Karen M. Mustian, Lisa K. Sprod, Michelle Janelsins, Luke J. Peppone, Kavita Chandwani, Charles Heckler, and Gary R. Morrow, James P. Wilmot Cancer Center, University of Rochester Medical Center, Rochester, NY; Oxana G. Palesh, Stanford University, Stanford, CA; Pavan S. Reddy, Wichita Community Clinical Oncology Program (CCOP), Wichita, KS; and Marianne K. Melnik, Grand Rapids CCOP, Grand Rapids, MI.
J Clin Oncol. 2013 Sep 10;31(26):3233-41. doi: 10.1200/JCO.2012.43.7707. Epub 2013 Aug 12.
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.
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.
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.
Yoga, specifically the YOCAS program, is a useful treatment for improving sleep quality and reducing sleep medication use among cancer survivors.
30%至 90%的癌症幸存者在治疗后报告睡眠质量受损，这足以增加发病率和死亡率。建议将生活方式干预（如运动）与药物和认知行为疗法结合起来，以改善睡眠质量受损的情况。初步证据表明，瑜伽——一种身心练习和运动形式——可能会改善癌症幸存者的睡眠。本随机对照临床试验的主要目的是确定标准化瑜伽干预与标准护理相比，在改善手术后、化疗和/或放疗后 2 至 24 个月期间患有中度或更严重睡眠障碍的癌症幸存者的整体睡眠质量（主要结局）方面的疗效。
共有 410 名幸存者在手术后、化疗和/或放疗后 2 至 24 个月期间出现中度或更严重的睡眠障碍，他们被随机分配到标准护理或标准护理加为期 4 周的瑜伽干预组。瑜伽干预使用了“癌症幸存者瑜伽（YOCAS）”项目，包括呼吸练习、16 个温和哈他瑜伽和恢复性瑜伽姿势以及冥想。参与者每周参加两次 75 分钟的课程。在干预前后使用匹兹堡睡眠质量指数和活动记录仪评估睡眠质量。
共入组 410 名幸存者（96%为女性；平均年龄为 54 岁；75%患有乳腺癌）。与标准护理组相比，瑜伽组在整体睡眠质量方面，以及次要结果的主观睡眠质量、白天功能障碍、睡眠后觉醒、睡眠效率和药物使用方面，在干预后都有更大的改善（所有 P≤0.05）。
瑜伽，特别是 YOCAS 项目，是改善癌症幸存者睡眠质量和减少睡眠药物使用的有效治疗方法。
