Wearable-based programme improves sleep in cancer survivors

A device-based exercise intervention programme may boost sleep quality in breast cancer survivors, according to a recent study.

“The ACTIVATE Trial examined the efficacy of a 12-week wearable technology-based physical activity intervention,” which involved the wrist-worn Garmin Vivofit 2, behavioural feedback, and health coaching, the researchers said. “Here, we examine whether there was an intervention effect on sleep quality within the ACTIVATE Trial.”

Eighty-three participants (mean age, 62±6.4 years) were randomly assigned to either the test intervention (n=43) or a waitlist (n=40). Body mass index at baseline was 29 kg/m². After 12 weeks, the intervention group showed a significantly shorter actigraphy-measured awake time after sleep onset (mean difference [MD], –5.7 minutes, 95 percent confidence interval [CI], –11.7 to –0.2). [J Cancer Surviv 2020;doi:10.1007/s11764-020-00930-7]

Similarly, the number of awakenings was statistically fewer in the intervention arm at this time point (MD, –2.0, 95 percent CI, –3.6 to –0.4). The exercise programme had no such significant impact on actigraphy sleep efficiency and Pittsburgh Sleep Quality Index (PSQI) scores.

Looking at within-group changes over 24 weeks, statistical improvements were observed in the intervention arm in terms of actigraphy sleep efficacy, awake time after sleep onset, and number of awakenings (p<0.001 for all). PSQI measures in the intervention arm, such as sleep disturbances (p=0.003) and sleep efficiency (p=0.03), were likewise significantly better at the end of the study.

Notably, significant improvements were also seen in actigraphy sleep efficiency (p=0.03) and awake time after sleep onset (p=0.04) at the final follow-up in the waitlist arm, although these changes were weaker in magnitude. Waitlist participants reported no change in PSQI outcomes.

“The ACTIVATE Trial was the first study to examine the effects of a wearable technology-based physical activity intervention on sleep outcomes using a randomized controlled trial design,” the researchers said. Other notable features were the high retention and adherence rates, and the use of a maintenance period to monitor for long-term effects.

Moreover, patients assigned to the active intervention went through 12 weeks of mandatory use of the Vivofit device and received behavioural feedback from a member of the research team. Participants also received five phone-delivered behavioural counselling sessions. The trial period was followed by another 12 weeks of maintenance, during which use of the device was discretionary.

During the maintenance phase, participants assigned to the waitlist were also given the wrist-worn device. This abridged intervention, where none of the behavioural counselling sessions were included, also lasted for 12 weeks.

“Sleep disturbances are one of the most frequently reported side effects of cancer treatment, and physical activity is a safe and efficacious treatment. The results from the ACTIVATE Trial suggest that wearable technology has potential as an efficient and sustainable method for increasing physical activity and improving sleep quality,” the researchers said.