1 2031 158 TAILORED INDIVIDUAL YOGA PRACTICE IMPROVES SLEEP QUALITY, FATIGUE, ANXIETY, AND DEPRESSION IN CHRONIC INSOMNIA DISORDER. BACKGROUND: CHRONIC INSOMNIA DISORDER (CI) IS A PREVALENT SLEEP DISORDER THAT CAN LEAD TO DISTURBED DAYTIME FUNCTIONING AND IS CLOSELY ASSOCIATED WITH ANXIETY AND DEPRESSION. FIRST-CHOICE TREATMENT IS COGNITIVE BEHAVIORAL THERAPY (CBT-I). OTHER MIND-BODY INTERVENTIONS, SUCH AS TAI-CHI AND YOGA, HAVE DEMONSTRATED SUBJECTIVE IMPROVEMENTS IN SLEEP QUALITY. THE PURPOSE OF THIS STUDY WAS TO ASSESS THE EFFICACY OF YOGA FOR IMPROVEMENT OF SUBJECTIVE AND OBJECTIVE SLEEP QUALITY AS WELL AS MEASURES OF ANXIETY, DEPRESSION, SLEEPINESS, AND FATIGUE IN PATIENTS WITH CI. METHODS: ADULTS WITH CI WERE PROSPECTIVELY INCLUDED IN THIS SINGLE GROUP PRE-POST STUDY. BASELINE ASSESSMENTS INCLUDED HOME POLYSOMNOGRAPHY (PSG), 7-DAY ACTIGRAPHY, AND QUESTIONNAIRES (PITTSBURGH SLEEP QUALITY INDEX QUESTIONNAIRE (PSQI), HOSPITAL ANXIETY DEPRESSION SCALE (HADS), EPWORTH SLEEPINESS SCALE (ESS), PICHOT FATIGUE SCALE (PS)). PATIENTS PRACTICED VINIYOGA, AN INDIVIDUALISED YOGA PRACTICE WITH DAILY SELF-ADMINISTERED EXERCISES, FOR 14 WEEKS. ASSESSMENTS WERE REPEATED AT THE END OF YOGA PRACTICE. RESULTS: TWENTY-ONE PATIENTS COMPLETED THE STUDY. OBJECTIVE SLEEP MEASUREMENTS REVEALED NO CHANGE IN PSG PARAMETERS AFTER YOGA PRACTICE, BUT A DECREASE IN AROUSALS ON ACTIGRAPHY (P < 0.001). SUBJECTIVE SYMPTOMS IMPROVED FOR ALL QUESTIONNAIRES (PSQI, P < 0.001; HAD-A, P = 0.020, HAD-D, P = 0.001, ESS, P = 0.041, PS, P = 0.010). IN UNIVARIATE CORRELATIONS, DECREASE IN PSQI WAS ASSOCIATED WITH INCREASE IN SLEEP STAGE N3 (P < 0.001) ON PSG. CONCLUSIONS: WE HAVE DEMONSTRATED A POSITIVE IMPACT OF INDIVIDUALIZED YOGA PRACTICE ON SUBJECTIVE PARAMETERS RELATED TO SLEEP AND DAYTIME SYMPTOMS IN CI, RESULTING IN FEWER AROUSALS ON ACTIGRAPHY. YOGA COULD BE PROPOSED AS A POTENTIALLY USEFUL ALTERNATIVE TO CBT-I IN CI, AS IT IS EASY TO PRACTICE AUTONOMOUSLY OVER THE LONG-TERM. HOWEVER, GIVEN THE DESIGN OF THE PRESENT STUDY, FUTURE PROSPECTIVE CONTROLLED STUDIES SHOULD FIRST CONFIRM OUR RESULTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT03314441 , DATE OF REGISTRATION: 19/10/2017. 