1167 Trajectories of Change in Cancer-related Fatigue and Insomnia over 12 Weeks of Radiation Therapy

Journal article

Elizabeth W Lampe, April Park, Mark Seewald, Gary Freedman, Sara Nowakowski, Michael Perlis, A. Muench
Sleep, 2025

Cite

APA Click to copy
Lampe, E. W., Park, A., Seewald, M., Freedman, G., Nowakowski, S., Perlis, M., & Muench, A. (2025). 1167 Trajectories of Change in Cancer-related Fatigue and Insomnia over 12 Weeks of Radiation Therapy. Sleep.

Chicago/Turabian Click to copy
Lampe, Elizabeth W, April Park, Mark Seewald, Gary Freedman, Sara Nowakowski, Michael Perlis, and A. Muench. “1167 Trajectories of Change in Cancer-Related Fatigue and Insomnia over 12 Weeks of Radiation Therapy.” Sleep (2025).

MLA Click to copy
Lampe, Elizabeth W., et al. “1167 Trajectories of Change in Cancer-Related Fatigue and Insomnia over 12 Weeks of Radiation Therapy.” Sleep, 2025.

BibTeX Click to copy

@article{elizabeth2025a,
  title = {1167 Trajectories of Change in Cancer-related Fatigue and Insomnia over 12 Weeks of Radiation Therapy},
  year = {2025},
  journal = {Sleep},
  author = {Lampe, Elizabeth W and Park, April and Seewald, Mark and Freedman, Gary and Nowakowski, Sara and Perlis, Michael and Muench, A.}
}

Abstract

The impact of radiation therapy (RT) on insomnia and cancer-related fatigue (CRF) among individuals with cancer is not well understood. Our study aimed to 1) examine trajectories of insomnia and CRF across RT and 2) understand whether these trajectories depend on age or sex.

Patients with cancer (all types) undergoing RT were recruited immediately prior to starting treatment (N=128; Mage=58.6±12.4y, 38% female, 80% White, 2% Hispanic or Latino). Subjects were asked to report on insomnia and CRF symptoms at baseline and then every 2 weeks for 3 months. Mixed effects models accounting for linear and quadratic effects of time were used to examine change in CRF and insomnia over 12-weeks. Additional models evaluated baseline age and sex as moderators of these relationships. All models were adjusted for the presence of other interventions (e.g., surgery, medications).

There was no significant linear (p=0.11) or quadratic (p=0.29) effect of time on fatigue, and sex did not moderate this effect. However, age moderated this effect (est=0.003, S.E.=0.001, p=0.03) such that those < 47y reported decreased CRF while those >72y reported increased CRF. There was also no significant linear (p=0.09) or quadratic (p=0.16) effect of time on insomnia, and sex did not moderate this effect. Again, age moderated the effect of time on insomnia (est=0.007, S.E.=0.003, p=0.03) such that those either < 47y or >72y reported reductions in insomnia symptoms with those < 47y reported greater reductions in insomnia symptoms compared to those >72y, while those between 47-72y reported slight increases in insomnia symptoms.

Findings indicate that those who are older (>72y) report increased CRF during and after RT compared to those who are younger (< 47y), where fatigue decreased more in this age cohort. Changes in both groups were modest. Results suggest that insomnia and CRF function independently in this population, as CRF increased while insomnia decreased within the full sample. Future research should explore additional risk- and maintenance-factors for insomnia and CRF during and after RT.

This work was partially supported via a trainee grant provided by Penn’s Department of Radiation Oncology.