1 1980 115 SLEEP MODERATES THE EFFECTS OF TIBETAN YOGA FOR WOMEN WITH BREAST CANCER UNDERGOING CHEMOTHERAPY. 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 X 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. 2022 2 172 38 A RANDOMIZED CONTROLLED PILOT STUDY OF YOGA SKILLS TRAINING VERSUS AN ATTENTION CONTROL DELIVERED DURING CHEMOTHERAPY ADMINISTRATION. CONTEXT: IT IS IMPORTANT TO ADDRESS FATIGUE AND CO-OCCURRING SYMPTOMS DURING CHEMOTHERAPY TO PRESERVE QUALITY OF LIFE IN PATIENTS WITH GASTROINTESTINAL (GI) CANCER. OBJECTIVE: TO CONDUCT A RANDOMIZED CONTROLLED PILOT STUDY OF A YOGA SKILLS TRAINING (YST) INTERVENTION COMPARED TO AN ATTENTION CONTROL (AC) AMONG ADULTS DIAGNOSED WITH GI CANCER. METHODS: YST CONSISTED OF FOUR 30-MINUTE SESSIONS DELIVERED INDIVIDUALLY DURING CHEMOTHERAPY PLUS HOME PRACTICE. AC PROVIDED EMPATHIC ATTENTION PLUS HOME DIARIES. PATIENT-REPORTED (PROMIS T-SCORE) ASSESSMENTS OF FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND PSYCHOLOGICAL STRESS (PERCEIVED STRESS SCALE) WERE COLLECTED AT CHEMOTHERAPY VISITS: BASELINE, WEEK 8, WEEK 10 AND WEEK 14, AND ANALYZED USING A MIXED EFFECTS MODEL. INFLAMMATORY CYTOKINES WERE ASSESSED AT BASELINE AND WEEK 10. RESULTS: FORTY-FOUR OF 77 ADULTS APPROACHED AGREED TO PARTICIPATE (57%; YST N = 23; AC N = 21). PARTICIPANTS' MEAN AGE WAS 58 YEARS AND 48% WERE MEN. PARTICIPANTS RANDOMIZED TO YST REPORTED A LARGER DECLINE IN FATIGUE (-2.4 DIFFERENCE, D = 0.30) AND DEPRESSIVE SYMPTOMS (-2.5 DIFFERENCE, D = 0.30) THAN AC PARTICIPANTS FROM BASELINE TO WEEK 10 AND SLEEP DISTURBANCES AT WEEK 8 (-3.9 DIFFERENCE, D = 0.50). DIFFERENCES IN MAGNITUDE OF CHANGE IN SYMPTOMS WERE CONSISTENT WITH OR EXCEEDED A MINIMALLY IMPORTANT DIFFERENCE. PSYCHOLOGICAL STRESS DECREASED MORE IN THE AC AT WEEK 10 (D = 0.30). REDUCTIONS IN INFLAMMATORY CYTOKINES (IL-6, STNF R1) WERE LARGER IN THE YST GROUP THAN AC. CONCLUSION: YST SHOWED PROMISE FOR IMPROVING FATIGUE, DEPRESSIVE SYMPTOMS, SLEEP DISTURBANCES, AND INFLAMMATION. YST IS ALSO FEASIBLE AND REACHES PATIENTS UNDERREPRESENTED IN YOGA RESEARCH (I.E., GI CANCER, MEN), THUS WARRANTING FURTHER EXAMINATION. 2022 3 117 37 A PILOT STUDY OF GENTLE YOGA FOR SLEEP DISTURBANCE IN WOMEN WITH OSTEOARTHRITIS. OBJECTIVES: THE PURPOSE OF THIS STUDY WAS TO TEST THE FEASIBILITY AND ACCEPTABILITY OF A GENTLE YOGA INTERVENTION FOR SLEEP DISTURBANCE IN OLDER WOMEN WITH OSTEOARTHRITIS (OA) AND TO COLLECT INITIAL EFFICACY DATA ON THE INTERVENTION. METHODS: ALL PARTICIPANTS COMPLETED AN 8-WEEK YOGA PROGRAM THAT INCLUDED 75-MIN WEEKLY CLASSES AND 20 MIN OF NIGHTLY HOME PRACTICE. PARTICIPANTS WERE WOMEN WITH OA AND SYMPTOMS CONSISTENT WITH INSOMNIA. SYMPTOM QUESTIONNAIRES AND 1 WEEK OF WRIST ACTIGRAPHY AND SLEEP DIARIES WERE COMPLETED FOR 1 WEEK PRE- AND POST-INTERVENTION. RESULTS: FOURTEEN WOMEN WERE ENROLLED OF WHOM 13 COMPLETED THE STUDY (MEAN AGE 65.2 +/- 6.9 YEARS). PARTICIPANTS ATTENDED A MEAN OF 7.2 +/- 1.0 CLASSES AND PRACTICED AT HOME 5.83 +/- 1.66 NIGHTS/WEEK. THE INSOMNIA SEVERITY INDEX AND DIARY-REPORTED SLEEP ONSET LATENCY, SLEEP EFFICIENCY, AND NUMBER OF NIGHTS WITH INSOMNIA WERE SIGNIFICANTLY IMPROVED AT POST-INTERVENTION VERSUS PRE-INTERVENTION (P < .05). OTHER SLEEP OUTCOMES (PITTSBURGH SLEEP QUALITY INDEX, EPWORTH SLEEPINESS SCALE, DIARY-REPORTED TOTAL SLEEP TIME AND WAKE AFTER SLEEP ONSET) SHOWED IMPROVEMENT ON MEAN SCORES AT POST-INTERVENTION, BUT THESE WERE NOT STATISTICALLY SIGNIFICANT. ACTIGRAPHIC SLEEP OUTCOMES WERE NOT SIGNIFICANTLY CHANGED. CONCLUSIONS: THIS STUDY SUPPORTS THE FEASIBILITY AND ACCEPTABILITY OF A STANDARDIZED EVENING YOGA PRACTICE FOR MIDDLE-AGED TO OLDER WOMEN WITH OA. PRELIMINARY EFFICACY FINDINGS SUPPORT FURTHER RESEARCH ON THIS PROGRAM AS A POTENTIAL TREATMENT OPTION FOR OA-RELATED INSOMNIA. 2011 4 1650 47 MULTICENTER, RANDOMIZED CONTROLLED TRIAL OF YOGA FOR SLEEP QUALITY AMONG CANCER SURVIVORS. PURPOSE: 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. PATIENTS AND METHODS: 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. RESULTS: 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 /= 80% OF YOGA PARTICIPANTS REPORTING AVERAGE SLEEP ONSET LATENCY < 30 MINUTES AND SLEEP EFFICIENCY > 80% AT 6-MONTH FOLLOW-UP. FOR OVER 50% OF YOGA PARTICIPANTS, THE INSOMNIA SEVERITY INDEX DECREASED BY AT LEAST 8 POINTS AT END OF TREATMENT AND FOLLOW-UP. CONCLUSIONS: YOGA, TAUGHT IN A SELF-CARE FRAMEWORK WITH MINIMAL INSTRUCTOR BURDEN, WAS ASSOCIATED WITH SELF-REPORTED IMPROVEMENTS ABOVE AND BEYOND AN ACTIVE SLEEP HYGIENE COMPARISON, SUSTAINED AT 6-MONTH FOLLOW-UP. FOLLOW-UP STUDIES ARE NEEDED TO ASSESS ACTIGRAPHY AND POLYSOMNOGRAPHY OUTCOMES, AS WELL AS POSSIBLE MECHANISMS OF CHANGE. CLINICAL TRIAL REGISTRATION: REGISTRY: CLINICALTRIALS.GOV; NAME: YOGA AS A TREATMENT FOR INSOMNIA; URL: HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT00033865; IDENTIFIER: NCT00033865. CITATION: KHALSA SBS, GOLDSTEIN MR. TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. J CLIN SLEEP MED. 2021;17(9):1841-1852. 2021 10 2654 39 YOGA IMPROVES QUALITY OF LIFE AND BENEFIT FINDING IN WOMEN UNDERGOING RADIOTHERAPY FOR BREAST CANCER. THIS STUDY EXAMINED THE EFFECTS OF YOGA ON QUALITY OF LIFE (QOL) AND PSYCHOSOCIAL OUTCOMES IN WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. SIXTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR A WAIT-LIST GROUP. YOGA CLASSES WERE TAUGHT BIWEEKLY DURING THE 6 WEEKS OF RADIOTHERAPY. PARTICIPANTS COMPLETED MEASURES OF QOL, FATIGUE, BENEFIT FINDING (FINDING MEANING IN THE CANCER EXPERIENCE), INTRUSIVE THOUGHTS, SLEEP DISTURBANCES, DEPRESSIVE SYMPTOMS, AND ANXIETY BEFORE RADIOTHERAPY AND THEN AGAIN 1 WEEK, 1 MONTH, AND 3 MONTHS AFTER THE END OF RADIOTHERAPY. GENERAL LINEAR MODEL ANALYSES REVEALED THAT COMPARED TO THE