2022 2 2726 47 YOGA NIDRA PRACTICE SHOWS IMPROVEMENT IN SLEEP IN PATIENTS WITH CHRONIC INSOMNIA: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND YOGA NIDRA IS PRACTISED BY SAGES FOR SLEEP. THE PRACTICE IS SIMPLE TO USE AND HAS BEEN CLEARLY LAID OUT, BUT ITS ROLE IN THE TREATMENT OF CHRONIC INSOMNIA HAS NOT BEEN WELL STUDIED. METHODS IN THIS RANDOMIZED PARALLEL-DESIGN STUDY CONDUCTED DURING 2012-16, WE ENROLLED 41 PATIENTS WITH CHRONIC INSOMNIA TO RECEIVE CONVENTIONAL INTERVENTION OF COGNITIVE BEHAVIOURAL THERAPY FOR INSOMNIA (N=20) OR YOGA NIDRA (N=21). OUTCOME MEASURES WERE BOTH SUBJECTIVE USING A SLEEP DIARY AND OBJECTIVE USING POLYSOMNOGRAPHY (PSG). SALIVARY CORTISOL LEVELS WERE ALSO MEASURED. PSG WAS DONE BEFORE THE INTERVENTION IN ALL PATIENTS AND REPEATED ONLY IN THOSE WHO VOLUNTEERED FOR THE SAME. RESULTS BOTH INTERVENTIONS SHOWED AN IMPROVEMENT IN SUBJECTIVE TOTAL SLEEP TIME (TST), SLEEP EFFICIENCY, WAKE AFTER SLEEP ONSET, REDUCTION IN TOTAL WAKE DURATION AND ENHANCEMENT IN SUBJECTIVE SLEEP QUALITY. OBJECTIVELY, BOTH THE INTERVENTIONS IMPROVED TST AND TOTAL WAKE DURATION AND INCREASED N1% OF TST. YOGA NIDRA SHOWED MARKED IMPROVEMENT IN N2% AND N3% IN TST. SALIVARY CORTISOL REDUCED STATISTICALLY SIGNIFICANTLY AFTER YOGA NIDRA (P=0.041). CONCLUSION IMPROVEMENT OF N3 SLEEP, TOTAL WAKE DURATION AND SUBJECTIVE SLEEP QUALITY OCCURRED FOLLOWING YOGA NIDRA PRACTICE. YOGA NIDRA PRACTICE CAN BE USED FOR TREATMENT OF CHRONIC INSOMNIA AFTER SUPERVISED PRACTICE SESSIONS. 2021 3 2631 28 YOGA FOR THE TREATMENT OF INSOMNIA AMONG CANCER PATIENTS: EVIDENCE, MECHANISMS OF ACTION, AND CLINICAL RECOMMENDATIONS. UP TO 90% OF CANCER PATIENTS REPORT SYMPTOMS OF INSOMNIA DURING AND AFTER TREATMENT. SYMPTOMS OF INSOMNIA INCLUDE EXCESSIVE DAYTIME SLEEPINESS, DIFFICULTY FALLING ASLEEP, DIFFICULTY STAYING ASLEEP, AND WAKING UP TOO EARLY. INSOMNIA SYMPTOMS ARE AMONG THE MOST PREVALENT, DISTRESSING AND PERSISTENT CANCER- AND CANCER TREATMENT-RELATED TOXICITIES REPORTED BY PATIENTS, AND CAN BE SEVERE ENOUGH TO INCREASE CANCER MORBIDITY AND MORTALITY. DESPITE THE UBIQUITY OF INSOMNIA SYMPTOMS, THEY ARE UNDER-SCREENED, UNDER-DIAGNOSED, AND UNDER-TREATED IN CANCER PATIENTS. WHEN INSOMNIA SYMPTOMS ARE IDENTIFIED, PROVIDERS ARE HESITANT TO PRESCRIBE, AND PATIENTS ARE HESITANT TO TAKE PHARMACEUTICALS DUE TO POLYPHARMACY CONCERNS. IN ADDITION, SLEEP MEDICATIONS DO NOT CURE INSOMNIA. YOGA IS A WELL-TOLERATED MODE OF EXERCISE WITH PROMISING EVIDENCE FOR ITS EFFICACY IN IMPROVING INSOMNIA SYMPTOMS AMONG CANCER PATIENTS. THIS ARTICLE REVIEWS EXISTING CLINICAL RESEARCH ON THE EFFECTIVENESS OF YOGA FOR TREATING INSOMNIA AMONG CANCER PATIENTS. THE ARTICLE ALSO PROVIDES CLINICAL RECOMMENDATIONS FOR PRESCRIBING YOGA FOR THE TREATMENT OF INSOMNIA IN THIS POPULATION. 