Relationship between Physical Activity and Fatigue and Sleep in Pediatric Brain Tumor Survivors

Abstract

Research Question: The primary aim of the proposed study is in a cohort of 8-17-year-old brain tumor survivors studied at six months through five years after the completion of their therapy, will physical activity be associated with fatigue, excessive daytime sleepiness, and sleep disruptions.

Background, Significance, and Rational: With improvement in survival rates in children diagnosed with brain tumors, there is an increasing population with potentially long-term health effects due to the tumor and associated treatment. Some of the more common problems experienced by this population include fatigue, daytime sleepiness, psychomotor development, and challenges to be physically active. Levels of physical activity among pediatric brain tumor survivors may be associated with fatigue, excessive daytime sleepiness and other sleep disorders. Analyzing the relationship between these parameters in pediatric brain tumor survivors will contribute to a gap in the literature on the relationship between physical activity and common symptoms survivors will experience.

Materials and Methods: The study is a component of an ongoing larger study conducted by our research team, which is exploring perceived stress, sleep, fatigue, and biomarkers in pediatric brain tumor survivors. A descriptive, cross-sectional, correlation design was used to address the relationships between the variables. In this study, survivors completed the Godin Leisure Time Exercise Questionnaire to evaluate their levels of physical activity. Additionally, data from selected variables from the larger study (e.g., sleep study parameters and reports of perceived fatigue and sleepiness) were available to augment data analysis in this study.

Results: The sample included eight brain tumor survivors, where five were male (62.5%), and all participants were 11 years of age or older, representing an adolescent population. Six different tumor types were represented in the sample, with low grade glioma (37.5%) being the most common. All participants reported physical activity levels considered appropriately active and relatively lower levels of fatigue. While excessive daytime sleepiness was not reported in this sample, most participants had a sleep diagnosis (87.5%), which included primary snoring (62.5%), obstructive sleep apnea (12.5%), and periodic limb movements (12.5%). The Multiple Sleep Latency Test results categorized most participants with daytime sleepiness (71.4%). There were no significant relationships between physical activity and fatigue or sleep measures. Conclusions and Impact: This study provides information on the relationship between physical activity levels and fatigue and sleep in a young brain tumor survivor population. This information can aid healthcare providers, caregivers, and the patients in understanding the significance of incorporating physical activity into the long-term treatment and symptom management plan. Improved informed care specific to the unique symptoms these survivors experience, will enhance their health-related quality of life.