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 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 3-POINT REDUCTION IN PSQI) AT 12 WEEKS VARIED BY CHANGES IN PAIN AND PHYSICAL FUNCTION AT 6 WEEKS. KEY RESULTS: AMONG PARTICIPANTS (MEAN AGE = 46.0, 64% FEMALE, 82% NON-WHITE), NEARLY ALL (92%) REPORTED POOR SLEEP QUALITY (PSQI > 5) AT BASELINE. AT 12 WEEKS, MODEST IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED AMONG THE YOGA (PSQI MEAN DIFFERENCE [MD] = - 1.19, 95% CONFIDENCE INTERVAL [CI] - 1.82, - 0.55) AND PT (PSQI MD = - 0.91, 95% CI - 1.61, - 0.20) GROUPS. PARTICIPANTS WHO REPORTED A >/= 30% IMPROVEMENT IN PAIN OR PHYSICAL FUNCTION AT 6 WEEKS, COMPARED WITH THOSE WHO IMPROVED < 10%, WERE MORE LIKELY TO BE A SLEEP QUALITY RESPONDER AT 12 WEEKS (ODDS RATIO [OR] = 3.51, 95% CI 1.73, 7.11 AND OR = 2.16, 95% CI 1.18, 3.95, RESPECTIVELY). RESULTS WERE SIMILAR AT 52 WEEKS. CONCLUSION: IN A SAMPLE OF ADULTS WITH CLBP, VIRTUALLY ALL WITH POOR SLEEP QUALITY PRIOR TO INTERVENTION, MODEST BUT STATISTICALLY SIGNIFICANT IMPROVEMENTS IN SLEEP QUALITY WERE OBSERVED WITH BOTH YOGA AND PT. IRRESPECTIVE OF TREATMENT, CLINICALLY IMPORTANT SLEEP IMPROVEMENTS AT THE END OF THE INTERVENTION WERE ASSOCIATED WITH MID-INTERVENTION PAIN AND PHYSICAL FUNCTION IMPROVEMENTS. TRIAL REGISTRATION: CLINICALTRIALS.GOV IDENTIFIER: NCT01343927. 2020 6 117 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 7 1020 36 EFFECTS OF YOGA AND AEROBIC EXERCISE ON ACTIGRAPHIC SLEEP PARAMETERS IN MENOPAUSAL WOMEN WITH HOT FLASHES. STUDY OBJECTIVES: TO DETERMINE EFFECTS OF YOGA AND AEROBIC EXERCISE COMPARED WITH USUAL ACTIVITY ON OBJECTIVE ASSESSMENTS OF SLEEP IN MIDLIFE WOMEN. METHODS: SECONDARY ANALYSES OF A RANDOMIZED CONTROLLED TRIAL IN THE MENOPAUSE STRATEGIES: FINDING LASTING ANSWERS FOR SYMPTOMS AND HEALTH (MSFLASH) NETWORK CONDUCTED AMONG 186 LATE TRANSITION AND POSTMENOPAUSAL WOMEN AGED 40-62 Y WITH HOT FLASHES. WOMEN WERE RANDOMIZED TO 12 W OF YOGA, SUPERVISED AEROBIC EXERCISE, OR USUAL ACTIVITY. THE MEAN AND COEFFICIENT OF VARIATION (CV) OF CHANGE IN ACTIGRAPH SLEEP MEASURES FROM EACH INTERVENTION GROUP WERE COMPARED TO THE USUAL ACTIVITY GROUP USING LINEAR REGRESSION MODELS. RESULTS: BASELINE VALUES OF THE PRIMARY SLEEP MEASURES FOR THE ENTIRE SAMPLE WERE MEAN TOTAL SLEEP TIME (TST) = 407.5 +/- 56.7 MIN; MEAN WAKE AFTER SLEEP ONSET (WASO) = 54.6 +/- 21.8 MIN; MEAN CV FOR WASO = 37.7 +/- 18.7 AND MEAN CV FOR NUMBER OF LONG AWAKENINGS > 5 MIN = 81.5 +/- 46.9. CHANGES IN THE ACTIGRAPHIC SLEEP OUTCOMES FROM BASELINE TO