CONTROL GROUP, THE YOGA GROUP REPORTED SIGNIFICANTLY BETTER GENERAL HEALTH PERCEPTION (P = .005) AND PHYSICAL FUNCTIONING SCORES (P = .04) 1 WEEK POSTRADIOTHERAPY; HIGHER LEVELS OF INTRUSIVE THOUGHTS 1 MONTH POSTRADIOTHERAPY (P = .01); AND GREATER BENEFIT FINDING 3 MONTHS POSTRADIOTHERAPY (P = .01). THERE WERE NO OTHER GROUP DIFFERENCES IN OTHER QOL SUBSCALES FOR FATIGUE, DEPRESSION, OR SLEEP SCORES. EXPLORATORY ANALYSES INDICATED THAT INTRUSIVE THOUGHTS 1 MONTH AFTER RADIOTHERAPY WERE SIGNIFICANTLY POSITIVELY CORRELATED WITH BENEFIT FINDING 3 MONTHS AFTER RADIOTHERAPY (R = .36, P = .011). OUR RESULTS INDICATED THAT THE YOGA PROGRAM WAS ASSOCIATED WITH STATISTICALLY AND CLINICALLY SIGNIFICANT IMPROVEMENTS IN ASPECTS OF QOL. 2010 11 1460 40 INFLUENCE OF YOGA ON CANCER-RELATED FATIGUE AND ON MEDIATIONAL RELATIONSHIPS BETWEEN CHANGES IN SLEEP AND CANCER-RELATED FATIGUE: A NATIONWIDE, MULTICENTER RANDOMIZED CONTROLLED TRIAL OF YOGA IN CANCER SURVIVORS. BACKGROUND: CANCER-RELATED FATIGUE (CRF) OFTEN CO-OCCURS WITH SLEEP DISTURBANCE AND IS ONE OF THE MOST PERVASIVE TOXICITIES RESULTING FROM CANCER AND ITS TREATMENT. WE AND OTHER INVESTIGATORS HAVE PREVIOUSLY REPORTED THAT YOGA THERAPY CAN IMPROVE SLEEP QUALITY IN CANCER PATIENTS AND SURVIVORS. NO NATIONWIDE MULTICENTER PHASE III RANDOMIZED CONTROLLED TRIAL (RCT) HAS INVESTIGATED WHETHER YOGA THERAPY IMPROVES CRF OR WHETHER IMPROVEMENTS IN SLEEP MEDIATE THE EFFECT OF YOGA ON CRF. WE EXAMINED THE EFFECT OF A STANDARDIZED, 4-WEEK, YOGA THERAPY PROGRAM (YOGA FOR CANCER SURVIVORS [YOCAS]) ON CRF AND WHETHER YOCAS-INDUCED CHANGES IN SLEEP MEDIATED CHANGES IN CRF AMONG SURVIVORS. STUDY DESIGN AND METHODS: FOUR HUNDRED TEN CANCER SURVIVORS WERE RECRUITED TO A NATIONWIDE MULTICENTER PHASE III RCT COMPARING THE EFFECT OF YOCAS TO STANDARD SURVIVORSHIP CARE ON CRF AND EXAMINING THE MEDIATING EFFECTS OF CHANGES IN SLEEP, STEMMING FROM YOGA, ON CHANGES IN CRF. CRF WAS ASSESSED BY THE MULTIDIMENSIONAL FATIGUE SYMPTOM INVENTORY. SLEEP WAS ASSESSED VIA THE PITTSBURGH SLEEP QUALITY INDEX. BETWEEN- AND WITHIN-GROUP INTERVENTION EFFECTS ON CRF WERE ASSESSED BY ANALYSIS OF COVARIANCE AND 2-TAILED T TEST, RESPECTIVELY. PATH ANALYSIS WAS USED TO EVALUATE MEDIATION. RESULTS: YOCAS PARTICIPANTS DEMONSTRATED SIGNIFICANTLY GREATER IMPROVEMENTS IN CRF COMPARED WITH PARTICIPANTS IN STANDARD SURVIVORSHIP CARE AT POST-INTERVENTION ( P < .01). IMPROVEMENTS IN OVERALL SLEEP QUALITY AND REDUCTIONS IN DAYTIME DYSFUNCTION (EG, EXCESSIVE NAPPING) RESULTING FROM YOGA SIGNIFICANTLY MEDIATED THE EFFECT OF YOGA ON CRF (22% AND 37%, RESPECTIVELY, BOTH P < .01). CONCLUSIONS: YOCAS IS EFFECTIVE FOR TREATING CRF AMONG CANCER SURVIVORS; 22% TO 37% OF THE IMPROVEMENTS IN CRF FROM YOGA THERAPY RESULT FROM IMPROVEMENTS IN SLEEP QUALITY AND DAYTIME DYSFUNCTION. ONCOLOGISTS SHOULD CONSIDER PRESCRIBING YOGA TO CANCER SURVIVORS FOR TREATING CRF AND SLEEP DISTURBANCE. 