1 1460 130 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 2 2503 35 YOGA AS TREATMENT FOR INSOMNIA AMONG CANCER PATIENTS AND SURVIVORS: A SYSTEMATIC REVIEW. MANY CANCER PATIENTS AND SURVIVORS, BETWEEN 15 TO 90%, REPORT SOME FORM OF INSOMNIA OR SLEEP QUALITY IMPAIRMENT DURING AND POST-TREATMENT, SUCH AS EXCESSIVE DAYTIME NAPPING, DIFFICULTY FALLING ASLEEP, DIFFICULTY STAYING ASLEEP, AND WAKING UP TOO EARLY. INSOMNIA AND SLEEP QUALITY IMPAIRMENT ARE AMONG THE MOST PREVALENT AND DISTRESSING PROBLEMS REPORTED BY CANCER PATIENTS AND SURVIVORS, AND CAN BE SEVERE ENOUGH TO INCREASE CANCER MORTALITY. DESPITE THE UBIQUITY OF INSOMNIA AND SLEEP QUALITY IMPAIRMENT, THEY ARE UNDER-DIAGNOSED AND UNDER-TREATED IN CANCER PATIENTS AND SURVIVORS. WHEN SLEEP PROBLEMS ARE PRESENT, PROVIDERS AND PATIENTS ARE OFTEN HESITANT TO PRESCRIBE OR TAKE PHARMACEUTICALS FOR SLEEP PROBLEMS DUE TO POLY PHARMACY CONCERNS, AND COGNITIVE BEHAVIORAL THERAPY FOR INSOMNIA CAN BE VERY DIFFICULT AND IMPRACTICAL FOR PATIENTS TO ADHERE TO THROUGHOUT THE CANCER EXPERIENCE. RESEARCH SUGGESTS YOGA IS A WELL-TOLERATED EXERCISE INTERVENTION WITH PROMISING EVIDENCE FOR ITS EFFICACY IN IMPROVING INSOMNIA AND SLEEP QUALITY IMPAIRMENT AMONG SURVIVORS. THIS ARTICLE PROVIDES A SYSTEMATIC REVIEW OF EXISTING CLINICAL RESEARCH ON THE EFFECTIVENESS OF YOGA FOR TREATING INSOMNIA AND SLEEP QUALITY IMPAIRMENT AMONG CANCER PATIENTS AND SURVIVORS. 2013 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 2382 55 YOCAS(C)(R) YOGA REDUCES SELF-REPORTED MEMORY DIFFICULTY IN CANCER SURVIVORS IN A NATIONWIDE RANDOMIZED CLINICAL TRIAL: INVESTIGATING RELATIONSHIPS BETWEEN MEMORY AND SLEEP. UNLABELLED: BACKGROUND INTERVENTIONS ARE NEEDED TO ALLEVIATE MEMORY DIFFICULTY IN CANCER SURVIVORS. WE PREVIOUSLY SHOWED IN A PHASE III RANDOMIZED CLINICAL TRIAL THAT YOCAS(C)(R) YOGA-A PROGRAM THAT CONSISTS OF BREATHING EXERCISES, POSTURES, AND MEDITATION-SIGNIFICANTLY IMPROVED SLEEP QUALITY IN CANCER SURVIVORS. THIS STUDY ASSESSED THE EFFECTS OF YOCAS(C)(R) ON MEMORY AND IDENTIFIED RELATIONSHIPS BETWEEN MEMORY AND SLEEP. STUDY DESIGN AND METHODS: SURVIVORS WERE RANDOMIZED TO STANDARD CARE (SC) OR SC WITH YOCAS(C)(R) . 328 PARTICIPANTS WHO PROVIDED DATA ON THE MEMORY DIFFICULTY ITEM OF THE MD ANDERSON SYMPTOM INVENTORY ARE INCLUDED. SLEEP QUALITY WAS MEASURED USING THE PITTSBURGH SLEEP QUALITY INDEX. GENERAL LINEAR MODELING (GLM) DETERMINED THE GROUP EFFECT OF YOCAS(C)(R) ON MEMORY DIFFICULTY COMPARED WITH SC. GLM ALSO DETERMINED MODERATION OF BASELINE MEMORY DIFFICULTY ON POSTINTERVENTION SLEEP AND VICE VERSA. PATH MODELING ASSESSED THE MEDIATING EFFECTS OF CHANGES IN MEMORY DIFFICULTY ON YOCAS(C)(R) CHANGES IN SLEEP AND VICE VERSA. RESULTS: YOCAS(C)(R) SIGNIFICANTLY REDUCED MEMORY DIFFICULTY AT POSTINTERVENTION COMPARED