WEEKS 11-12 WERE SMALL, AND NONE DIFFERED BETWEEN GROUPS. IN AN EXPLORATORY ANALYSIS, WOMEN WITH BASELINE PITTSBURGH SLEEP QUALITY INDEX HIGHER THAN 8 HAD SIGNIFICANTLY REDUCED TST-CV FOLLOWING YOGA COMPARED WITH USUAL ACTIVITY. CONCLUSIONS: THIS STUDY ADDS TO THE CURRENTLY SCANT LITERATURE ON OBJECTIVE SLEEP OUTCOMES FROM YOGA AND AEROBIC EXERCISE INTERVENTIONS FOR THIS POPULATION. ALTHOUGH SMALL EFFECTS ON SELF-REPORTED SLEEP QUALITY WERE PREVIOUSLY REPORTED, THE INTERVENTIONS HAD NO STATISTICALLY SIGNIFICANT EFFECTS ON ACTIGRAPH MEASURES, EXCEPT FOR POTENTIALLY IMPROVED SLEEP STABILITY WITH YOGA IN WOMEN WITH POOR SELF-REPORTED SLEEP QUALITY. 2017 8 2590 41 YOGA FOR MANAGING KNEE OSTEOARTHRITIS IN OLDER WOMEN: A PILOT RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OSTEOARTHRITIS (OA) IS A COMMON PROBLEM IN OLDER WOMEN THAT IS ASSOCIATED WITH PAIN AND DISABILITIES. ALTHOUGH YOGA IS RECOMMENDED AS AN EXERCISE INTERVENTION TO MANAGE ARTHRITIS, THERE IS LIMITED EVIDENCE DOCUMENTING ITS EFFECTIVENESS, WITH LITTLE KNOWN ABOUT ITS LONG TERM BENEFITS. THIS STUDY'S AIMS WERE TO ASSESS THE FEASIBILITY AND POTENTIAL EFFICACY OF A HATHA YOGA EXERCISE PROGRAM IN MANAGING OA-RELATED SYMPTOMS IN OLDER WOMEN WITH KNEE OA. METHODS: ELIGIBLE PARTICIPANTS (N=36; MEAN AGE 72 YEARS) WERE RANDOMLY ASSIGNED TO 8-WEEK YOGA PROGRAM INVOLVING GROUP AND HOME-BASED SESSIONS OR WAIT-LIST CONTROL. THE YOGA INTERVENTION PROGRAM WAS DEVELOPED BY A GROUP OF YOGA EXPERTS (N=5). THE PRIMARY OUTCOME WAS THE WESTERN ONTARIO AND MCMASTER UNIVERSITIES OSTEOARTHRITIS INDEX (WOMAC) TOTAL SCORE THAT MEASURES KNEE OA PAIN, STIFFNESS, AND FUNCTION AT 8 WEEKS. THE SECONDARY OUTCOMES, PHYSICAL FUNCTION OF THE LOWER EXTREMITIES, BODY MASS INDEX (BMI), QUALITY OF SLEEP (QOS), AND QUALITY OF LIFE (QOL), WERE MEASURED USING WEIGHT, HEIGHT, THE SHORT PHYSICAL PERFORMANCE BATTERY (SPPB), THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), THE CANTRIL SELF-ANCHORING LADDER, AND THE SF12V2 HEALTH SURVEY. DATA WERE COLLECTED AT BASELINE, 4 WEEKS AND 8 WEEKS, AND 20 WEEKS. RESULTS: THE RECRUITMENT TARGET WAS MET, WITH STUDY RETENTION AT 95%. BASED ON ANCOVAS, PARTICIPANTS IN THE TREATMENT GROUP EXHIBITED SIGNIFICANTLY GREATER IMPROVEMENT IN WOMAC PAIN (ADJUSTED MEANS [SE]) (8.3 [.67], 5.8 [.67]; P=.01), STIFFNESS (4.7 [.28], 3.4 [.28]; P=.002) AND SPPB (REPEATED CHAIR STANDS) (2.0 [.23], 2.8 [.23]; P=.03) AT 8 WEEKS. SIGNIFICANT TREATMENT AND TIME EFFECTS WERE SEEN IN WOMAC PAIN (7.0 [.46], 5.4 [.54]; P=.03), FUNCTION (24.5 [1.8], 19.9 [1.6]; P=.01) AND