Observational studyBMJ supportive & palliative care2025
Circadian rest-activity rhythm disorders in advanced cancer: assessment, diagnosis and clinical correlates.
Observational study in BMJ supportive & palliative care, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
4 citing papers in PubMed.
- REstoring Sleep and Energy using a mulTimodal non-pharmacological intervention in advanced Cancer: A feasibility study (RESET-C).Palliative medicine · 2026Article
- Sleep quality and sleepiness in adults with multiple myeloma. Is melatonin a potential treatment?Physiological reports · 2026Observational
- Chrono-immunotherapy's current and future optimization strategies: immunotherapy timing in line with the circadian rhythm brings longer survival benefits.Frontiers in immunology · 2026Review
- Measuring sleep disturbance in advanced cancer using the brief Pittsburgh sleep quality index (bPSQI).Sleep advances : a journal of the Sleep Research Society · 2026Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
INTRODUCTION AND
aimsCircadian rest-activity rhythms describe patterns in rest and physical activity across and between 24-hour periods. Research highlights important associations between circadian disruption, including the rest-activity rhythm, and clinical outcomes in patients with cancer. This study aimed to assess the circadian rest-activity rhythms, and prevalence of circadian rest-activity rhythm disorders (CARDs), in patients with advanced cancer.
methodsAn observational study of 72 outpatients with locally advanced or metastatic cancer took place over a 1-year period, considering objective (accelerometry) and subjective (patient diary) measures of circadian rest-activity rhythms, patient-reported outcomes (Memorial Symptom Assessment Scale-Short Form, European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire, brief Pittsburgh Sleep Quality Index and Epworth Sleepiness Scale) and clinical markers.
resultsCARDs affected up to 60% of patients with advanced cancer. Increased circadian disruption was seen in patients with more advanced disease, particularly with metastatic organ involvement (p=0.038), poorer performance status (p=0.018), higher inflammatory status (p=0.018), anaemia (p=0.007) and iron deficiency (p=0.002). The study also highlights that patients with advanced cancer and a CARD diagnosis have a higher symptom burden, particularly fatigue (p=0.003) and drowsiness (p=0.005), higher symptom-related distress (p<0.001), a poorer Global Health tatus (p=0.005) and poorer functioning subscales (p<0.014).
conclusionThis is the first study to assess circadian rest-activity rhythms in accordance with new assessment and diagnostic guidelines. Further research is now required to validate the diagnostic criteria, standardise technical approaches to assessment and consider risk factors for the development of a CARD and additional clinical outcomes of interest.
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