Sleep moderates the effects of Tibetan yoga for women with breast cancer undergoing chemotherapy

Author: Kelsey L Sinclair1, Emalee Kiser1, Chelsea G Ratcliff2,3, Alejandro Chaoul4, Martica H Hall5, Tenzin Wangyal Rinpoche6, Lorenzo Cohen7
Affiliation:
1 Department of Psychology and Philosophy, Sam Houston State University, TX, Huntsville, USA.
2 Department of Psychology and Philosophy, Sam Houston State University, TX, Huntsville, USA. chelsea.ratcliff@shsu.edu.
3 Baylor College of Medicine, Houston, 1 Baylor Plaza, Houston, TX, USA. chelsea.ratcliff@shsu.edu.
4 The Jung Center's Mind Body Spirit Institute, Houston, TX, USA.
5 The University of Pittsburgh, Pittsburgh, PA, USA.
6 Ligmincha International, Shipman, VA, USA.
7 The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Conference/Journal: Support Care Cancer
Date published: 2022 Feb 2
Other: Special Notes: doi: 10.1007/s00520-022-06861-6. , Word Count: 246


This study examined self-reported and actigraphy-assessed sleep and depression as moderators of the effect of a Tibetan yoga intervention on sleep and depression among women undergoing chemotherapy for breast cancer. This is a secondary analysis of an RCT examining a 4-session Tibetan yoga program (TYP; n = 74) versus stretching program (STP; n = 68) or usual care (UC; n = 85) on self-reported sleep (Pittsburgh Sleep Quality Index (PSQI), actigraphy-assessed sleep efficiency (SE)) and depression (Centers for Epidemiological Studies Depression Scale; CES-D) for women undergoing chemotherapy for breast cancer. Data were collected at baseline and 1-week and 3-month post-intervention. Baseline PSQI, actigraphy-SE, and CES-D were examined as moderators of the effect of group on PSQI, actigraphy-SE, and CES-D 1 week and 3 months after treatment. There was a significant baseline actigraphy-SE × group effect on PSQI at 1 week (p < .001) and 3 months (p = .002) and on CES-D at 3 months (p = .049). Specifically, the negative association of baseline actigraphy-SE with subsequent PSQI and CES-D was buffered for women in the TYP and, to a lesser extent in STP, compared to those in the UC. Baseline PSQI and CES-D were not significant moderators of the effect of group on any outcome. Behaviorally assessed sleep may be a more robust indicator of which patients are most appropriate for a yoga intervention than self-reported sleep quality. Women with poor sleep efficiency may derive the greatest benefit in terms of sleep quality and mood from a yoga intervention.

Keywords: Breast cancer; Depression; Sleep quality; Yoga.

PMID: 35107599 DOI: 10.1007/s00520-022-06861-6

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