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Effects of a wearable technology-based physical activity intervention on sleep quality in breast cancer survivors: the ACTIVATE Trial

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Abstract

Introduction

Physical activity interventions can improve sleep quality in breast cancer survivors. This paper examines the effects of the ACTIVATE Trial, a wearable-based physical activity intervention (Garmin Vivofit2® coupled with behavioral feedback, goal setting, and health coaching) on sleep outcomes.

Methods

Post-primary treatment, inactive, postmenopausal breast cancer survivors were recruited and randomized to primary intervention or waitlist. Wrist-worn actigraphy (sleep onset latency, SOL; total sleep time, TST; sleep efficiency, SE; wake after sleep onset, WASO; and number of awakenings, NWAKE) and questionnaire-derived sleep measures (Pittsburgh Sleep Quality Index) were assessed at baseline (T1), 12 weeks (end of primary intervention and start of waitlist intervention, T2), and at 24 weeks (T3).

Results

Eighty-three women (mean age = 62 years) were randomized; trial retention was 94% at T2 and 87% at T3. At T2, primary intervention participants had greater improvements in WASO (− 5.7 min, 95% CI − 11.7 to − 0.2) and NWAKE compared with the waitlist arm (− 2.0, 95% CI − 3.6 to − 0.4). At T3, within-group improvements were observed for SE (both groups), WASO (both groups), NWAKE (primary intervention group only), total PSQI score (primary intervention group), and sleep efficacy (primary intervention group).

Conclusions

The intervention reduced actigraphy-measured sleep disturbances. Within-group analyses suggest that improvements in sleep quality are sustained over a longer duration, and there may be similar benefits from an abridged intervention (wearable device only). Actigraphy-measured effects appeared stronger in participants who were poor sleepers at study entry.

Implications for Cancer Survivors

Wearable technology can increase physical activity and improve sleep for breast cancer survivors.

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Acknowledgments

This research was supported by Register4 through its members’ participation in research and/or provision of samples and information. Thanks also to the National Breast Cancer Foundation, the Breast Cancer Network of Australia, and Counterpart for their promotion of the ACTIVATE Trial and assistance with recruitment.

Funding

This work was enabled by a grant from the World Cancer Research Fund International (2015/1397). Vallance was supported by the Canada Research Chairs program; Buman was supported by an Endeavour Research Fellowship from the Department of Education and Training of the Australian Government (6316 – 2018); Boyle was supported by a National Health and Medical Research Council Early Career Fellowship (1072266); Lynch was supported by a National Breast Cancer Foundation Fellowship (ECF-15-012).

Author information

Authors and Affiliations

  1. Cancer Epidemiology Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, VIC, 3004, Australia

    Nga H. Nguyen, Dallas R. English & Brigid M. Lynch

  2. Faculty of Health Disciplines, Athabasca University, Athabasca, Canada

    Jeff K. Vallance

  3. School of Nutrition and Health Promotion, Arizona State University, Phoenix, AZ, USA

    Matthew P. Buman

  4. Medical Oncology, St Vincent’s Hospital, Melbourne, Australia

    Melissa M. Moore

  5. School of Public Health, The University of Queensland, Brisbane, Australia

    Marina M. Reeves

  6. Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA

    Dori E. Rosenberg

  7. Centre for Population Health Research, School of Health Sciences, University of South Australia, Adelaide, Australia

    Terry Boyle

  8. Centre for Cancer Research, Faculty of Medicine Dentistry and Health Sciences, The University of Melbourne, Melbourne, Australia

    Shakira Milton

  9. Department of General Practice, Melbourne Medical School, University of Melbourne, Melbourne, Australia

    Shakira Milton

  10. Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Canada

    Christine M. Friedenreich

  11. Departments of Oncology and Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada

    Christine M. Friedenreich

  12. Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia

    Dallas R. English & Brigid M. Lynch

  13. Physical Activity Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia

    Brigid M. Lynch

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  1. Nga H. Nguyen
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Corresponding author

Correspondence to Brigid M. Lynch.

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The ACTIVATE Trial protocol was approved by Cancer Council Victoria’s Human Research Ethics Committee (HREC-1602) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Nguyen, N.H., Vallance, J.K., Buman, M.P. et al. Effects of a wearable technology-based physical activity intervention on sleep quality in breast cancer survivors: the ACTIVATE Trial. J Cancer Surviv 15, 273–280 (2021). https://doi.org/10.1007/s11764-020-00930-7

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  • DOI: https://doi.org/10.1007/s11764-020-00930-7

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