2019 12 294 26 AFFECT AND MINDFULNESS AS PREDICTORS OF CHANGE IN MOOD DISTURBANCE, STRESS SYMPTOMS, AND QUALITY OF LIFE IN A COMMUNITY-BASED YOGA PROGRAM FOR CANCER SURVIVORS. LITTLE ATTENTION HAS BEEN PAID TO THE PSYCHOLOGICAL DETERMINANTS BY WHICH BENEFITS ARE ACCRUED VIA YOGA PRACTICE IN CANCER-RELATED CLINICAL SETTINGS. USING A LONGITUDINAL MULTILEVEL MODELING APPROACH, ASSOCIATIONS BETWEEN AFFECT, MINDFULNESS, AND PATIENT-REPORTED MENTAL HEALTH OUTCOMES, INCLUDING MOOD DISTURBANCE, STRESS SYMPTOMS, AND HEALTH-RELATED QUALITY OF LIFE (HRQL), WERE EXAMINED IN AN EXISTING SEVEN-WEEK YOGA PROGRAM FOR CANCER SURVIVORS. PARTICIPANTS (N = 66) WERE ASSESSED BEFORE AND AFTER THE YOGA PROGRAM AND AT THREE- AND SIX-MONTH FOLLOW-UPS. DECREASES IN MOOD DISTURBANCE AND STRESS SYMPTOMS AND IMPROVEMENTS IN HRQL WERE OBSERVED UPON PROGRAM COMPLETION. IMPROVEMENTS IN MOOD DISTURBANCE AND STRESS SYMPTOMS WERE MAINTAINED AT THE THREE- AND SIX-MONTH FOLLOW-UPS. HRQL EXHIBITED FURTHER IMPROVEMENT AT THE THREE-MONTH FOLLOW-UP, WHICH WAS MAINTAINED AT THE SIX-MONTH FOLLOW-UP. IMPROVEMENTS IN MEASURES OF WELL-BEING WERE PREDICTED BY INITIAL POSITIVE YOGA BELIEFS AND CONCURRENTLY ASSESSED AFFECTIVE AND MINDFULNESS PREDICTOR VARIABLES. PREVIOUS YOGA EXPERIENCE, AFFECT, MINDFULNESS, AND HRQL WERE RELATED TO YOGA PRACTICE MAINTENANCE OVER THE COURSE OF THE STUDY. 2013 13 2729 37 YOGA OF AWARENESS PROGRAM FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS: RESULTS FROM A RANDOMIZED TRIAL. GOAL OF WORK: BREAST CANCER SURVIVORS HAVE LIMITED OPTIONS FOR THE TREATMENT OF HOT FLASHES AND RELATED SYMPTOMS. FURTHER, THERAPIES WIDELY USED TO PREVENT RECURRENCE IN SURVIVORS, SUCH AS TAMOXIFEN, TEND TO INDUCE OR EXACERBATE MENOPAUSAL SYMPTOMS. THE AIM OF THIS PRELIMINARY, RANDOMIZED CONTROLLED TRIAL WAS TO EVALUATE THE EFFECTS OF A YOGA INTERVENTION ON MENOPAUSAL SYMPTOMS IN A SAMPLE OF SURVIVORS OF EARLY-STAGE BREAST CANCER (STAGES IA-IIB). MATERIALS AND METHODS: THIRTY-SEVEN DISEASE-FREE WOMEN EXPERIENCING HOT FLASHES WERE RANDOMIZED TO THE 8-WEEK YOGA OF AWARENESS PROGRAM (GENTLE YOGA POSES, MEDITATION, AND BREATHING EXERCISES) OR TO WAIT-LIST CONTROL. THE PRIMARY OUTCOME WAS DAILY REPORTS OF HOT FLASHES COLLECTED AT BASELINE, POSTTREATMENT, AND 3 MONTHS AFTER TREATMENT VIA AN INTERACTIVE TELEPHONE SYSTEM. DATA WERE ANALYZED BY INTENTION TO TREAT. MAIN RESULTS: AT POSTTREATMENT, WOMEN WHO RECEIVED THE YOGA PROGRAM SHOWED SIGNIFICANTLY GREATER IMPROVEMENTS RELATIVE TO THE CONTROL CONDITION IN HOT-FLASH FREQUENCY, SEVERITY, AND TOTAL SCORES AND IN LEVELS OF JOINT PAIN, FATIGUE, SLEEP DISTURBANCE, SYMPTOM-RELATED BOTHER, AND VIGOR. AT 3 MONTHS FOLLOW-UP, PATIENTS MAINTAINED THEIR TREATMENT GAINS IN HOT FLASHES, JOINT PAIN, FATIGUE, SYMPTOM-RELATED BOTHER, AND VIGOR AND SHOWED ADDITIONAL SIGNIFICANT GAINS IN NEGATIVE MOOD, RELAXATION, AND ACCEPTANCE. CONCLUSIONS: THIS PILOT STUDY PROVIDES PROMISING SUPPORT FOR THE BENEFICIAL EFFECTS OF A COMPREHENSIVE YOGA PROGRAM FOR HOT FLASHES AND OTHER MENOPAUSAL SYMPTOMS IN EARLY-STAGE BREAST CANCER SURVIVORS. 