Yoga improves cancer-related fatigue, insomnia among survivors
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Key takeaways:
- Yoga and cognitive behavioral therapy improved insomnia and cancer-related fatigue over placebo.
- Researchers advise clinicians should prescribe these interventions for survivors.
CHICAGO — Both yoga and cognitive behavioral therapy helped alleviate insomnia among cancer survivors and led to improvement in cancer-related fatigue, results from a randomized phase 3 study showed.
The findings, presented at ASCO Annual Meeting, offer potential therapeutic options for survivors experiencing these frequent adverse events related to cancer treatment.
“A significant portion of intervention, in fact between 37% and 60%, are attributed to the early improvements in insomnia at mid-intervention,” Po-Ju Lin, PhD, MPH, RD, assistant professor in the department of surgery at University of Rochester Medical Center, said during a presentation.
Background and methodology
Cancer-related fatigue (CRF) can often occur simultaneously with insomnia, both of which are frequent toxicities related to cancer treatment. Both can persist for months or years after treatment completion, according to background information presented by Lin.
Yoga for Cancer Survivors (YOCAS) and cognitive behavioral therapy for insomnia have shown promise as behavioral approaches in improving CRF for this population, but research on the influence of changes in insomnia from the implementation of these interventions is lacking.
Lin and colleagues conducted a mediation analysis on data from a multicenter phase 3 trial of 550 cancer survivors (93% women; 75% breast cancer survivors) randomly assigned to either 75-minute sessions of YOCAS twice a week for 4 weeks, 90-minute cognitive behavioral therapy sessions once a week for 8 weeks or a behavioral placebo of ASCO-recommended survivorship education via 75-minute sessions twice a week for 4 weeks.
Researchers used Brief Fatigue Inventory and Insomnia Severity Index to assess both CRF and insomnia before, during and after intervention; causal mediation analyses estimated the influence of change in insomnia at mid-intervention resulting from each of the three interventions after treatment.
Results, next steps
Researchers noted that YOCAS, when compared with placebo, significantly improved both CRF and insomnia at mid-intervention (CRF: 0.38 ± 0.16; insomnia: 1.15 ± 0.35) and after intervention (CRF: 0.35 ± 0.17; insomnia: 1.43 ± 0.41).
Among cancer survivors who received YOCAS, improvement in insomnia at mid-intervention significantly influenced the subsequent reaction in CRF (0.14 ± 0.06) and accounted for a 37% (95% CI, 0-78) of the total reduction in CRF after intervention.
Additionally, cognitive behavioral therapy for insomnia significantly improved CRF and insomnia at mid-intervention (CRF: 0.32 ± 0.18; insomnia: 2.64 ± 0.0) and after intervention (CRF: 0.59 ± 0.18; insomnia: 4.95 ± 0.46) compared with placebo.
Among cancer survivors who received cognitive behavioral therapy for insomnia, the improvement in insomnia at mid-intervention also appeared to influence the subsequent reaction in CRF (0.4 ± 0.09) and accounted for 60% (95% CI, 21-99) of the total reduction in CRF after intervention.
The results suggest that oncologists should seek to implement such activity for cancer survivors within their institutions, Lin said.
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Lin P, et al. Abstract 12015. Presented at: ASCO Annual Meeting; May 30 – June 4, 2024; Chicago.
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