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@ARTICLE{Castelli:169805,
      author       = {L. Castelli and T. Elter and F. Wolf and M. Watson and A.
                      Schenk and K. Steindorf$^*$ and W. Bloch and M. Hallek and
                      N. Joisten and P. Zimmer},
      title        = {{S}leep problems and their interaction with physical
                      activity and fatigue in hematological cancer patients during
                      onset of high dose chemotherapy.},
      journal      = {Supportive care in cancer},
      volume       = {30},
      number       = {1},
      issn         = {1433-7339},
      address      = {New York,NY},
      publisher    = {Springer},
      reportid     = {DKFZ-2021-01559},
      pages        = {167-176},
      year         = {2022},
      note         = {2022 Jan;30(1):167-176},
      abstract     = {Sleep problems reported by hematological cancer patients
                      are usually linked to higher levels of cancer-related
                      fatigue. Although the awareness of sleep problems in solid
                      cancer patients is rising, there has been less attention to
                      the issue in hematological cancer patients. The present
                      study assesses the differences in sleep by comparing
                      physical activity and fatigue levels among hematological
                      cancer patients during the onset of chemotherapy.
                      Furthermore, it investigates the relationship between sleep,
                      physical activity, and fatigue through mediation
                      analysis.The recruited sample consists of 58 newly diagnosed
                      hematological cancer patients (47.1 ± 15.4 yrs; $51.7\%$
                      males). Subjects completed questionnaires assessing sleep
                      (PSQI), physical activity (visual analogue scale), fatigue
                      (MFI-20), anxiety, depression (HADS), and quality of life
                      (EORTC QLQ-C30) within two weeks from starting treatment.The
                      sample reported more sleep problems in comparison to the
                      German population norm. The classification as good (ca
                      $25\%)$ or bad sleepers (ca $75\%)$ showed less frequent
                      physical activity (p = .04), higher fatigue (p = .032),
                      anxiety (p = .003), depression (p = .011) and pain (p =
                      .011) in bad sleepers. The mediation analysis revealed
                      significant indirect effects of sleep on fatigue through
                      physical activity habits.This study highlights the combined
                      action of sleep problems and physical activity on fatigue
                      during the onset of induction chemotherapy. These two
                      parameters could represent meaningful intervention targets
                      to improve a patient's status during chemotherapy.The study
                      was registered on the WHO trial register (DRKS00007824).},
      keywords     = {Fatigue (Other) / Hematological cancer (Other) / Leukemia
                      (Other) / Physical activity (Other) / Sleep (Other)},
      cin          = {C110},
      ddc          = {610},
      cid          = {I:(DE-He78)C110-20160331},
      pnm          = {313 - Krebsrisikofaktoren und Prävention (POF4-313)},
      pid          = {G:(DE-HGF)POF4-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:34245360},
      doi          = {10.1007/s00520-021-06377-5},
      url          = {https://inrepo02.dkfz.de/record/169805},
}