2014 4 2323 52 TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. STUDY OBJECTIVES: PRIOR STUDIES HAVE SUGGESTED A BENEFIT OF YOGA FOR ALLEVIATING SLEEP DISTURBANCE; HOWEVER, MANY STUDIES HAVE HAD METHODOLOGICAL LIMITATIONS. THIS TRIAL STUDY AIMED TO EXTEND THAT LITERATURE BY INCLUDING AN ACTIVE SLEEP HYGIENE COMPARISON. METHODS: PARTICIPANTS AGED 25-59 YEARS WITH A PRIMARY COMPLAINT OF SLEEP ONSET INSOMNIA LASTING AT LEAST 6 MONTHS WERE BLOCK RANDOMIZED TO AN 8-WEEK KUNDALINI YOGA OR SLEEP HYGIENE INTERVENTION, BOTH CONSISTING OF INITIAL 60-MINUTE INSTRUCTION AND WEEKLY CHECK-INS. DAILY SLEEP DIARIES AND QUESTIONNAIRES WERE COLLECTED AT BASELINE, THROUGHOUT THE INTERVENTION, AND AT 6-MONTH FOLLOW-UP. DATA WERE ANALYZED USING LINEAR MIXED MODELS (N = 20 IN EACH GROUP). RESULTS: PARTICIPANT RATINGS OF THE INTERVENTIONS DID NOT SIGNIFICANTLY DIFFER. SLEEP HYGIENE IMPROVED SEVERAL DIARY AND QUESTIONNAIRE OUTCOMES, HOWEVER, YOGA RESULTED IN EVEN GREATER IMPROVEMENTS CORRESPONDING TO MEDIUM-TO-LARGE BETWEEN-GROUP EFFECT SIZES. TOTAL SLEEP TIME INCREASED PROGRESSIVELY ACROSS YOGA TREATMENT (D = 0.95, P = .002), CONCURRENT WITH INCREASED SLEEP EFFICIENCY (D = 1.36, P < .001) AND DECREASED SLEEP ONSET LATENCY (D = -1.16, P < .001), BUT WITHOUT CHANGES IN PRE-SLEEP AROUSAL (D =-0.30, P = .59). REMISSION RATES WERE ALSO HIGHER FOR YOGA COMPARED TO SLEEP HYGIENE, WITH >/= 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 5 2321 42 TREATMENT OF CHRONIC INSOMNIA WITH YOGA: A PRELIMINARY STUDY WITH SLEEP-WAKE DIARIES. THERE IS GOOD EVIDENCE FOR COGNITIVE AND PHYSIOLOGICAL AROUSAL IN CHRONIC INSOMNIA. ACCORDINGLY, CLINICAL TRIAL STUDIES OF INSOMNIA TREATMENTS AIMED AT REDUCING AROUSAL, INCLUDING RELAXATION AND MEDITATION, HAVE REPORTED POSITIVE RESULTS. YOGA IS A MULTICOMPONENT PRACTICE THAT IS ALSO KNOWN TO BE EFFECTIVE IN REDUCING AROUSAL, ALTHOUGH IT HAS NOT BEEN WELL EVALUATED AS A TREATMENT FOR INSOMNIA. IN THIS PRELIMINARY STUDY, A SIMPLE DAILY YOGA TREATMENT WAS EVALUATED IN A CHRONIC INSOMNIA POPULATION CONSISTING OF SLEEP-ONSET AND/OR SLEEP-MAINTENANCE INSOMNIA AND PRIMARY OR SECONDARY INSOMNIA. PARTICIPANTS MAINTAINED SLEEP-WAKE DIARIES DURING A PRETREATMENT 2-WEEK BASELINE AND A SUBSEQUENT 8-WEEK INTERVENTION, IN WHICH THEY PRACTICED THE TREATMENT ON THEIR OWN FOLLOWING A SINGLE IN-PERSON TRAINING SESSION WITH SUBSEQUENT BRIEF IN-PERSON AND TELEPHONE FOLLOW-UPS. SLEEP EFFICIENCY (SE), TOTAL SLEEP TIME (TST), TOTAL WAKE TIME (TWT), SLEEP ONSET LATENCY (SOL), WAKE TIME AFTER SLEEP ONSET (WASO), NUMBER OF AWAKENINGS, AND SLEEP QUALITY MEASURES WERE DERIVED FROM SLEEP-WAKE DIARY ENTRIES AND WERE AVERAGED IN 2-WEEK INTERVALS. FOR 20 PARTICIPANTS COMPLETING THE PROTOCOL, STATISTICALLY SIGNIFICANT IMPROVEMENTS WERE OBSERVED IN SE, TST, TWT, SOL, AND WASO AT END-TREATMENT AS COMPARED WITH PRETREATMENT VALUES. 2004 6 117 49 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 7 1650 50 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 /= 60 Y) WITH INSOMNIA. INTERVENTION: THE YI GROUP PARTICIPATED IN 12 WK OF CLASSES, HELD 2 X/WK, INCORPORATING YOGA POSTURES, MEDITATIVE YOGA, AND DAILY HOME PRACTICE OF MEDITATIVE YOGA. OUTCOME MEASURES: THE STUDY USED SELF-REPORT ASSESSMENTS OF SLEEP QUALITY USING THE FOLLOWING: (1) SLEEP QUALITY-THE KAROLINSKA SLEEPINESS SCALE (KSS), THE EPWORTH SLEEPINESS SCALE (ESS), AND THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), AND DAILY SLEEP AND PRACTICE LOGS; (2) MOOD STATES-THE DEPRESSION ANXIETY STRESS SCALE LONG FORM (DASS-42) AND THE PROFILE OF MOOD STATES SHORT FORM (POMS-SF); (3) A HEALTH SURVEY (SF-36); AND (4) MOBILE AT-HOME SLEEP STUDIES. RESULTS: COMPARED WITH CONTROLS, THE YI GROUP SHOWED SIGNIFICANT IMPROVEMENTS IN A RANGE OF SUBJECTIVE FACTORS, INCLUDING OVERALL SLEEP QUALITY; SLEEP EFFICIENCY; SLEEP LATENCY AND DURATION; SELF-ASSESSED SLEEP QUALITY; FATIGUE; GENERAL WELL-BEING; DEPRESSION; ANXIETY; STRESS; TENSION; ANGER; VITALITY; AND FUNCTION IN PHYSICAL, EMOTIONAL, AND SOCIAL ROLES. CONCLUSIONS: YOGA WAS SHOWN TO BE SAFE AND IMPROVED SLEEP AND QOL IN A GROUP OF OLDER ADULTS WITH INSOMNIA. OUTCOMES DEPENDED ON PRACTICE COMPLIANCE. 2014 11 2521 50 YOGA DECREASES INSOMNIA IN POSTMENOPAUSAL WOMEN: A RANDOMIZED CLINICAL TRIAL. OBJECTIVE: THE PRACTICE OF YOGA HAS BEEN PROVEN TO HAVE POSITIVE EFFECTS ON REDUCING INSOMNIA. STUDIES HAVE ALSO SHOWN ITS EFFECTS ON REDUCING CLIMACTERIC SYMPTOMS. TO DATE, HOWEVER, NO STUDIES THAT EVALUATE THE EFFECTS OF YOGA ON POSTMENOPAUSAL WOMEN WITH A DIAGNOSIS OF INSOMNIA IN A RANDOMIZED CLINICAL TRIAL HAVE BEEN CONDUCTED. THE AIM OF THIS STUDY WAS TO EVALUATE THE EFFECT OF YOGA PRACTICE ON THE PHYSICAL AND MENTAL HEALTH AND CLIMACTERIC SYMPTOMS OF POSTMENOPAUSAL WOMEN WITH A DIAGNOSIS OF INSOMNIA. METHODS: POSTMENOPAUSAL WOMEN NOT UNDERGOING HORMONE THERAPY, WHO WERE 50 TO 65 YEARS OLD, WHO HAD AN APNEA-HYPOPNEA INDEX