2009 14 1866 55 RANDOMIZED TRIAL OF TIBETAN YOGA IN PATIENTS WITH BREAST CANCER UNDERGOING CHEMOTHERAPY. BACKGROUND: THE CURRENT RANDOMIZED TRIAL EXAMINED THE EFFECTS OF A TIBETAN YOGA PROGRAM (TYP) VERSUS A STRETCHING PROGRAM (STP) AND USUAL CARE (UC) ON SLEEP AND FATIGUE IN WOMEN WITH BREAST CANCER WHO WERE UNDERGOING CHEMOTHERAPY. METHODS: WOMEN WITH STAGE (AMERICAN JOINT COMMITTEE ON CANCER (AJCC) TNM) I TO III BREAST CANCER WHO WERE UNDERGOING CHEMOTHERAPY WERE RANDOMIZED TO TYP (74 WOMEN), STP (68 WOMEN), OR UC (85 WOMEN). PARTICIPANTS IN THE TYP AND STP GROUPS PARTICIPATED IN 4 SESSIONS DURING CHEMOTHERAPY, FOLLOWED BY 3 BOOSTER SESSIONS OVER THE SUBSEQUENT 6 MONTHS, AND WERE ENCOURAGED TO PRACTICE AT HOME. SELF-REPORT MEASURES OF SLEEP DISTURBANCES (PITTSBURGH SLEEP QUALITY INDEX), FATIGUE (BRIEF FATIGUE INVENTORY), AND ACTIGRAPHY WERE COLLECTED AT BASELINE; 1 WEEK AFTER TREATMENT; AND AT 3, 6, AND 12 MONTHS. RESULTS: THERE WERE NO GROUP DIFFERENCES NOTED IN TOTAL SLEEP DISTURBANCES OR FATIGUE LEVELS OVER TIME. HOWEVER, PATIENTS IN THE TYP GROUP REPORTED FEWER DAILY DISTURBANCES 1 WEEK AFTER TREATMENT COMPARED WITH THOSE IN THE STP (DIFFERENCE, -0.43; 95% CONFIDENCE INTERVAL [95% CI], -0.82 TO -0.04 [P = .03]) AND UC (DIFFERENCE, -0.41; 95% CI, -0.77 TO -0.05 [P = .02]) GROUPS. GROUP DIFFERENCES AT THE OTHER TIME POINTS WERE MAINTAINED FOR TYP VERSUS STP. ACTIGRAPHY DATA REVEALED GREATER MINUTES AWAKE AFTER SLEEP ONSET FOR PATIENTS IN THE STP GROUP 1 WEEK AFTER TREATMENT VERSUS THOSE IN THE TYP (DIFFERENCE, 15.36; 95% CI, 7.25-23.48 [P = .0003]) AND UC (DIFFERENCE, 14.48; 95% CI, 7.09-21.87 [P = .0002]) GROUPS. PATIENTS IN THE TYP GROUP WHO PRACTICED AT LEAST 2 TIMES A WEEK DURING FOLLOW-UP REPORTED BETTER PITTSBURGH SLEEP QUALITY INDEX AND ACTIGRAPHY OUTCOMES AT 3 MONTHS AND 6 MONTHS AFTER TREATMENT COMPARED WITH THOSE WHO DID NOT AND BETTER OUTCOMES COMPARED WITH THOSE IN THE UC GROUP. CONCLUSIONS: PARTICIPATING IN TYP DURING CHEMOTHERAPY RESULTED IN MODEST SHORT-TERM BENEFITS IN SLEEP QUALITY, WITH LONG-TERM BENEFITS EMERGING OVER TIME FOR THOSE WHO PRACTICED TYP AT LEAST 2 TIMES A WEEK. CANCER 2018;124:36-45. (C) 2017 AMERICAN CANCER SOCIETY. 2018 15 1375 38 IMPACT OF DAILY YOGA-BASED EXERCISE ON PAIN, CATASTROPHIZING, AND SLEEP AMONGST INDIVIDUALS WITH FIBROMYALGIA. BACKGROUND: FIBROMYALGIA (FM) IS A CHRONIC WIDESPREAD PAIN DISORDER CHARACTERIZED BY NEGATIVE AFFECT, SLEEP DISTURBANCE, AND FATIGUE. THIS UNCONTROLLED PILOT STUDY INVESTIGATED THE EFFICACY OF DAILY YOGA-BASED EXERCISE TO IMPROVE FM SYMPTOMS AND EXPLORED BASELINE PHENOTYPIC CHARACTERISTICS ASSOCIATED WITH THE GREATEST BENEFIT. METHODS: