Implications of the study of rest-activity circadian rhythm in head and neck cancer patients

Rhythm alterations consisting of decrease in amplitude, modification in peak time, including the suppression of one or several circadian outputs have been reported in patients suffering from breast, ovarian and colorectal cancer. The aim of the present study was to evaluate the rest-activity circadian rhythm in patients suffering from head and neck cancer. Nine patients were randomly selected from the indoor ward of the Regional Cancer Center, Raipur, India. Rest-activity rhythm and various sleep parameters in these patients were studied non-invasively by using wrist actigraphy. A statistically significant circadian rhythm in rest-activity was validated in all cancer patients. They had lower activity levels (p > 0.05) and amplitudes (p < 0.05) as compared to their respective controls. Further, the fragmentation index was found to be more in male cancer patients as compared with their respective female (p < 0.05) and healthy male (p < 0.05) counterparts. In addition, female cancer patients experienced better sleep efficiency (p < 0.05) and had longer actual sleep time (p < 0.05) as compared to male cancer patients. We conclude that the 24-h average activity and amplitude of rest-activity circadian rhythm declined in head and neck cancer patients. A larger peak spread in the circadian rhythm in rest-activity of cancer patients was discovered. Therefore, the scheduling of therapies should be based on patient-specific individual findings.