TOTAL SCORES (35.4 [2.3], 28.6 [2.1]; P=.01) FROM 4 TO 20 WEEKS. SLEEP DISTURBANCE WAS IMPROVED BUT THE PSQI TOTAL SCORE DECLINED SIGNIFICANTLY AT 20 WEEKS. CHANGES IN BMI AND QOL WERE NOT SIGNIFICANT. NO YOGA RELATED ADVERSE EVENTS WERE OBSERVED. CONCLUSIONS: A WEEKLY YOGA PROGRAM WITH HOME PRACTICE IS FEASIBLE, ACCEPTABLE, AND SAFE FOR OLDER WOMEN WITH KNEE OA, AND SHOWS THERAPEUTIC BENEFITS. TRIAL REGISTRATION: CLINICALTRIALS.GOV: NCT01832155. 2014 9 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 10 2382 36 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 11 945 39 EFFECTS OF A 12-WEEK YOGA VERSUS A 12-WEEK EDUCATIONAL FILM INTERVENTION ON SYMPTOMS OF RESTLESS LEGS SYNDROME AND RELATED OUTCOMES: AN EXPLORATORY RANDOMIZED CONTROLLED TRIAL. STUDY OBJECTIVES: TO ASSESS THE EFFECTS OF A YOGA VERSUS EDUCATIONAL FILM (EF) PROGRAM ON RESTLESS LEGS SYNDROME (RLS) SYMPTOMS AND RELATED OUTCOMES IN ADULTS WITH RLS. METHODS: FORTY-ONE COMMUNITY-DWELLING, AMBULATORY NONPREGNANT ADULTS WITH MODERATE TO SEVERE RLS WERE RANDOMIZED TO A 12-WEEK YOGA (N = 19) OR EF PROGRAM (N = 22). IN ADDITION TO ATTENDING CLASSES, ALL PARTICIPANTS COMPLETED PRACTICE/TREATMENT LOGS. YOGA GROUP PARTICIPANTS WERE ASKED TO PRACTICE AT HOME 30 MINUTES PER DAY ON NONCLASS DAYS; EF PARTICIPANTS WERE INSTRUCTED TO RECORD ANY RLS TREATMENTS USED ON THEIR DAILY LOGS. CORE OUTCOMES ASSESSED PRETREATMENT AND POSTTREATMENT WERE RLS SYMPTOMS AND SYMPTOM SEVERITY (INTERNATIONAL RLS STUDY GROUP SCALE (IRLS) AND RLS ORDINAL SCALE), SLEEP QUALITY, MOOD, PERCEIVED STRESS, AND QUALITY OF LIFE (QOL). RESULTS: THIRTY ADULTS (13 YOGA, 17 EF), AGED 24 TO 73 (MEAN = 50.4 +/- 2.4 YEARS), COMPLETED THE 12-WEEK STUDY (78% FEMALE, 80.5% WHITE). POST-INTERVENTION, BOTH GROUPS SHOWED SIGNIFICANT IMPROVEMENT IN RLS SYMPTOMS AND SEVERITY, PERCEIVED STRESS, MOOD, AND QOL-MENTAL HEALTH (P 0.05). THE GLOBAL SCORE OF PSQI IMPROVED (P = 0.017) IN YOGA GROUP ALONE. CONCLUSION: THE RESULTS INDICATE THE BENEFICIAL EFFECTS OF IAYT ON BODY COMPOSITION AND SLEEP QUALITY IN OBESE MALES. THE YOGA PRACTICE MAY REDUCE OBESITY WITH THE IMPROVEMENT IN QUALITY OF LIFE. 2017 16 1194 44 EXAMINING MEDIATORS AND MODERATORS OF YOGA FOR WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. HYPOTHESIS THIS STUDY EXAMINES MODERATORS AND MEDIATORS OF A YOGA INTERVENTION TARGETING QUALITY-OF-LIFE (QOL) OUTCOMES IN WOMEN WITH BREAST CANCER RECEIVING RADIOTHERAPY.METHODS WOMEN UNDERGOING 6 WEEKS OF RADIOTHERAPY WERE RANDOMIZED TO A YOGA (YG; N = 53) OR STRETCHING (ST; N = 