FM PATIENTS (N=46, WITH 36 COMPLETERS) REPORTED PSYCHOSOCIAL FUNCTIONING AND A RANGE OF FM SYMPTOMS USING VALIDATED INSTRUMENTS BEFORE AND AFTER PARTICIPATION IN SATYANANDA YOGA, WHICH INCLUDED WEEKLY IN-PERSON PAIN-TAILORED GROUP CLASSES FOR 6 WEEKS AND DAILY HOME YOGA VIDEO PRACTICE. RESULTS: CHANGES IN FM SYMPTOMS FROM PRE- TO POST-YOGA WERE VARIABLE AMONGST PARTICIPANTS. GROUP MEANS FOR PAIN DECREASED, AS REPORTED BY AVERAGE DAILY DIARY AND BRIEF PAIN INVENTORY, WITH GREATER HOME PRACTICE MINUTES ASSOCIATED WITH A GREATER DECREASE IN PAIN. AVERAGE DAILY RATINGS OF SLEEP AND FATIGUE IMPROVED. PAIN CATASTROPHIZING WAS DECREASED OVERALL, WITH GREATER CHANGE CORRELATED TO A DECREASE IN FM SYMPTOMS. WE DID NOT OBSERVE ANY GROUP MEAN CHANGES IN ACTIGRAPHY SLEEP EFFICIENCY, PATIENT-REPORTED OUTCOMES MEASUREMENT INFORMATION SYSTEM-ANXIETY AND THE REVISED FIBROMYALGIA IMPACT QUESTIONNAIRE. MULTILEVEL MODELING ANALYSIS REVEALED A SIGNIFICANT INTERACTION BETWEEN ANXIETY AND CATASTROPHIZING FOR END-STUDY SLEEP EFFICIENCY, FATIGUE, AND PAIN, SUCH THAT PATIENTS WITH HIGHER BASELINE CATASTROPHIZING AND LOWER BASELINE ANXIETY REPORTED LESS PAIN AND FATIGUE, AND HIGHER SLEEP EFFICIENCY AFTER THE SIXTH WEEK OF YOGA PRACTICE. CONCLUSION: THIS PILOT STUDY SUGGESTS THAT YOGA MAY REDUCE PAIN AND CATASTROPHIZING, AS WELL AS IMPROVE SLEEP, BUT THESE CHANGES WERE MODEST ACROSS STUDY PARTICIPANTS. GREATER UPTAKE OF HOME YOGA PRACTICE AS WELL AS A PHENOTYPE OF HIGHER BASELINE CATASTROPHIZING COMBINED WITH LOWER BASELINE ANXIETY WERE ASSOCIATED WITH GREATER IMPACT. FUTURE RANDOMIZED, CONTROLLED TRIALS COMPARING DIFFERENT TYPES OF YOGA OR EXERCISE WILL ALLOW DETERMINATION OF THE MOST EFFECTIVE TREATMENTS FOR FM AND ALLOW CLOSER TARGETING TO THE PATIENTS WHO WILL BENEFIT MOST FROM THEM. 2019 16 2604 38 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE AFFLICTS UP TO 33% OF BREAST CANCER SURVIVORS, YET THERE ARE NO EMPIRICALLY VALIDATED TREATMENTS FOR THIS SYMPTOM. METHODS: THE AUTHORS CONDUCTED A 2-GROUP RANDOMIZED CONTROLLED TRIAL TO DETERMINE THE FEASIBILITY AND EFFICACY OF AN IYENGAR YOGA INTERVENTION FOR BREAST CANCER SURVIVORS WITH PERSISTENT POST-TREATMENT FATIGUE. PARTICIPANTS WERE BREAST CANCER SURVIVORS WHO HAD COMPLETED CANCER TREATMENTS (OTHER THAN ENDOCRINE THERAPY) AT LEAST 6 MONTHS BEFORE ENROLLMENT, REPORTED SIGNIFICANT CANCER-RELATED FATIGUE, AND HAD NO OTHER MEDICAL CONDITIONS THAT WOULD ACCOUNT FOR FATIGUE SYMPTOMS OR INTERFERE WITH YOGA PRACTICE. BLOCK RANDOMIZATION WAS USED TO ASSIGN PARTICIPANTS TO A 12-WEEK, IYENGAR-BASED YOGA INTERVENTION OR TO 12 WEEKS OF HEALTH EDUCATION (CONTROL). THE PRIMARY OUTCOME WAS CHANGE IN FATIGUE MEASURED AT BASELINE, IMMEDIATELY POST-TREATMENT, AND 3 MONTHS AFTER TREATMENT COMPLETION. ADDITIONAL OUTCOMES INCLUDED CHANGES IN VIGOR, DEPRESSIVE SYMPTOMS, SLEEP, PERCEIVED STRESS, AND PHYSICAL