LESS THAN 15, AND WHO HAD A DIAGNOSIS OF INSOMNIA WERE RANDOMLY ASSIGNED TO ONE OF THREE GROUPS, AS FOLLOWS: CONTROL, PASSIVE STRETCHING, AND YOGA. QUESTIONNAIRES WERE ADMINISTERED BEFORE AND 4 MONTHS AFTER THE INTERVENTION TO EVALUATE QUALITY OF LIFE, ANXIETY AND DEPRESSION SYMPTOMS, CLIMACTERIC SYMPTOMS, INSOMNIA SEVERITY, DAYTIME SLEEPINESS, AND STRESS. THE VOLUNTEERS ALSO UNDERWENT POLYSOMNOGRAPHY. THE STUDY LASTED 4 MONTHS. RESULTS: THERE WERE 44 VOLUNTEERS AT THE END OF THE STUDY. WHEN COMPARED WITH THE CONTROL GROUP, THE YOGA GROUP HAD SIGNIFICANTLY LOWER POSTTREATMENT SCORES FOR CLIMACTERIC SYMPTOMS AND INSOMNIA SEVERITY AND HIGHER SCORES FOR QUALITY OF LIFE AND RESISTANCE PHASE OF STRESS. THE REDUCTION IN INSOMNIA SEVERITY IN THE YOGA GROUP WAS SIGNIFICANTLY HIGHER THAN THAT IN THE CONTROL AND PASSIVE-STRETCHING GROUPS. CONCLUSIONS: THIS STUDY SHOWED THAT A SPECIFIC SEQUENCE OF YOGA MIGHT BE EFFECTIVE IN REDUCING INSOMNIA AND MENOPAUSAL SYMPTOMS AS WELL AS IMPROVING QUALITY OF LIFE IN POSTMENOPAUSAL WOMEN WITH INSOMNIA. 2012 12 1087 47 EFFECTS OF YOGA ON SYMPTOM MANAGEMENT IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. OBJECTIVES: THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY ON DISTRESSFUL SYMPTOMS IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY. MATERIALS AND METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS WERE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO THEIR RADIOTHERAPY TREATMENT. INTERVENTION CONSISTED OF YOGA SESSIONS LASTING 60 MIN DAILY WHILE THE CONTROL GROUP WAS IMPARTED SUPPORTIVE THERAPY ONCE IN 10 DAYS DURING THE COURSE OF THEIR ADJUVANT RADIOTHERAPY. ASSESSMENTS INCLUDED ROTTERDAM SYMPTOM CHECK LIST AND EUROPEAN ORGANIZATION FOR RESEARCH IN THE TREATMENT OF CANCER-QUALITY OF LIFE (EORTC QOL C30) SYMPTOM SCALE. ASSESSMENTS WERE DONE AT BASELINE AND AFTER 6 WEEKS OF RADIOTHERAPY TREATMENT. RESULTS: A GLM REPEATED-MEASURES ANOVA SHOWED A SIGNIFICANT DECREASE IN PSYCHOLOGICAL DISTRESS (P = 0.01), FATIGUE (P = 0.007), INSOMNIA (P = 0.001), AND APPETITE LOSS (P = 0.002) OVER TIME IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS SIGNIFICANT IMPROVEMENT IN THE ACTIVITY LEVEL (P = 0.02) IN THE YOGA GROUP AS COMPARED TO CONTROLS. THERE WAS A SIGNIFICANT POSITIVE CORRELATION BETWEEN PHYSICAL AND PSYCHOLOGICAL DISTRESS AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, APPETITE LOSS, AND CONSTIPATION. THERE WAS A SIGNIFICANT NEGATIVE CORRELATION BETWEEN THE ACTIVITY LEVEL AND FATIGUE, NAUSEA AND VOMITING, PAIN, DYSPNEA, INSOMNIA, AND APPETITE LOSS. CONCLUSION: THE RESULTS SUGGEST BENEFICIAL EFFECTS WITH YOGA INTERVENTION IN MANAGING CANCER-AND TREATMENT-RELATED SYMPTOMS IN BREAST CANCER PATIENTS. 