WITH SC (MEAN CHANGE: YOGA=-0.60; SC=-0.16; P<.05). BASELINE MEMORY DIFFICULTY DID NOT MODERATE THE EFFECTS OF POSTINTERVENTION SLEEP QUALITY IN YOCAS(C)(R) COMPARED WITH SC. BASELINE SLEEP QUALITY DID MODERATE THE EFFECTS OF POSTINTERVENTION MEMORY DIFFICULTY IN YOCAS(C)(R) COMPARED WITH SC (P<.05). CHANGES IN SLEEP QUALITY WAS A SIGNIFICANT MEDIATOR OF REDUCED MEMORY DIFFICULTY IN YOCAS(C)(R) COMPARED WITH SC (P<.05); HOWEVER, CHANGES IN MEMORY DIFFICULTY DID NOT SIGNIFICANTLY MEDIATE IMPROVED SLEEP QUALITY IN YOCAS(C)(R) COMPARED WITH SC. CONCLUSIONS: IN THIS LARGE NATIONWIDE TRIAL, YOCAS(C)(R) YOGA SIGNIFICANTLY REDUCED PATIENT-REPORTED MEMORY DIFFICULTY IN CANCER SURVIVORS. 2016 5 1650 53 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 /=60YEARS OF AGE), BETWEEN 2MONTHS AND 2YEARS POST-TREATMENT, WHO PARTICIPATED IN THE ORIGINAL TRIAL. RESULTS: PARTICIPANTS IN THE YOCAS(C)(R) INTERVENTION ARM REPORTED SIGNIFICANTLY LOWER CANCER-RELATED FATIGUE, PHYSICAL FATIGUE, MENTAL FATIGUE, AND GLOBAL SIDE-EFFECT BURDEN THAN PARTICIPANTS IN THE STANDARD CARE ARM FOLLOWING THE 4-WEEK INTERVENTION PERIOD (P<0.05). CONCLUSIONS: YOCAS(C)(R) IS AN EFFECTIVE STANDARDIZED YOGA INTERVENTION FOR REDUCING CANCER-RELATED FATIGUE, PHYSICAL FATIGUE, MENTAL FATIGUE, AND GLOBAL SIDE-EFFECT BURDEN AMONG OLDER CANCER SURVIVORS. 2015 8 1517 36 IS YOGA ASSOCIATED WITH IMPROVED SLEEP AMONGST BREAST CANCER SURVIVORS? BACKGROUND: BREAST CANCER SURVIVORS MAY EXPERIENCE SLEEP DISTURBANCES THAT CAN AFFECT THEIR PHYSICAL AND MENTAL WELL-BEING. WE SOUGHT TO DETERMINE THE ASSOCIATION, IF ANY, BETWEEN YOGA AND SLEEP AMONG BREAST CANCER SURVIVORS IN A POPULATION-BASED COHORT. METHODS: THE NATIONAL HEALTH INTERVIEW SURVEY IS DESIGNED TO BE REPRESENTATIVE OF THE US CIVILIAN NON-INSTITUTIONALIZED POPULATION. WE EVALUATED BREAST CANCER SURVIVORS IN THE 2017 COHORT TO DETERMINE THE ASSOCIATION BETWEEN YOGA AND SELF-REPORTED QUALITY OF SLEEP. RESULTS: OF THE 25,905 PEOPLE SURVEYED, REPRESENTING 238,738,039 IN THE POPULATION, 1.59% REPORTED A PREVIOUS HISTORY OF BREAST CANCER. BREAST CANCER SURVIVORS WERE LESS LIKELY TO REPORT HAVING PRACTICED YOGA IN THE PRECEDING 12 MONTHS, COMPARED TO THOSE WITHOUT A HISTORY OF BREAST CANCER (9.98% VS 13.78%, P = .011). IN ADDITION, THEY WERE MORE LIKELY TO REPORT HAVING HAD TROUBLE FALLING ASLEEP (44.64% VS 36.32%, P = .002), STAYING ASLEEP (53.72% VS 39.43%, P < .001), AND USING SLEEP MEDICATION ON AT LEAST 1 DAY WITHIN THE PREVIOUS WEEK (23.80% VS 13.49%, P < .001) THAN THOSE WITHOUT BREAST CANCER. AMONG BREAST CANCER SURVIVORS, THERE WERE NO SIGNIFICANT DIFFERENCES IN DIFFICULTY FALLING ASLEEP (39.16% VS 44.98%, P = .482), DIFFICULTY STAYING ASLEEP (61.17% VS 52.70%, P = .305), AND NEEDING SLEEP MEDICATION (19.03% VS 24.53%, P = .395) BETWEEN THOSE WHO PRACTICED YOGA AND THOSE WHO DID NOT. CONTROLLING FOR SOCIODEMOGRAPHIC FACTORS, THERE REMAINED NO ASSOCIATION BETWEEN YOGA AND DIFFICULTY FALLING OR STAYING ASLEEP AMONG BREAST CANCER SURVIVORS. CONCLUSION: THERE IS NO DIRECT ASSOCIATION BETWEEN YOGA AND SLEEP QUALITY IN BREAST CANCER SURVIVORS. 