{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T15:31:02Z","timestamp":1793806262215,"version":"4.6.1"},"reference-count":29,"publisher":"SAGE Publications","issue":"12","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Japan Agency for Medical Research and Development","award":["Grant-in-Aid for Scientific Research from the Prac"],"award-info":[{"award-number":["Grant-in-Aid for Scientific Research from the Prac"]}],"id":[{"id":"https:\/\/ror.org\/004rtk039","id-type":"ROR","asserted-by":"crossref"}]},{"name":"Japan Society for the Promotion of Science","award":["23K27830"],"award-info":[{"award-number":["23K27830"]}],"id":[{"id":"https:\/\/ror.org\/00hhkn466","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Palliative Medicine"],"published-print":{"date-parts":[[2026,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Restlessness is a common and distressing symptom in terminally ill patients with cancer. It is often described as a sudden phenomenon near death; however, its longitudinal progression has not been well characterized.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To examine whether terminal restlessness that worsens suddenly is preceded by changes detectable based on continuous monitoring using a sheet-type nonwearable sensor device.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted secondary analysis of a single-center prospective observational study in a Japanese palliative care unit (2019\u20132022). The severity of restlessness was measured as activity scores using a sheet-type nonwearable sensor device placed under the mattress. Group-based trajectory modeling was applied to night-time activity scores during the last 30 days of life. Richmond Agitation\u2013Sedation Scale (RASS) scores and medication use were compared across trajectory groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 1,209 enrolled patients, 959 were included in the final analysis (median age: 75 years, 55% male). A specific patient cluster showing acute exacerbation of terminal restlessness just before death was identified (model-estimated group proportion, 11.1%). In this group, RASS scores and rates of using antipsychotics and benzodiazepines in the final days were significantly higher compared with those in the other groups. Activity scores did not show a sudden increase immediately prior to death; a gradual upward trend was observed beginning approximately two weeks before death, preceding the terminal rise.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Approximately 10% of patients experienced exacerbation of terminal restlessness just before death. Continuous monitoring with a non-invasive sensor device may enable earlier detection and prevent exacerbation of terminal restlessness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10966218261473336","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T06:02:45Z","timestamp":1785304965000},"page":"1704-1710","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Is Acute Exacerbation of Terminal Restlessness Predictable Using Continuous Monitoring with a Sheet-Type Nonwearable Sensor Device?"],"prefix":"10.1177","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2800-5271","authenticated-orcid":false,"given":"Kayo","family":"Hirooka","sequence":"first","affiliation":[{"name":"School of Health Care Sciences, Faculty of Medicine, Institute of Science Tokyo, Bunkyo, Tokyo."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshinobu","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Internal Medicine, NHO Kinki Chuo Chest Medical Center, Sakai, Osaka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kengo","family":"Imai","sequence":"additional","affiliation":[{"name":"Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saori","family":"Toyota","sequence":"additional","affiliation":[{"name":"Paramount Bed Sleep Research Laboratory, PARAMOUNT BED CO., LTD., Koto, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takamasa","family":"Kogure","sequence":"additional","affiliation":[{"name":"Paramount Bed Sleep Research Laboratory, PARAMOUNT BED CO., LTD., Koto, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunihiko","family":"Takahashi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, M&amp;D Data Science Center, Institute of Integrated Research, Institute of Science Tokyo, Bunkyo, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Yamauchi","sequence":"additional","affiliation":[{"name":"Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9955-1667","authenticated-orcid":false,"given":"Satoru","family":"Miwa","sequence":"additional","affiliation":[{"name":"Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Misuzu","family":"Yuasa","sequence":"additional","affiliation":[{"name":"Palliative Care Division, Suzuka General Hospital, Suzuka, Mie, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soichiro","family":"Okamoto","sequence":"additional","affiliation":[{"name":"Uguisu Home Clinic, Hamamatsu, Shizuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Inoue","sequence":"additional","affiliation":[{"name":"Clinical Laboratory Department, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, Shizuoka, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"e_1_3_3_2_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.6.786"},{"key":"e_1_3_3_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.43.3.183"},{"key":"e_1_3_3_4_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.psy.45.2.107"},{"key":"e_1_3_3_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.24215"},{"key":"e_1_3_3_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.5915"},{"key":"e_1_3_3_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/082585979100700102"},{"key":"e_1_3_3_8_1","doi-asserted-by":"publisher","DOI":"10.1191\/026921600666097479"},{"key":"e_1_3_3_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2007.10.014"},{"key":"e_1_3_3_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-009-0632-4"},{"key":"e_1_3_3_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-011-1217-6"},{"key":"e_1_3_3_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-017-4011-2"},{"key":"e_1_3_3_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520-020-05516-8"},{"key":"e_1_3_3_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216312457214"},{"key":"e_1_3_3_15_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2011.39.8784"},{"key":"e_1_3_3_16_1","doi-asserted-by":"publisher","DOI":"10.1177\/0269216319854944"},{"key":"e_1_3_3_17_1","doi-asserted-by":"publisher","DOI":"10.1177\/082585971102700210"},{"key":"e_1_3_3_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2024.05.024"},{"key":"e_1_3_3_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/jjco\/hyac034"},{"key":"e_1_3_3_20_1","doi-asserted-by":"publisher","DOI":"10.5582\/ddt.2017.01015"},{"key":"e_1_3_3_21_1","doi-asserted-by":"publisher","DOI":"10.2114\/jpa2.30.103"},{"key":"e_1_3_3_22_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6932"},{"key":"e_1_3_3_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0b013e3181484347"},{"key":"e_1_3_3_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2012.05.015"},{"key":"e_1_3_3_25_1","doi-asserted-by":"publisher","DOI":"10.2512\/jspm.11.331"},{"key":"e_1_3_3_26_1","doi-asserted-by":"publisher","DOI":"10.1017\/S1478951504040507"},{"key":"e_1_3_3_27_1","doi-asserted-by":"publisher","DOI":"10.1159\/000360229"},{"key":"e_1_3_3_28_1","unstructured":"27.S\u00e1nchez-Gelabert A. Group based trajectory modelling: Methodological guide. Available from: https:\/\/fe.up.pt\/complext\/images\/demo\/Unit%204%202%20-%20GBTM%20Guide.pdf [Last accessed: July15 2026]."},{"key":"e_1_3_3_29_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.19394"},{"key":"e_1_3_3_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjspcare-2020-002251"}],"container-title":["Journal of Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261473336","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10966218261473336","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10966218261473336","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,4]],"date-time":"2026-11-04T15:18:57Z","timestamp":1793805537000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10966218261473336"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":29,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2026,12,1]]}},"alternative-id":["10.1177\/10966218261473336"],"URL":"https:\/\/doi.org\/10.1177\/10966218261473336","relation":{},"ISSN":["1096-6218","1557-7740"],"issn-type":[{"value":"1096-6218","type":"print"},{"value":"1557-7740","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]}}}