2009 13 1980 37 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 14 1557 50 LONG-TERM EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR WORRIED OLDER ADULTS. OBJECTIVES: COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA DECREASE WORRY AND ANXIETY. THERE ARE NO LONG-TERM DATA COMPARING CBT AND YOGA FOR WORRY, ANXIETY, AND SLEEP IN OLDER ADULTS. THE IMPACT OF PREFERENCE AND SELECTION ON THESE OUTCOMES IS UNKNOWN. IN THIS SECONDARY DATA ANALYSIS, WE COMPARED LONG-TERM EFFECTS OF CBT BY TELEPHONE AND YOGA ON WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, AND PAIN; AND EXAMINED PREFERENCE AND SELECTION EFFECTS. DESIGN: IN THIS RANDOMIZED PREFERENCE TRIAL, PARTICIPANTS (N = 500) WERE RANDOMIZED TO A: 1) RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR 2) PREFERENCE TRIAL (SELECTED CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND WEEK 37. SETTING: COMMUNITY. PARTICIPANTS: COMMUNITY-DWELLING OLDER ADULTS (AGE 60+ YEARS). INTERVENTIONS: CBT (BY TELEPHONE) AND YOGA (IN-PERSON GROUP CLASSES). MEASUREMENTS: PENN STATE WORRY QUESTIONNAIRE - ABBREVIATED (WORRY);(1)(,)(2) INSOMNIA SEVERITY INDEX (SLEEP);(3) PROMIS ANXIETY SHORT FORM V1.0 (ANXIETY);(4)(,)(5) GENERALIZED ANXIETY DISORDER SCREENER (GENERALIZED ANXIETY);(6)(,)(7) AND PROMIS-29 (DEPRESSION, FATIGUE, PHYSICAL FUNCTION, SOCIAL PARTICIPATION, PAIN).(8)(,)(9) RESULTS: SIX MONTHS AFTER INTERVENTION COMPLETION, CBT AND YOGA RCT PARTICIPANTS REPORTED SUSTAINED IMPROVEMENTS FROM BASELINE IN WORRY, ANXIETY, SLEEP, DEPRESSIVE SYMPTOMS, FATIGUE, AND SOCIAL PARTICIPATION (NO SIGNIFICANT BETWEEN-GROUP DIFFERENCES). USING DATA COMBINED FROM THE RANDOMIZED AND PREFERENCE TRIALS, THERE WERE NO SIGNIFICANT PREFERENCE OR SELECTION EFFECTS. LONG-TERM INTERVENTION EFFECTS WERE OBSERVED AT CLINICALLY MEANINGFUL LEVELS FOR MOST OF THE STUDY OUTCOMES. CONCLUSIONS: CBT AND YOGA BOTH DEMONSTRATED MAINTAINED IMPROVEMENTS FROM BASELINE ON MULTIPLE OUTCOMES SIX MONTHS AFTER INTERVENTION COMPLETION IN A LARGE SAMPLE OF OLDER ADULTS. TRIAL REGISTRATION: WWW. CLINICALTRIALS: GOV IDENTIFIER NCT02968238. 