1 2726 113 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
2 2031 47 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
3 2321 46 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
4 1980 29 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
5 761 37 EFFECT OF SUDARSHAN KRIYA YOGA (SKY) ON DAYTIME AND SITUATIONAL SLEEP PROPENSITY IN NOVICE PRACTITIONERS: A PROSPECTIVE COHORT STUDY. OBJECTIVES: HECTIC, LATE-NIGHT LIFESTYLE HAS REDUCED 90 MIN SLEEP IN 20% ADULTS RESULTING IN INSOMNIA AND EXCESSIVE DAYTIME SLEEPINESS (EDS). WE ASSESS THE SCOPE OF SUDARSHAN KRIYA YOGA (SKY), A 4-COMPONENT, BREATHING PROCESS IN REDUCING EDS, GENERALLY AND SITUATIONALLY. METHODS: THIS IS A PROSPECTIVE, CONTROLLED STUDY INVOLVING RANDOMIZED SUBJECTS WITHOUT ANY SLEEP-WAKE CYCLE ANOMALIES AND PRIOR EXPERIENCE IN SKY. SUBJECTS (N=52) PERFORMED 30 MIN OF SKY FOR 6 DAYS/WEEK FOR 8 WEEKS, WHILE CONTROLS (N=53) PERFORMED SITTING ACTIVITY AND SURYANAMASKAR FOR 4-WEEKS EACH. EPWORTH SLEEPINESS SCALE (ESS) WAS USED TO MEASURE EDS AT 0, 4, AND 8 WEEKS. RESULTS: SKY GROUP SHOWED SIGNIFICANT ESS SCORE IMPROVEMENTS BETWEEN 0-4 WEEKS AND 4-8 WEEKS OF 1.22 (P=0.0001) AND 1.66 (P=0.001) RESPECTIVELY. CONTROLS HOWEVER FAILED TO IMPROVE WITH SCORE DIFFERENCES OF 0.02 (P=0.892) AND 0.02 (P=0.8212) RESPECTIVELY. SKY GROUP SHOWED SIGNIFICANT ESS SCORE IMPROVEMENT OVER CONTROLS AT 4-WEEKS (DIFFERENCE=1.74; P=0.013) AND 8-WEEKS (DIFFERENCE EIGHT; P=0.0001). IMPROVEMENT WAS MOST FOR OBESE PEOPLE AND THOSE SITTING IN A HALTED CAR. CONCLUSIONS: IMPROVEMENT IN SUBJECTS' NIGHTTIME SLEEP AND DAYTIME WAKEFULNESS IN SKY PRACTITIONERS CAN BE ATTRIBUTED TO POLYVAGAL THEORY. INCREASED HEART RATE VARIABILITY (HRV) ALTERATIONS AND SYMPATHETIC HYPERAROUSAL IN CHRONIC INSOMNIA; AND CHOLINERGIC AND GABAERGIC DYSREGULATION IN ANXIETY DISORDERS ARE COUNTERED BY REGULATED VAGAL NERVE STIMULATION POST SKY. OUR STUDY ESTABLISHES EFFECTIVITY OF SKY IN REDUCING EDS (TOTAL AND SITUATIONAL), PROVIDES A CLINICAL CORRELATION FOR PRIOR POLYSOMNOGRAPHIC EVIDENCE AND PAVES WAY FOR LARGER TRIALS DIRECTED TOWARDS SKY PRESCRIPTIONS FOR INSOMNIA. 2020
6 2323 43 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
7 117 38 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
8 1020 39 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
9 1650 44 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 </= .05) COMPARED WITH STANDARD CARE PARTICIPANTS. CONCLUSION: YOGA, SPECIFICALLY THE YOCAS PROGRAM, IS A USEFUL TREATMENT FOR IMPROVING SLEEP QUALITY AND REDUCING SLEEP MEDICATION USE AMONG CANCER SURVIVORS. 2013
10 2851 45 YOGA, PHYSICAL THERAPY, AND BACK PAIN EDUCATION FOR SLEEP QUALITY IN LOW-INCOME RACIALLY DIVERSE ADULTS WITH CHRONIC LOW BACK PAIN: A SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: POOR SLEEP IS COMMON AMONG ADULTS WITH CHRONIC LOW BACK PAIN (CLBP), BUT THE INFLUENCE OF CLBP TREATMENTS, SUCH AS YOGA AND PHYSICAL THERAPY (PT), ON SLEEP QUALITY IS UNDER STUDIED. OBJECTIVE: EVALUATE THE EFFECTIVENESS OF YOGA AND PT FOR IMPROVING SLEEP QUALITY IN ADULTS WITH CLBP. DESIGN: SECONDARY ANALYSIS OF A RANDOMIZED CONTROLLED TRIAL. SETTING: ACADEMIC SAFETY-NET HOSPITAL AND 7 AFFILIATED