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@ARTICLE{Chong:290040,
      author       = {M. Y. Chong and K. G. Frenken and S. J. P. M. Eussen and A.
                      Koster and G. K. Pot and S. O. Breukink and M.
                      Janssen-Heijnen and E. T. P. Keulen and W. Bijnens and L. M.
                      Buffart and K. Meijer and F. A. J. L. Scheer and K.
                      Steindorf$^*$ and J. de Vos-Geelen and M. P. Weijenberg and
                      E. H. van Roekel and M. J. L. Bours},
      title        = {{L}ongitudinal associations of diurnal rest-activity
                      rhythms with fatigue, insomnia, and health-related quality
                      of life in survivors of colorectal cancer up to 5 years
                      post-treatment.},
      journal      = {International journal of behavioral nutrition and physical
                      activity},
      volume       = {21},
      number       = {1},
      issn         = {1479-5868},
      address      = {London},
      publisher    = {BioMed Central},
      reportid     = {DKFZ-2024-00945},
      pages        = {51},
      year         = {2024},
      abstract     = {There is a growing population of survivors of colorectal
                      cancer (CRC). Fatigue and insomnia are common symptoms after
                      CRC, negatively influencing health-related quality of life
                      (HRQoL). Besides increasing physical activity and decreasing
                      sedentary behavior, the timing and patterns of physical
                      activity and rest over the 24-h day (i.e. diurnal
                      rest-activity rhythms) could also play a role in alleviating
                      these symptoms and improving HRQoL. We investigated
                      longitudinal associations of the diurnal rest-activity
                      rhythm (RAR) with fatigue, insomnia, and HRQoL in survivors
                      of CRC.In a prospective cohort study among survivors of
                      stage I-III CRC, 5 repeated measurements were performed from
                      6 weeks up to 5 years post-treatment. Parameters of RAR,
                      including mesor, amplitude, acrophase, circadian quotient,
                      dichotomy index, and 24-h autocorrelation coefficient, were
                      assessed by a custom MATLAB program using data from
                      tri-axial accelerometers worn on the upper thigh for 7
                      consecutive days. Fatigue, insomnia, and HRQoL were measured
                      by validated questionnaires. Confounder-adjusted linear
                      mixed models were applied to analyze longitudinal
                      associations of RAR with fatigue, insomnia, and HRQoL from 6
                      weeks until 5 years post-treatment. Additionally,
                      intra-individual and inter-individual associations over time
                      were separated.Data were available from 289 survivors of
                      CRC. All RAR parameters except for 24-h autocorrelation
                      increased from 6 weeks to 6 months post-treatment, after
                      which they remained relatively stable. A higher mesor,
                      amplitude, circadian quotient, dichotomy index, and 24-h
                      autocorrelation were statistically significantly associated
                      with less fatigue and better HRQoL over time. A higher
                      amplitude and circadian quotient were associated with lower
                      insomnia. Most of these associations appeared driven by both
                      within-person changes over time and between-person
                      differences in RAR parameters. No significant associations
                      were observed for acrophase.In the first five years after
                      CRC treatment, adhering to a generally more active (mesor)
                      and consistent (24-h autocorrelation) RAR, with a pronounced
                      peak activity (amplitude) and a marked difference between
                      daytime and nighttime activity (dichotomy index) was found
                      to be associated with lower fatigue, lower insomnia, and a
                      better HRQoL. Future intervention studies are needed to
                      investigate if restoring RAR among survivors of CRC could
                      help to alleviate symptoms of fatigue and insomnia while
                      enhancing their HRQoL.EnCoRe study NL6904 (
                      https://www.onderzoekmetmensen.nl/ ).},
      keywords     = {Humans / Sleep Initiation and Maintenance Disorders:
                      therapy / Quality of Life / Colorectal Neoplasms / Male /
                      Female / Fatigue / Middle Aged / Prospective Studies /
                      Circadian Rhythm: physiology / Cancer Survivors: psychology
                      / Rest / Aged / Longitudinal Studies / Exercise / Surveys
                      and Questionnaires / Colorectal cancer survivorship (Other)
                      / Diurnal rest-activity rhythms (Other) / Fatigue (Other) /
                      Health-related quality of life (Other) / Insomnia (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:38698447},
      pmc          = {pmc:PMC11067118},
      doi          = {10.1186/s12966-024-01601-x},
      url          = {https://inrepo02.dkfz.de/record/290040},
}