Multicenter, Randomized Controlled Trial of Yoga for Sleep Quality Among Cancer Survivors
- Karen M. Mustian⇑,
- Lisa K. Sprod,
- Michelle Janelsins,
- Luke J. Peppone,
- Oxana G. Palesh,
- Kavita Chandwani,
- Pavan S. Reddy,
- Marianne K. Melnik,
- Charles Heckler and
- Gary R. Morrow
+ Author Affiliations
- Corresponding author: Karen M. Mustian, PhD, MPH, University of Rochester Medical Center, 265 Crittenden Blvd, CU 420658, Rochester, NY 14642; e-mail: karen_mustian@urmc.rochester.edu.
Abstract
Purpose Thirty percent
to 90% of cancer survivors report impaired sleep quality
post-treatment, which can be severe enough to increase
morbidity and mortality. Lifestyle
interventions, such as exercise, are recommended in conjunction with
drugs and cognitive
behavioral therapy for the treatment of impaired
sleep. Preliminary evidence indicates that yoga—a mind-body practice
and
form of exercise—may improve sleep among cancer
survivors. The primary aim of this randomized, controlled clinical trial
was
to determine the efficacy of a standardized yoga
intervention compared with standard care for improving global sleep
quality
(primary outcome) among post-treatment cancer
survivors.
Patients and Methods
In all, 410 survivors suffering from moderate or greater sleep
disruption between 2 and 24 months after surgery, chemotherapy,
and/or radiation therapy were randomly assigned
to standard care or standard care plus the 4-week yoga intervention. The
yoga
intervention used the Yoga for Cancer Survivors
(YOCAS) program consisting of pranayama (breathing exercises), 16 Gentle
Hatha
and Restorative yoga asanas (postures), and
meditation. Participants attended two 75-minute sessions per week. Sleep
quality
was assessed by using the Pittsburgh Sleep
Quality Index and actigraphy pre- and postintervention.
Results In all, 410
survivors were accrued (96% female; mean age, 54 years; 75% had breast
cancer). Yoga participants demonstrated
greater improvements in global sleep quality
and, secondarily, subjective sleep quality, daytime dysfunction, wake
after sleep
onset, sleep efficiency, and medication use at
postintervention (all P ≤ .05) compared with standard care participants.
Conclusion Yoga, specifically the YOCAS program, is a useful treatment for improving sleep quality
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