Meta-analysis of effects of yoga exercise intervention on sleep quality in breast cancer patients

Jingzhi Zhu; Xiaojuan Chen; Xinxian Zhen; Huan Zheng; Hong Chen; Huimin Chen; Huizhao Liao; Jinru Zhu; Chaoyu Wang; Zhenzhen Zheng; Riken Chen; Yang Wang

doi:10.3389/fonc.2023.1146433

Meta-analysis of effects of yoga exercise intervention on sleep quality in breast cancer patients

Front Oncol. 2023 Jun 30:13:1146433. doi: 10.3389/fonc.2023.1146433. eCollection 2023.

Authors

Jingzhi Zhu¹, Xiaojuan Chen², Xinxian Zhen³, Huan Zheng⁴, Hong Chen⁵, Huimin Chen⁶, Huizhao Liao⁷, Jinru Zhu⁸, Chaoyu Wang⁹, Zhenzhen Zheng⁸, Riken Chen⁷, Yang Wang¹⁰

Affiliations

¹ South China Research Center for Acupuncture and Moxibustion, Medical College of Acupuncture Moxibustion and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
² Medical College, Jiaying University, Meizhou, Guangdong, China.
³ Department of Respiratory and Critical Care Medicine, Taishan People's Hospital, Jiangmen, Guangdong, China.
⁴ Department of Endocrinology, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
⁵ Department of Respiratory and Critical Care Medicine, The People's Hospital of Yubei, District of Chongqing City, Chongqing, China.
⁶ Department of Traditional Chinese Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
⁷ Guangzhou Medical University, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong, China.
⁸ Department of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Guangdong Medical University, Zhanjiang, Guangdong, China.
⁹ Department of Respiratory and Critical Care Medicine, Taishan Hospital of Traditional Chinese Medicine, Jiangmen, Guangdong, China.
¹⁰ Department of Respiratory and Critical Care Medicine, The People's Hospital of Chongqing Liang Jiang New Area, Chongqing, China.

Abstract

Objective: This study seeks to systematically evaluate and test the effects of yoga exercise intervention programs on sleep quality in breast cancer patients in order to suggest more optimized exercise programs.

Method: Computer searches of the PubMed, Embase, Cochrane Library, Web of Science and CINAHL databases are conducted from the date of their inception to June 8^th, 2022 to collect randomized controlled trials on the effects of yoga exercise intervention on sleep quality in breast cancer patients. Two investigators independently carry out the inclusion and exclusion criteria literature screening, data extraction and methodological quality assessment of the included literature by applying the Cochrane risk of bias tool. Subgroup analysis is performed using RevMan 5.4.1 software, and the six moderating variables of intervention format, intervention type, weekly intervention frequency, total intervention duration, single intervention duration and intervention evaluation at different time points are set for the 782 subjects of the 12 included publications.

Results: Twelve randomized controlled trials with a total sample size of 782 subjects are included, including 393 subjects in the experimental group and 389 subjects in the control group. The meta-analysis shows that yoga exercise intervention is effective in improving sleep quality in breast cancer patients [SMD = -0.40, 95% CI: (-0.71, -0.09), P = 0.01]; yoga exercise intervention focusing on positive meditation [SMD = -0.55, 95% CI: (-1.08, -0.03), P = 0.04] is effective in improving sleep; yoga exercise intervention two or three times a week is effective in improving sleep quality [SMD = -0.69, 95% CI: (-1.19, -0.19), P = 0.007]; yoga exercise intervention for 6-8 weeks significantly improves sleep quality [SMD = -0.86, 95% CI: (-1.65, -0.08), P =0.03]; and evaluation immediately after the end of intervention improves sleep outcomes [SMD = -0.17, 95% CI: (-0.33, 0.00), P = 0.05], while differences in sleep quality improvement are not statistically significant for the remaining subgroup outcomes (P > 0.05).

Conclusion: The available evidence suggests that yoga exercise intervention has good effects on improving sleep quality in breast cancer patients. Positive meditation intervention type, intervention frequency of two or three times per week, total intervention duration of 6-8 weeks and evaluation immediately after the end of intervention are shown to be effective in improving sleep quality.

Keywords: breast cancer; exercise; meta-analysis; sleep quality; yoga.

Publication types

Systematic Review

Grants and funding

This study was funded by The First batch of key Disciplines On Public Health in Chongqing and Medical Research Project of Chongqing Municipal Health Commission(2022wsjk051).