2022 9 2129 30 THE EFFECTIVENESS OF YOGA ON CANCER-RELATED FATIGUE: A SYSTEMATIC REVIEW AND META-ANALYSIS. PROBLEM IDENTIFICATION: THE AIM OF THIS ARTICLE IS TO EVALUATE THE EFFECTIVENESS OF YOGA ON CANCER-RELATED FATIGUE (CRF) IN PATIENTS UNDERGOING CHEMOTHERAPY AND/OR RADIATION THERAPY. LITERATURE SEARCH: RELEVANT ENGLISH AND CHINESE ARTICLES WERE RETRIEVED FROM MEDICAL DATABASES AND INCLUDED IN THIS ANALYSIS. STANDARDIZED CRITICAL APPRAISAL INSTRUMENTS FROM THE JOANNA BRIGGS INSTITUTE WERE ADOPTED FOR THE QUALITY ASSESSMENT. DATA EVALUATION: 16 RANDOMIZED CONTROLLED TRIALS MET THE INCLUSION CRITERIA. SYNTHESIS: YOGA INTERVENTIONS HAD A POSITIVE EFFECT IN REDUCING CRF AMONG PATIENTS UNDERGOING CHEMOTHERAPY AND/OR RADIATION THERAPY, BUT THE ADHERENCE TO YOGA WAS LOW. MIXED TYPES OF YOGA, IN ADDITION TO SUPERVISED AND SELF-PRACTICING STRATEGIES, WERE ASSOCIATED WITH INCREASED PATIENT ADHERENCE AND IMPROVED CRF. IMPLICATIONS FOR PRACTICE: YOGA APPEARS TO BE A SAFE AND EFFECTIVE EXERCISE FOR THE MANAGEMENT OF CRF DURING CHEMOTHERAPY AND/OR RADIATION THERAPY; HOWEVER, ADDITIONAL HIGH-QUALITY STUDIES ARE NEEDED TO DEFINE AN OPTIMAL YOGA INTERVENTION STRATEGY. 2021 10 2093 48 THE EFFECT OF YOCAS(C)(R) YOGA FOR MUSCULOSKELETAL SYMPTOMS AMONG BREAST CANCER SURVIVORS ON HORMONAL THERAPY. UP TO 50% OF BREAST CANCER SURVIVORS ON AROMATASE INHIBITOR THERAPY REPORT MUSCULOSKELETAL SYMPTOMS SUCH AS JOINT AND MUSCLE PAIN, SIGNIFICANTLY IMPACTING TREATMENT ADHERENCE AND DISCONTINUATION RATES. WE CONDUCTED A SECONDARY DATA ANALYSIS OF A NATIONWIDE, MULTI-SITE, PHASE II/III RANDOMIZED, CONTROLLED, CLINICAL TRIAL EXAMINING THE EFFICACY OF YOGA FOR IMPROVING MUSCULOSKELETAL SYMPTOMS AMONG BREAST CANCER SURVIVORS CURRENTLY RECEIVING HORMONE THERAPY (AROMATASE INHIBITORS [AI] OR TAMOXIFEN [TAM]). BREAST CANCER SURVIVORS CURRENTLY RECEIVING AI (N = 95) OR TAM (N = 72) WITH NO PARTICIPATION IN YOGA DURING THE PREVIOUS 3 MONTHS WERE RANDOMIZED INTO 2 ARMS: (1) STANDARD CARE MONITORING AND (2) STANDARD CARE PLUS THE 4-WEEK YOGA INTERVENTION (2X/WEEK; 75 MIN/SESSION) AND INCLUDED IN THIS ANALYSIS. THE YOGA INTERVENTION UTILIZED THE UR YOGA FOR CANCER SURVIVORS (YOCAS(C)((R))) PROGRAM CONSISTING OF BREATHING EXERCISES, 18 GENTLE HATHA AND RESTORATIVE YOGA POSTURES, AND MEDITATION. MUSCULOSKELETAL SYMPTOMS WERE ASSESSED PRE- AND POST-INTERVENTION. AT BASELINE, AI USERS REPORTED HIGHER LEVELS OF GENERAL PAIN, MUSCLE ACHES, AND TOTAL PHYSICAL DISCOMFORT THAN TAM USERS (ALL P