Major Finding: Cancer survivors randomized to standard care plus 4 weeks of yoga classes reported better quality of sleep, less fatigue, and better quality of life than did those who received standard care alone.
Data Source: A randomized, multicenter study of 410 cancer survivors who reported sleeping problems between 2 and 24 months after completing adjuvant therapy.
Disclosures: Supported by grants from the National Cancer Institute. The researchers had nothing to disclose.
Yoga, widely practiced for maintaining flexibility and coping with stress, may also benefit cancer survivors who report impaired sleep quality and fatigue, results from a nationwide study demonstrated.
During a press briefing at the meeting, lead author Karen Mustian, Ph.D., of the University of Rochester (N.Y.) Medical Center, discussed results from what she said is the largest randomized, controlled study to date examining a yoga program designed specifically for cancer survivors.
The researchers used the University of Rochester Cancer Center Community Clinical Oncology Program (CCOP) Research Base to conduct a phase II/III randomized, controlled clinical trial at nine CCOP centers in the United States, examining the efficacy of yoga for improving sleep quality, fatigue, and quality of life among 410 cancer survivors who reported problems sleeping between 2 and 24 months after completing adjuvant therapy for their cancer.
To be eligible for the study, patients were required to have a sleep disturbance level of 3 or greater on a scale ranging from 0-10, Dr. Mustian said. Those who had attended a yoga class within the last 3 months were excluded from the study, as were those with sleep apnea and those with distant metastatic disease.
Patients were randomized to standard follow-up care or to standard follow-up care plus enrollment in Yoga for Cancer Survivors, (YOCAS), which encompasses components of hatha yoga and restorative yoga, including postures, breathing exercises, and mindfulness (including meditation exercises and visualization). The 75-minute classes were led by instructors certified in the techniques and met twice each week for 4 weeks.
At baseline and at the end of 4 weeks the researchers used the Pittsburgh Sleep Quality Index (PSQI) to measure sleep, the Multidimensional Fatigue Symptom Inventory to measure fatigue, and the Functional Assessment of Chronic Illness Therapy measurement system to assess quality of life. The mean age of the study participants was 56, most (96%) were female, and 75% were breast cancer patients.
Dr. Mustian reported that at the end of 4 weeks patients in the yoga group improved their overall sleep quality by 22%, while patients in the control group improved their overall sleep quality by 12%, a difference that was statistically significant.
At baseline, 84% of patients in the yoga group and 83% of patients in the control group had clinically impaired sleep quality defined as a PSQI score of 5 or higher.
At the end of the 4-week study, 31% of patients in the yoga group recovered and no longer had clinically impaired sleep quality, while only 16% of patients in the control group recovered.
Dr. Mustian also reported that, compared with their counterparts in the control group, patients in the yoga group had significantly greater reductions in fatigue (42% vs. 12%, respectively), daytime sleepiness (29% vs. 5%), and quality of life (6% vs. 0%).
In addition, use of sleep medication decreased by 21% in the yoga group but increased by 5% in the control group.
“Gentle hatha yoga classes and restorative yoga classes might be useful to cancer survivors in communities across the United States for helping these side effects, which create impairments in quality of life,” Dr. Mustian concluded. She added that it remains unclear whether other forms of yoga, “such as heated yoga or more rigorous types of yoga, would be effective in mitigating these side effects or [be] safe for cancer survivors.”
Dr. George W. Sledge Jr., ACSO's president-elect, called the YOCAS program “a readily applicable approach that improves quality of life and reduced medicine intake in cancer survivors. This is a real positive, [and] emphasizes the increasing importance of ameliorating complications of therapy in long-term cancer survivors. There are millions of patients to whom this might be applicable.”
The Yoga for Cancer Survivors program includes postures and breathing exercises from hatha yoga and restorative yoga.
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