |
|---|---|
| Conditions: | Breast Cancer, Cancer |
| Therapuetic Areas: | Oncology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 2/8/2019 |
| Start Date: | November 2005 |
| End Date: | November 2009 |
Patients treated with chemotherapy complain of poor sleep, fatigue and depression. In
addition, chemotherapy disrupts the body's internal "biological clock", which may make sleep,
fatigue and depression all worse. Women with breast cancer undergoing chemotherapy are not
exposed to much bright light and this may also contribute to the disruption of their body
clock, because bright light is necessary for a strong biological clock. One of the easiest
ways to strengthen the biological clock is by increasing bright light exposure. The correct
timing of the light exposure will help the women feel more alert during the day.
addition, chemotherapy disrupts the body's internal "biological clock", which may make sleep,
fatigue and depression all worse. Women with breast cancer undergoing chemotherapy are not
exposed to much bright light and this may also contribute to the disruption of their body
clock, because bright light is necessary for a strong biological clock. One of the easiest
ways to strengthen the biological clock is by increasing bright light exposure. The correct
timing of the light exposure will help the women feel more alert during the day.
Patients treated with chemotherapy complain of poor sleep, fatigue and depression. Our
preliminary research suggests that these symptoms may all be related, that chemotherapy
disrupts circadian rhythms which may exacerbate the poor sleep and fatigue and that during
chemotherapy, women are not exposed to much bright light which likely also contributes to the
disruption of rhythms. One of the easiest circadian rhythms to measure is sleep/wake activity
and the easiest way to synchronize this rhythm is with bright light treatment. It is well
established that bright light exposure will make rhythms more robust, and the correct timing
of the light exposure will have an alerting effect.
We hypothesize that after bright light treatment compared to dim light treatment during three
cycles of chemotherapy: fatigue (measured by the Multidimensional Fatigue Symptom Inventory),
depression (measured by the Center of Epidemiological Studies-Depression scale), functional
outcome scores (measured by the Functional Outcome of Sleep Questionnaire and by the
Functional Assessment of Cancer Therapy-Breast), and sleep measures (measured by actigraphy,
e.g., total sleep time, total wake time, bouts of sleep, napping) will all be improved. We
also hypothesize that circadian rhythms (measured by actigraphy) will be more robust and more
synchronized.
The aims are to examine the effect of bright light treatment on subjective measures of
fatigue, mood and functional outcome experienced during chemotherapy, to examine the effect
of bright light treatment on the quality and quantity of sleep during chemotherapy, to
examine the effect of bright light treatment on sleep/wake rhythms during chemotherapy. Women
with breast cancer stages I-III scheduled to begin chemotherapy will be recruited. Wrist
actigraphy data (for the measurement of sleep/wake activity) will be collected for three
consecutive days and nights immediately preceding chemotherapy and questionnaire data
(fatigue, mood, quality of life, functional outcome, sleep) will be collected during this
same time period. Half the women will be randomized to receive bright light and the other
half to dim red light as a control. Daily bright light or dim light treatment will be
administered during cycles 2, 3 and 4 of chemotherapy and all measures (actigraphy and
questionnaires) will be repeated during the first and last weeks of cycle 1 and cycle 4
chemotherapy. If bright light can improve sleep rhythms and fatigue, then the quality of life
of these women is likely to improve.
preliminary research suggests that these symptoms may all be related, that chemotherapy
disrupts circadian rhythms which may exacerbate the poor sleep and fatigue and that during
chemotherapy, women are not exposed to much bright light which likely also contributes to the
disruption of rhythms. One of the easiest circadian rhythms to measure is sleep/wake activity
and the easiest way to synchronize this rhythm is with bright light treatment. It is well
established that bright light exposure will make rhythms more robust, and the correct timing
of the light exposure will have an alerting effect.
We hypothesize that after bright light treatment compared to dim light treatment during three
cycles of chemotherapy: fatigue (measured by the Multidimensional Fatigue Symptom Inventory),
depression (measured by the Center of Epidemiological Studies-Depression scale), functional
outcome scores (measured by the Functional Outcome of Sleep Questionnaire and by the
Functional Assessment of Cancer Therapy-Breast), and sleep measures (measured by actigraphy,
e.g., total sleep time, total wake time, bouts of sleep, napping) will all be improved. We
also hypothesize that circadian rhythms (measured by actigraphy) will be more robust and more
synchronized.
The aims are to examine the effect of bright light treatment on subjective measures of
fatigue, mood and functional outcome experienced during chemotherapy, to examine the effect
of bright light treatment on the quality and quantity of sleep during chemotherapy, to
examine the effect of bright light treatment on sleep/wake rhythms during chemotherapy. Women
with breast cancer stages I-III scheduled to begin chemotherapy will be recruited. Wrist
actigraphy data (for the measurement of sleep/wake activity) will be collected for three
consecutive days and nights immediately preceding chemotherapy and questionnaire data
(fatigue, mood, quality of life, functional outcome, sleep) will be collected during this
same time period. Half the women will be randomized to receive bright light and the other
half to dim red light as a control. Daily bright light or dim light treatment will be
administered during cycles 2, 3 and 4 of chemotherapy and all measures (actigraphy and
questionnaires) will be repeated during the first and last weeks of cycle 1 and cycle 4
chemotherapy. If bright light can improve sleep rhythms and fatigue, then the quality of life
of these women is likely to improve.
Inclusion Criteria:
- stage I-III breast cancer
- adjuvant or neoadjuvant anthracycline-based chemotherapy
Exclusion Criteria:
- under age 18
- pregnancy
- metastatic or inoperable (including inflammatory) breast cancer
- confounding underlying medical illnesses
- history of mania
- history of other axis-I psychiatric disorder
- other physical or psychological impairments -
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