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Actigraphy assessment of sleep quality among patients with acute myeloid leukaemia during induction chemotherapy
  1. Chi-Fu Jeffrey Yang1,
  2. Kelli Aibel1,
  3. Ryan Meyerhoff1,
  4. Frances Wang2,
  5. David Harpole1,
  6. Amy P Abernethy1,3 and
  7. Thomas W LeBlanc1
  1. 1 Duke Cancer Institute, Durham, North Carolina, USA
  2. 2 Department of Biostatistics and Bioinformatics, Duke University, Durham, North Carolina, USA
  3. 3 Flatiron Health, Inc, New York City, New York, USA
  1. Correspondence to Dr Thomas W LeBlanc, Duke Cancer Institute, Durham, NC 27710, USA; thomas.leblanc{at}


Objectives Patients receiving induction chemotherapy for acute myeloid leukaemia (AML) anecdotally describe poor sleep, but sleep disturbances have not been well-characterised in this population. We aimed to test the feasibility of measuring sleep quality in AML inpatients using a wearable actigraphy device.

Methods Using the Actigraph GT3X ‘watch’, we assessed the total sleep time, sleep onset latency, wake after sleep onset, number of awakenings after sleep onset and sleep efficiency for inpatients with AML receiving induction chemotherapy. We assessed patient self-reported sleep quality using the Pittsburgh Sleep Quality Index (PSQI).

Results Of the 12 patients enrolled, 11 completed all actigraphy and PSQI assessments, demonstrating feasibility. Patients wore the Actigraph device for a mean (SD) of 15.92 (8.3) days, and actigraphy measures suggested poor sleep. Patients had a median average awakening length of 6.92 min, a median number of awakenings after sleep onset of 4 and a median sleep onset latency of 10.8 min. Actual median sleep efficiency (0.91) was high, suggesting that patients’ poor sleep was not due to insomnia but perhaps due to interruptions, such as administration of medications, lab draws and vital sign measurements.

Conclusions Collection of sleep quality data among inpatients with AML via a wearable actigraphy device is feasible. AML inpatients appear to have poor sleep quality and quantity, suggesting that sleep issues represent an area of unmet supportive care needs in AML. Further research in this areas is needed to inform the development of interventions to improve sleep duration and quality in hospitalised patients with AML.

  • leukemia
  • actigraphy
  • sleep
  • acute myeloid leukemia
  • supportive care
  • Psqi

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  • Contributors All authors contributed substantially to the design and conduct of this study and writing/revision/final approval of the manuscript. Conception and design: all authors. Study conduct and data collection: C-FJY, KA, RM, APA and TWL. Analysis and interpretation: all authors. Manuscript writing and final approval: all authors.

  • Funding This work was funded in part by a Junior Career Development Grant from the National Palliative Care Research Center to TWLB. He currently receives research support from a Sojourns Scholars Award from the Cambia Health Foundation and a Mentored Research Scholar Grant from the American Cancer Society.

  • Competing interests APA is an employee of Flatiron Health, Inc.

  • Patient consent Not required.

  • Ethics approval This study was obtained ethics approval from the Duke University School of Medicine Institutional Review Board. All participants provided signed informed consent before taking part.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The authors are happy to share deidentified study data as requested, provided a signed data use agreement is in place that meets Duke University’s requirements for data sharing.