56) INTERVENTION OR A WAITLIST CONTROL GROUP (WL; N = 54). DEPRESSIVE SYMPTOMS AND SLEEP DISTURBANCES WERE MEASURED AT BASELINE. MEDIATOR (POSTTRAUMATIC STRESS SYMPTOMS, BENEFIT FINDING, AND CORTISOL SLOPE) AND OUTCOME (36-ITEM SHORT FORM [SF]-36 MENTAL AND PHYSICAL COMPONENT SCALES [MCS AND PCS]) VARIABLES WERE ASSESSED AT BASELINE, END-OF-TREATMENT, AND 1-, 3-, AND 6-MONTHS POSTTREATMENT. RESULTS BASELINE DEPRESSIVE SYMPTOMS (P = .03) AND SLEEP DISTURBANCES (P < .01) MODERATED THE GROUP X TIME EFFECT ON MCS, BUT NOT PCS. WOMEN WITH HIGH BASELINE DEPRESSIVE SYMPTOMS IN YG REPORTED MARGINALLY HIGHER 3-MONTH MCS THAN THEIR COUNTERPARTS IN WL (P = .11). WOMEN WITH HIGH BASELINE SLEEP DISTURBANCES IN YG REPORTED HIGHER 3-MONTHS MCS THAN THEIR COUNTERPARTS IN WL (P < .01) AND HIGHER 6-MONTH MCS THAN THEIR COUNTERPARTS IN ST (P = .01). YG LED TO GREATER BENEFIT FINDING THAN ST AND WL ACROSS THE FOLLOW-UP (P = .01). THREE-MONTH BENEFIT FINDING PARTIALLY MEDIATED THE EFFECT OF YG ON 6-MONTH PCS. POSTTRAUMATIC STRESS SYMPTOMS AND CORTISOL SLOPE DID NOT MEDIATE TREATMENT EFFECT ON QOL. CONCLUSION YOGA MAY PROVIDE THE GREATEST MENTAL-HEALTH-RELATED QOL BENEFITS FOR THOSE EXPERIENCING PRE-RADIOTHERAPY SLEEP DISTURBANCE AND DEPRESSIVE SYMPTOMS. YOGA MAY IMPROVE PHYSICAL-HEALTH-RELATED QOL BY INCREASING ABILITY TO FIND BENEFIT IN THE CANCER EXPERIENCE. 2016 17 1080 31 EFFECTS OF YOGA ON QUALITY OF SLEEP OF WOMEN WITH PREMENSTRUAL SYNDROME. OBJECTIVE: WOMEN WITH PREMENSTRUAL SYNDROME (PMS) COMMONLY COMPLAIN OF SLEEP DISTURBANCES, SPECIFICALLY IN THE LUTEAL PHASE OF THE MENSTRUAL CYCLE. THEREFORE, THE EFFECTS OF YOGA ON QUALITY OF SLEEP OF WOMEN EXPERIENCING PMS WAS INVESTIGATED. MATERIAL AND METHODS: WOMEN (AGED 20-45 Y) MONITORED FOR PMS, WHO WERE REFERRED TO THE PRIVATE OBSTETRICS AND GYNECOLOGY CLINICS IN TABRIZ, IRAN, WERE REFERRED TO THE PRIVATE OBSTETRICS AND GYNECOLOGY CLINICS IN TABRIZ, IRAN. AFTERWARD, 62 WOMEN, WERE SELECTED AND DIVIDED INTO 2 GROUPS, RANDOMLY: 31 SUBJECTS IN YOGA THE YOGA GROUP AND 31 IN THE CONTROL GROUP. SUBJECTS IN YOGA PERFORMED FOR 10 WK IN 3 SESSIONS, WITH EACH SESSION LASTING 60 MIN. SUBJECTS IN THE CONTROL GROUP DID NOT PERFORM ANY YOGA. SUBJECTS COMPLETED A DEMOGRAPHIC QUESTIONNAIRE AND THE PITTSBURGH SLEEP QUALITY INDEX QUESTIONNAIRE BEFORE AND AFTER YOGA IN BOTH GROUPS. RESULTS: AFTER YOGA INTERVENTION, SUBJECTS SIGNIFICANTLY EXPRESSED IMPROVEMENT IN SLEEPING (P < .05). BASED ON THE MANN-WHITNEY U TEST, A SIGNIFICANT DIFFERENCE WAS OBSERVED IN THE SUBDOMAINS OF BOTH GROUPS ON QUALITY OF SLEEP (P < .01), SLEEP LATENCY (P < .01), AND SLEEP EFFICIENCY (P < .05). CONCLUSION: YOGA REDUCED THE DISTURBANCES OF SLEEP IN THE SUBJECTS WITH PMS, WHICH SUBSEQUENTLY IMPROVED THE EFFICIENCY OF THEIR SLEEP. THEREFORE, WE CONCLUDE THAT YOGA CAN BE PRESCRIBED FOR IMPROVING SLEEP DISTURBANCES IN WOMEN WITH PMS AND MEDICAL THERAPY WILL PROBABLY BE NEEDED IN SEVERE SITUATIONS. 