PERFORMANCE. INTENT-TO-TREAT ANALYSES WERE CONDUCTED WITH ALL RANDOMIZED PARTICIPANTS USING LINEAR MIXED MODELS. RESULTS: THIRTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO YOGA (N = 16) OR HEALTH EDUCATION (N = 15). FATIGUE SEVERITY DECLINED SIGNIFICANTLY FROM BASELINE TO POST-TREATMENT AND OVER A 3-MONTH FOLLOW-UP IN THE YOGA GROUP RELATIVE TO CONTROLS (P = .032). IN ADDITION, THE YOGA GROUP HAD SIGNIFICANT INCREASES IN VIGOR RELATIVE TO CONTROLS (P = .011). BOTH GROUPS HAD POSITIVE CHANGES IN DEPRESSIVE SYMPTOMS AND PERCEIVED STRESS (P < .05). NO SIGNIFICANT CHANGES IN SLEEP OR PHYSICAL PERFORMANCE WERE OBSERVED. CONCLUSIONS: A TARGETED YOGA INTERVENTION LED TO SIGNIFICANT IMPROVEMENTS IN FATIGUE AND VIGOR AMONG BREAST CANCER SURVIVORS WITH PERSISTENT FATIGUE SYMPTOMS. 2012 17 493 25 COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA, MINDFULNESS, AND YOGA IN PATIENTS WITH BREAST CANCER WITH SLEEP DISTURBANCE: A LITERATURE REVIEW. THE NUMBER OF PATIENTS WITH BREAST CANCER DIAGNOSED WITH SLEEP DISTURBANCE HAS GROWN SUBSTANTIALLY WITHIN THE UNITED STATES OVER THE PAST 20 YEARS. MEANWHILE, THERE HAVE BEEN SIGNIFICANT IMPROVEMENTS IN THE PSYCHOLOGICAL TREATMENT OF SLEEP DISTURBANCE IN PATIENTS WITH BREAST CANCER. MORE SPECIFICALLY, COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA (CBT-I), MINDFULNESS, AND YOGA HAVE SHOWN TO BE 3 PROMISING TREATMENTS WITH VARYING DEGREES OF BENEFIT, SUPPORTING DATA, AND INHERENT LIMITATIONS. IN THIS ARTICLE, WE WILL OUTLINE THE TREATMENT APPROACH FOR SLEEP DISTURBANCE IN PATIENTS WITH BREAST CANCER AND CONDUCT A COMPREHENSIVE REVIEW OF CBT-I, MINDFULNESS, AND YOGA AS THEY PERTAIN TO THIS PATIENT POPULATION. 2017 18 2605 36 YOGA FOR PERSISTENT FATIGUE IN BREAST CANCER SURVIVORS: RESULTS OF A PILOT STUDY. APPROXIMATELY ONE-THIRD OF BREAST CANCER SURVIVORS EXPERIENCES PERSISTENT FATIGUE FOR MONTHS OR YEARS AFTER SUCCESSFUL TREATMENT COMPLETION. THERE IS A LACK OF EVIDENCE-BASED TREATMENTS FOR CANCER-RELATED FATIGUE, PARTICULARLY AMONG CANCER SURVIVORS. THIS SINGLE-ARM PILOT STUDY EVALUATED THE FEASIBILITY AND PRELIMINARY EFFICACY OF A YOGA INTERVENTION FOR FATIGUED BREAST CANCER SURVIVORS BASED ON THE IYENGAR TRADITION. IYENGAR YOGA PRESCRIBES SPECIFIC POSES FOR INDIVIDUALS WITH SPECIFIC MEDICAL PROBLEMS AND CONDITIONS; THIS TRIAL EMPHASIZED POSTURES BELIEVED TO BE EFFECTIVE FOR REDUCING FATIGUE AMONG BREAST CANCER SURVIVORS, INCLUDING INVERSIONS AND BACKBENDS PERFORMED WITH THE SUPPORT OF PROPS. TWELVE WOMEN WERE ENROLLED IN THE TRIAL, AND 11 COMPLETED THE FULL 12-WEEK COURSE OF TREATMENT. THERE WAS A SIGNIFICANT IMPROVEMENT IN FATIGUE SCORES FROM PRE- TO POST-INTERVENTION THAT WAS MAINTAINED AT THE 3-MONTH POST-INTERVENTION FOLLOWUP. SIGNIFICANT IMPROVEMENTS WERE ALSO OBSERVED IN MEASURES OF PHYSICAL FUNCTION, DEPRESSED MOOD, AND QUALITY OF LIFE. THESE RESULTS SUPPORT THE ACCEPTABILITY OF THIS INTERVENTION AND SUGGEST THAT IT MAY HAVE BENEFICIAL EFFECTS ON PERSISTENT POST-TREATMENT FATIGUE. HOWEVER, RESULTS REQUIRE REPLICATION IN A LARGER RANDOMIZED CONTROLLED TRIAL. 