2022 15 524 44 COMPARISON OF COGNITIVE-BEHAVIORAL THERAPY AND YOGA FOR THE TREATMENT OF LATE-LIFE WORRY: A RANDOMIZED PREFERENCE TRIAL. BACKGROUND: THE PURPOSE OF THIS STUDY WAS TO COMPARE THE EFFECTS OF COGNITIVE-BEHAVIORAL THERAPY (CBT) AND YOGA ON LATE-LIFE WORRY, ANXIETY, AND SLEEP; AND EXAMINE PREFERENCE AND SELECTION EFFECTS ON THESE OUTCOMES. METHODS: A RANDOMIZED PREFERENCE TRIAL OF CBT AND YOGA WAS CONDUCTED IN COMMUNITY-DWELLING ADULTS 60 YEARS OR OLDER, WHO SCORED 26 OR ABOVE ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A). CBT CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BIWEEKLY GROUP YOGA CLASSES. THE PRIMARY OUTCOME WAS WORRY (PSWQ-A); THE SECONDARY OUTCOMES WERE ANXIETY (PROMIS-ANXIETY) AND SLEEP (INSOMNIA SEVERITY INDEX [ISI]). WE EXAMINED BOTH PREFERENCE EFFECTS (AVERAGE EFFECT FOR THOSE WHO RECEIVED THEIR PREFERRED INTERVENTION [REGARDLESS OF WHETHER IT WAS CBT OR YOGA] MINUS THE AVERAGE FOR THOSE WHO DID NOT RECEIVE THEIR PREFERRED INTERVENTION [REGARDLESS OF THE INTERVENTION]) AND SELECTION EFFECT (WHICH ADDRESSES THE QUESTION OF WHETHER THERE IS A BENEFIT TO GETTING TO SELECT ONE INTERVENTION OVER THE OTHER, AND MEASURES THE EFFECT ON OUTCOMES OF SELF-SELECTION TO A SPECIFIC INTERVENTION). RESULTS: FIVE HUNDRED OLDER ADULTS WERE RANDOMIZED TO THE RANDOMIZED TRIAL (125 EACH IN CBT AND YOGA) OR THE PREFERENCE TRIAL (120 CHOSE CBT; 130 CHOSE YOGA). IN THE RANDOMIZED TRIAL, THE INTERVENTION EFFECT OF YOGA COMPARED WITH CBT ADJUSTED FOR BASELINE PSYCHOTROPIC MEDICATION USE, GENDER, AND RACE WAS 1.6 (-0.2, 3.3), P = .08 FOR THE PSWQ-A. SIMILAR RESULTS WERE OBSERVED WITH PROMIS-ANXIETY (ADJUSTED INTERVENTION EFFECT: 0.3 [-1.5, 2.2], P = .71). PARTICIPANTS RANDOMIZED TO CBT EXPERIENCED A GREATER REDUCTION IN THE ISI COMPARED WITH YOGA (ADJUSTED INTERVENTION EFFECT: 2.4 [1.2, 3.7], P < .01]). ESTIMATED IN THE COMBINED DATA SET (N = 500), THE PREFERENCE AND SELECTION EFFECTS WERE NOT SIGNIFICANT FOR THE PSWQ-A, PROMIS-ANXIETY, AND ISI. OF THE 52 ADVERSE EVENTS, ONLY TWO WERE POSSIBLY RELATED TO THE INTERVENTION. NONE OF THE 26 SERIOUS ADVERSE EVENTS WERE RELATED TO THE STUDY INTERVENTIONS. CONCLUSIONS: CBT AND YOGA WERE BOTH EFFECTIVE AT REDUCING LATE-LIFE WORRY AND ANXIETY. HOWEVER, A GREATER IMPACT WAS SEEN FOR CBT COMPARED WITH YOGA FOR IMPROVING SLEEP. NEITHER PREFERENCE NOR SELECTION EFFECTS WAS FOUND. 