151 Symptom burden in patients with advanced cancer and a circadian rest-activity rhythm disorder

<h3></h3> Due to the building evidence of circadian rest-activity rhythm disruption in patients with cancer, and the potential implications, an international e-Delphi study recently created recommendations for the standardised assessment and diagnosis of the Circadian rest-Activity Rhythm Disorders (CARDs). A CARD describes abnormalities in a patient’s rest and physical activity levels, either with daytime sedentariness and nighttime restlessness, or day-to-day irregularity in their rest and activity patterns. A diagnosis also requires an associated clinical impact and for there to be no additional underlying causes. As a new clinical entity, the prevalence rates of CARDs, and the important associations with clinical outcomes, were yet to be established. This observational study aimed to assess circadian rest-activity rhythms, to diagnose CARDs, and to assess for significant associations with symptomatology, in a cohort of patients with advanced cancer. 65 participants underwent a comprehensive assessment over a week period. This included gathering biopsychosocial patient characteristics, objective accelerometry data, patient sleep and physical activity diary data, and the completion of several patient-rated questionnaires, including the Memorial Symptom Assessment Scale-Short Form. A CARD was diagnosed in 60% of patients with advanced cancer, with a higher rate of daytime sedentariness and nighttime restlessness, compared with day-to-day rest-activity irregularity. Patients with a CARD diagnosis had significantly more symptoms (p = 0.018), including ‘Lack of energy’ (p = 0.003) and ‘Feeling drowsy’ (p = 0.005), and higher Global distress (p &lt; 0.001), Psychological distress (p = 0.005) and Physical distress scores (p = 0.003). Larger observational studies are required to further characterise CARDs in patients with cancer, particularly considering the presence of potential risk factors, differences between cancer subgroups, and to further establish important associations with clinical outcomes.