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Circadian disruption and cancer- and treatment-related symptoms
(2022-10) Amidi, Ali; Wu, Lisa M.; Department of Psychology
Cancer patients experience a number of co-occurring side- and late-effects due to cancer and its treatment including fatigue, sleep difficulties, depressive symptoms, and cognitive impairment. These symptoms can impair quality of life and may persist long after treatment completion. Furthermore, they may exacerbate each other’s intensity and development over time. The co-occurrence and interdependent nature of these symptoms suggests a possible shared underlying mechanism. Thus far, hypothesized mechanisms that have been purported to underlie these symptoms include disruptions to the immune and endocrine systems. Recently circadian rhythm disruption has emerged as a related pathophysiological mechanism underlying cancer- and cancer-treatment related symptoms. Circadian rhythms are endogenous biobehavioral cycles lasting approximately 24 hours in humans and generated by the circadian master clock – the hypothalamic suprachiasmatic nucleus. The suprachiasmatic nucleus orchestrates rhythmicity in a wide range of bodily functions including hormone levels, body temperature, immune response, and rest-activity behaviors. In this review, we describe four common approaches to the measurement of circadian rhythms, highlight key research findings on the presence of circadian disruption in cancer patients, and provide a review of the literature on associations between circadian rhythm disruption and cancer- and treatment-related symptoms. Implications for future research and interventions will be discussed.
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Sleep during oncological treatment – a systematic review and meta-analysis of associations with treatment response, time to progression and survival
(2022-04-19) Strøm, Louise; Danielsen, Josefine T.; Amidi, Ali; Egusquiza, Ana Lucia Cardenas; Wu, Lisa M.; Zachariae, Robert; Department of Psychology
Introduction: Disrupted sleep and sleep-wake activity are frequently observed in cancer patients undergoing oncological treatment. These disruptions are often associated with aggravated symptom burden and diminished health-related quality of life that in turn may compromise treatment adherence and, thus, effectiveness. In addition, disrupted sleep has been linked to carcinogenic processes, which ultimately could result in worse prognostic outcomes. Aims: Our aim was to systematically review and conduct a meta-analysis of studies examining the associations between sleep and sleep-wake activity and prognostic outcomes in cancer patients undergoing oncological treatment. Methods: A comprehensive systematic search of English language papers was undertaken in June 2020 using PubMed, The Cochrane Library, and CINAHL. Two reviewers independently screened 4,879 abstracts. A total of 26 papers were included in the narrative review. Thirteen papers reporting hazard ratios reflecting associations between a dichotomized predictor variable (sleep) and prognostic outcomes were subjected to meta-analysis. Results: Nineteen of the 26 eligible studies on a total of 7,092 cancer patients reported associations between poorer sleep and poorer response to treatment, shorter time to progression, and/or reduced overall survival, but were highly heterogeneous with respect to the sleep and outcome parameters investigated. Meta-analysis revealed statistically significant associations between poor self-reported sleep and reduced overall survival (HR = 1.33 [95% CI 1.09-1.62], k = 11), and shorter time to progression (HR = 1.40 [95% CI 1.23-1.59], k = 3) and between poor objectively assessed sleep and reduced overall survival (HR = 1.74 [95% CI 1.05-2.88], k = 4). Conclusion: The current findings indicate that disturbed sleep during treatment may be a relevant behavioral marker of poor cancer prognosis. The limited number of studies, the common use of single item sleep measures, and potential publication bias highlight the need for further high quality and longitudinal studies.
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Sleep and allostatic load : A systematic review and meta-analysis
(2022-08) Christensen, Dinne Skjærlund; Zachariae, Robert; Amidi, Ali; Wu, Lisa Maria; Department of Psychology
The detrimental effects of sleep disturbances on health and wellbeing are well-established but not fully understood. The allostatic load model has been suggested as a framework for understanding the adverse effects of sleep disturbances. We conducted a systematic review and meta-analysis to examine the associations of sleep disturbance and sleep duration with allostatic load. PubMed, PsycINFO, Embase, and Web of Science were searched for records relating to sleep and allostatic load published from 1993 to January 14th, 2022. Two independent raters screened 395 titles and abstracts and 51 full texts. Data were extracted from 18 studies that were assessed for methodological quality. Of these, 17 studies of 26,924 participants were included in the meta-analysis. Sleep disturbance was significantly associated with higher allostatic load (effect size correlation [ESr] = 0.09, p < 0.001), and the association was weaker in samples with a larger proportion of women. When compared to normal sleep, long sleep was significantly associated with higher allostatic load (ESr = 0.12, p = 0.003). Results indicated heterogeneity. No association was found for short sleep (ESr = 0.05, p = 0.069) or sleep duration (ESr = −0.06, p = 0.36). Future research should identify mechanisms and directionality in longitudinal studies.
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Risk Factors for Workplace Sexual Harassment and Violence Among Women: A Population-Based Study
(2022) Jónsdóttir, Svava Dögg; Hauksdóttir, Arna; Aspelund, Thor; Jakobsdóttir, Jóhanna; Rúnarsdóttir, Harpa; Guðmundsdóttir, Berglind; Tómasson, Gunnar; Valdimarsdóttir, Unnur Anna; Halldorsdottir, Thorhildur; Thordardottir, Edda Bjork
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Correction: Reducing Intrusive Memories of Childhood Trauma Using a Visuospatial Intervention: Case Study in Iceland (Preprint)
(2021-11-11) Thorarinsdottir, Kristjana; Holmes, Emily A; Hardarson, Johann; Hedinsdottir, Unnur; Kanstrup, Marie; Singh, Laura; Hauksdottir, Arna; Halldorsdottir, Thorhildur; Gudmundsdottir, Berglind; Valdimarsdottir, Unnur; Thordardottir, Edda Bjork; Gamble, Beau; Bjornsson, Andri

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