2020 16 2132 36 THE EFFECTS OF A GENTLE YOGA PROGRAM ON SLEEP, MOOD, AND BLOOD PRESSURE IN OLDER WOMEN WITH RESTLESS LEGS SYNDROME (RLS): A PRELIMINARY RANDOMIZED CONTROLLED TRIAL. OBJECTIVE. TO EXAMINE THE EFFECTS OF YOGA VERSUS AN EDUCATIONAL FILM PROGRAM ON SLEEP, MOOD, PERCEIVED STRESS, AND SYMPATHETIC ACTIVATION IN OLDER WOMEN WITH RLS. METHODS. PARTICIPANTS WERE DRAWN FROM A LARGER TRIAL REGARDING THE EFFECTS OF YOGA ON CARDIOVASCULAR DISEASE RISK PROFILES IN OVERWEIGHT, SEDENTARY POSTMENOPAUSAL WOMEN. SEVENTY-FIVE WOMEN WERE RANDOMIZED TO RECEIVE EITHER AN 8-WEEK YOGA (N = 38) OR EDUCATIONAL FILM (N = 37) PROGRAM. ALL 75 PARTICIPANTS COMPLETED AN RLS SCREENING QUESTIONNAIRE. THE 20 WOMEN WHO MET ALL FOUR DIAGNOSTIC CRITERIA FOR RLS (N = 10 YOGA, 10 FILM GROUP) COMPRISED THE POPULATION FOR THIS NESTED STUDY. MAIN OUTCOMES ASSESSED PRE- AND POST-TREATMENT INCLUDED: SLEEP (PITTSBURGH SLEEP QUALITY INDEX), STRESS (PERCEIVED STRESS SCALE), MOOD (PROFILE OF MOOD STATES, STATE-TRAIT ANXIETY INVENTORY), BLOOD PRESSURE, AND HEART RATE. RESULTS. THE YOGA GROUP DEMONSTRATED SIGNIFICANTLY GREATER IMPROVEMENTS THAN CONTROLS IN MULTIPLE DOMAINS OF SLEEP QUALITY AND MOOD, AND SIGNIFICANTLY GREATER REDUCTIONS IN INSOMNIA PREVALENCE, ANXIETY, PERCEIVED STRESS, AND BLOOD PRESSURE (ALL P'S/=60 YEARS WHO SCORED >/=26 ON THE PENN STATE WORRY QUESTIONNAIRE-ABBREVIATED (PSWQ-A), RECRUITED FROM OUTPATIENT MEDICAL CLINICS, MAILINGS, AND ADVERTISEMENTS. COGNITIVE-BEHAVIORAL THERAPY CONSISTED OF 10 WEEKLY TELEPHONE SESSIONS. YOGA CONSISTED OF 20 BI-WEEKLY GROUP YOGA CLASSES. PARTICIPANTS WERE RANDOMIZED TO(1): A RANDOMIZED CONTROLLED TRIAL (RCT) OF CBT OR YOGA (N = 250); OR (2) A PREFERENCE TRIAL IN WHICH THEY SELECTED THEIR TREATMENT (CBT OR YOGA; N = 250). OUTCOMES WERE MEASURED AT BASELINE AND POST-INTERVENTION. RESULTS: WITHIN THE RCT, THERE WERE SIGNIFICANT BETWEEN-GROUP DIFFERENCES FOR BOTH PAIN INTERFERENCE AND INTENSITY. THE PAIN INTERFERENCE SCORE IMPROVED MORE FOR THE CBT GROUP COMPARED WITH THE YOGA GROUP [INTERVENTION EFFECT OF (MEAN (95% CI) = 2.5 (.5, 4.6), P = .02]. FOR THE PAIN INTENSITY SCORE, THE INTERVENTION EFFECT ALSO FAVORED CBT OVER YOGA [.7 (.2, 1.3), P < .01]. DEPRESSIVE SYMPTOMS, GENERALIZED ANXIETY, AND FATIGUE SHOWED CLINICALLY MEANINGFUL WITHIN-GROUP CHANGES IN BOTH GROUPS. THERE WERE NO CHANGES IN OR DIFFERENCE BETWEEN PHYSICAL FUNCTION OR SOCIAL PARTICIPATION FOR EITHER GROUP. NO PREFERENCE OR SELECTION EFFECTS WERE FOUND. CONCLUSION: BOTH CBT AND YOGA MAY BE USEFUL FOR OLDER ADULTS FOR IMPROVING PSYCHOLOGICAL SYMPTOMS AND FATIGUE. COGNITIVE-BEHAVIORAL THERAPY MAY OFFER EVEN GREATER BENEFIT THAN YOGA FOR DECREASING PAIN. 2022