2019 18 2323 41 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 19 2415 40 YOGA AND MEDITATION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS-A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: BREAST CANCER SURVIVORS HAVE ONLY VERY LIMITED TREATMENT OPTIONS FOR MENOPAUSAL SYMPTOMS. THE OBJECTIVE OF THIS TRIAL WAS TO EVALUATE THE EFFECTS OF A 12-WEEK TRADITIONAL HATHA YOGA AND MEDITATION INTERVENTION ON MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. METHODS: PATIENTS WERE RANDOMLY ASSIGNED EITHER TO A 12-WEEK YOGA AND MEDITATION INTERVENTION OR TO USUAL CARE. THE PRIMARY OUTCOME MEASURE WAS TOTAL MENOPAUSAL SYMPTOMS (MENOPAUSE RATING SCALE [MRS] TOTAL SCORE). SECONDARY OUTCOME MEASURES INCLUDED MRS SUBSCALES, QUALITY OF LIFE (FUNCTIONAL ASSESSMENT OF CANCER THERAPY-BREAST), FATIGUE (FUNCTIONAL ASSESSMENT OF CHRONIC ILLNESS THERAPY-FATIGUE), DEPRESSION, AND ANXIETY (HOSPITAL ANXIETY AND DEPRESSION SCALE). OUTCOMES WERE ASSESSED AT WEEK 12 AND WEEK 24 AFTER RANDOMIZATION. RESULTS: IN TOTAL, 40 WOMEN (MEAN AGE +/- STANDARD DEVIATION, 49.2 +/- 5.9 YEARS) WERE RANDOMIZED TO YOGA (N = 19) OR TO USUAL CARE (N = 21). WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LOWER TOTAL MENOPAUSAL SYMPTOMS COMPARED WITH THE USUAL CARE GROUP AT WEEK 12 (MEAN DIFFERENCE, -5.6; 95% CONFIDENCE INTERVAL, -9.2 TO -1.9; P = .004) AND AT WEEK 24 (MEAN DIFFERENCE, -4.5; 95% CONFIDENCE INTERVAL, -8.3 TO -0.7; P = .023). AT WEEK 12, THE YOGA GROUP REPORTED LESS SOMATOVEGETATIVE, PSYCHOLOGICAL, AND UROGENITAL MENOPAUSAL SYMPTOMS; LESS FATIGUE; AND IMPROVED QUALITY OF LIFE (ALL P < .05). AT WEEK 24, ALL EFFECTS PERSISTED EXCEPT FOR PSYCHOLOGICAL MENOPAUSAL SYMPTOMS. SHORT-TERM EFFECTS ON MENOPAUSAL SYMPTOMS REMAINED SIGNIFICANT WHEN ONLY WOMEN WHO WERE RECEIVING ANTIESTROGEN MEDICATION (N = 36) WERE ANALYZED. SIX MINOR ADVERSE EVENTS OCCURRED IN EACH GROUP. CONCLUSIONS: YOGA COMBINED WITH MEDITATION CAN BE CONSIDERED A SAFE AND EFFECTIVE COMPLEMENTARY INTERVENTION FOR MENOPAUSAL SYMPTOMS IN BREAST CANCER SURVIVORS. THE EFFECTS SEEM TO PERSIST FOR AT LEAST 3 MONTHS. 2015 20 2726 29 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