The mindfulness-based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta-analysis

Author: Hyo-Weon Suh1, Ha Yeong Jeong2, Sunggyu Hong3, Jong Woo Kim4, Seong Woo Yoon5, Jee Young Lee6, Sun-Yong Chung7
Affiliation:
1 College of Korean Medicine, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea. Electronic address: hyoweonsuh@gmail.com.
2 Department of Physiology, College of Korean Medicine, Gachon University, Seongnam-daero, Sujeong-gu, Seongnam-si, Gyeonggi-do, 13120, Republic of Korea. Electronic address: jhyg1003@gmail.com.
3 Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea. Electronic address: hongsk25@naver.com.
4 Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea; Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea. Electronic address: aromaqi@khu.ac.kr.
5 Department of Internal Medicine, Korean Medicine Cancer Center, Kyung Hee University Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea. Electronic address: stepano212@daum.net.
6 Department of Internal Medicine, Korean Medicine Cancer Center, Kyung Hee University Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea. Electronic address: happiade@daum.net.
7 Department of Clinical Korean Medicine, Graduate School, Kyung Hee University, Kyung Hee Dae-ro 26, Dongdaemun-gu, Seoul, 02447, Republic of Korea; Department of Neuropsychiatry, Kyung Hee University Korean Medicine Hospital at Gangdong, Dongnam-ro 892, Gangdong-gu, Seoul, 05278, Republic of Korea. Electronic address: lovepwr@khu.ac.kr.
Conference/Journal: Complement Ther Med
Date published: 2021 Jan 15
Other: Special Notes: doi: 10.1016/j.ctim.2021.102667. , Word Count: 255

Introduction:
This study aims to evaluate the efficacy and effectiveness of a mindfulness-based stress reduction (MBSR) program in improving sleep in cancer survivors.

Methods:
Four electronic databases (Cochrane Library, EMBASE, PubMed, and PsycARTICLES) were searched for randomized controlled trials evaluating the effects of MBSR on the sleep of cancer survivors from their inception to May 2020. The primary outcome was sleep quality measured by validated questionnaires such as the Insomnia Severity Index and Pittsburgh Sleep Quality Index. The secondary outcome was sleep parameters obtained from a sleep diary, polysomnography, and actigraphy. The included studies were critically appraised by the Cochrane risk of bias tool and meta-analyzed.

Results:
Ten studies were included, and nine studies were analyzed quantitatively. MBSR significantly improved sleep quality compared to usual care (standardized mean difference -0.29, 95% confidence interval -0.55 to -0.04, I2 = 58%). However, there were no favorable results with sleep parameters. Compared to active controls, MBSR presented mixed results with sleep quality according to the outcomes and negative results with sleep parameters.

Conclusion:
This review suggests that MBSR helps cancer survivors improve sleep quality. Our results support the possibility of using MBSR for cancer survivors. However, its efficacy and effectiveness in improving sleep quality and sleep parameters are inconclusive because the number of included studies was few with inconsistent results. Further studies with high methodological quality are required to establish conclusive evidence about the efficacy and effectiveness of MBSR in improving sleep quality and sleep parameters in cancer survivors.

Keywords: Cancer Survivors; Meditation; Meta-Analysis; Mindfulness; Sleep; Systematic Review.

PMID: 33460741 DOI: 10.1016/j.ctim.2021.102667

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