2011 19 111 28 A PILOT STUDY OF A HATHA YOGA TREATMENT FOR MENOPAUSAL SYMPTOMS. OBJECTIVE: TO ASSESS THE FEASIBILITY AND EFFICACY OF A YOGA TREATMENT FOR MENOPAUSAL SYMPTOMS. BOTH PHYSIOLOGIC AND SELF-REPORTED MEASURES OF HOT FLASHES WERE INCLUDED. METHODS: A PROSPECTIVE WITHIN-GROUP PILOT STUDY WAS CONDUCTED. PARTICIPANTS WERE 12 PERI- AND POST-MENOPAUSAL WOMEN EXPERIENCING AT LEAST 4 MENOPAUSAL HOT FLASHES PER DAY, AT LEAST 4 DAYS PER WEEK. ASSESSMENTS WERE ADMINISTERED BEFORE AND AFTER COMPLETION OF A 10-WEEK YOGA PROGRAM. PRE- AND POST-TREATMENT MEASURES INCLUDED: SEVERITY OF QUESTIONNAIRE-RATED MENOPAUSAL SYMPTOMS (WIKLUND SYMPTOM CHECK LIST), FREQUENCY, DURATION, AND SEVERITY OF HOT FLASHES (24-H AMBULATORY SKIN-CONDUCTANCE MONITORING; HOT-FLASH DIARY), INTERFERENCE OF HOT FLASHES WITH DAILY LIFE (HOT FLASH RELATED DAILY INTERFERENCE SCALE), AND SUBJECTIVE SLEEP QUALITY (PITTSBURGH SLEEP QUALITY INDEX). YOGA CLASSES INCLUDED BREATHING TECHNIQUES, POSTURES, AND RELAXATION POSES DESIGNED SPECIFICALLY FOR MENOPAUSAL SYMPTOMS. PARTICIPANTS WERE ASKED TO PRACTICE AT HOME 15 MIN EACH DAY IN ADDITION TO WEEKLY CLASSES. RESULTS: ELEVEN WOMEN COMPLETED THE STUDY AND ATTENDED A MEAN OF 7.45 (S.D. 1.63) CLASSES. SIGNIFICANT PRE- TO POST-TREATMENT IMPROVEMENTS WERE FOUND FOR SEVERITY OF QUESTIONNAIRE-RATED TOTAL MENOPAUSAL SYMPTOMS, HOT-FLASH DAILY INTERFERENCE; AND SLEEP EFFICIENCY, DISTURBANCES, AND QUALITY. NEITHER 24-H MONITORING NOR ACCOMPANYING DIARIES YIELDED SIGNIFICANT CHANGES IN HOT FLASHES. CONCLUSIONS: THE YOGA TREATMENT AND STUDY PROCEDURES WERE FEASIBLE FOR MIDLIFE WOMEN. IMPROVEMENT IN SYMPTOM PERCEPTIONS AND WELL BEING WARRANT FURTHER STUDY OF YOGA FOR MENOPAUSAL SYMPTOMS, WITH A LARGER NUMBER OF WOMEN AND INCLUDING A CONTROL GROUP. 2007 20 252 28 A YOGA PROGRAM FOR THE SYMPTOMS OF POST-TRAUMATIC STRESS DISORDER IN VETERANS. THE PURPOSE OF THIS PILOT STUDY WAS TO EVALUATE THE FEASIBILITY AND EFFECTIVENESS OF A YOGA PROGRAM AS AN ADJUNCTIVE THERAPY FOR IMPROVING POST-TRAUMATIC STRESS DISORDER (PTSD) SYMPTOMS IN VETERANS WITH MILITARY-RELATED PTSD. VETERANS (N = 12) PARTICIPATED IN A 6 WEEK YOGA INTERVENTION HELD TWICE A WEEK. THERE WAS SIGNIFICANT IMPROVEMENT IN PTSD HYPERAROUSAL SYMPTOMS AND OVERALL SLEEP QUALITY AS WELL AS DAYTIME DYSFUNCTION RELATED TO SLEEP. THERE WERE NO SIGNIFICANT IMPROVEMENTS IN THE TOTAL PTSD, ANGER, OR QUALITY OF LIFE OUTCOME SCORES. THESE RESULTS SUGGEST THAT THIS YOGA PROGRAM MAY BE AN EFFECTIVE ADJUNCTIVE THERAPY FOR IMPROVING HYPERAROUSAL SYMPTOMS OF PTSD INCLUDING SLEEP QUALITY. THIS STUDY DEMONSTRATES THAT THE YOGA PROGRAM IS ACCEPTABLE, FEASIBLE, AND THAT THERE IS GOOD ADHERENCE IN A VETERAN POPULATION. 2013