COMMUNITY HEALTH CENTERS. PARTICIPANTS: A TOTAL OF 320 ADULTS WITH CLBP. INTERVENTION: TWELVE WEEKLY YOGA CLASSES, 1-ON-1 PT SESSIONS, OR AN EDUCATIONAL BOOK. MAIN MEASURES: SLEEP QUALITY WAS MEASURED USING THE PITTSBURGH SLEEP QUALITY INDEX (PSQI) GLOBAL SCORE (0-21) AT BASELINE, 12 WEEKS, AND 52 WEEKS. ADDITIONALLY, WE ALSO EVALUATED HOW THE PROPORTION OF PARTICIPANTS WHO ACHIEVED A CLINICALLY MEANINGFUL IMPROVEMENT IN SLEEP QUALITY (> 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
11 1866 34 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
12 2631 24 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
13 2250 43 THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON BLOOD BIOMARKERS, AUTONOMIC FUNCTIONS, AND PSYCHOLOGICAL PARAMETERS OF PATIENTS WITH CHRONIC FATIGUE SYNDROME: A PILOT STUDY. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT PRACTICING SEATED ISOMETRIC YOGA REGULARLY FOR 2 MONTHS IMPROVED THE FATIGUE OF PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS PILOT STUDY WAS TO INVESTIGATE THE POSSIBLE MECHANISMS BEHIND THIS FINDING BY COMPARING BLOOD BIOMARKERS, AUTONOMIC NERVOUS FUNCTION, AND PSYCHOLOGICAL INDICES BEFORE VERSUS AFTER AN INTERVENTION PERIOD OF SEATED ISOMETRIC YOGA PRACTICE. METHODS: FIFTEEN PATIENTS WITH CFS WHO DID NOT SHOW SATISFACTORY IMPROVEMENTS AFTER AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SEATED ISOMETRIC YOGA (BIWEEKLY 20-MIN SESSIONS WITH A YOGA INSTRUCTOR AND DAILY PRACTICE AT HOME) FOR 2 MONTHS. THE LONGITUDINAL EFFECTS OF SEATED ISOMETRIC YOGA ON FATIGUE, BLOOD BIOMARKERS, AUTONOMIC FUNCTION, AND PSYCHOLOGICAL STATE WERE INVESTIGATED BY COMPARING THE FOLLOWING PARAMETERS BEFORE AND AFTER THE INTERVENTION PERIOD: FATIGUE SEVERITY WAS ASSESSED BY THE CHALDER FATIGUE SCALE (FS) SCORE. LEVELS OF THE BLOOD BIOMARKERS CORTISOL, DHEA-S, TNF-ALPHA, IL-6, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, HVA, AND ALPHA-MSH WERE MEASURED. THE AUTONOMIC NERVOUS FUNCTIONS ASSESSED WERE HEART RATE (HR) AND HR VARIABILITY. PSYCHOLOGICAL INDICES INCLUDED THE 20-ITEM TORONTO ALEXITHYMIA SCALE (TAS-20) AND THE HOSPITAL ANXIETY AND DEPRESSION SCALE (HADS). RESULTS: PRACTICING SEATED ISOMETRIC YOGA FOR 2 MONTHS RESULTED IN SIGNIFICANT REDUCTIONS IN THE CHALDER FS (P = 0.002) AND HADS-DEPRESSION (P = 0.02) SCORES. NO SIGNIFICANT CHANGES WERE OBSERVED IN ANY OTHER PARAMETER EVALUATED. THE CHANGE IN CHALDER FS SCORE WAS NOT CORRELATED WITH THE CHANGE IN HADS-DEPRESSION SCORE. HOWEVER, THIS CHANGE WAS POSITIVELY CORRELATED WITH CHANGES IN THE SERUM TNF-ALPHA LEVELS (P = 0.048), THE HIGH FREQUENCY COMPONENT OF HR VARIABILITY (P = 0.042), AND TAS-20 SCORES (P = 0.001). CONCLUSIONS: REGULAR PRACTICE OF SEATED ISOMETRIC YOGA FOR 2 MONTHS REDUCED THE FATIGUE AND DEPRESSIVE SYMPTOM SCORES OF PATIENTS WITH CFS WITHOUT AFFECTING ANY OTHER PARAMETERS WE INVESTIGATED. THIS STUDY FAILED TO IDENTIFY THE MARKERS RESPONSIBLE FOR THE LONGITUDINAL FATIGUE-RELIEVING EFFECT OF SEATED ISOMETRIC YOGA. HOWEVER, CONSIDERING THAT THE REDUCED FATIGUE WAS ASSOCIATED WITH DECREASED SERUM TNF-ALPHA LEVEL AND TAS-20 SCORES, FATIGUE IMPROVEMENT MIGHT BE RELATED TO REDUCED INFLAMMATION AND IMPROVED ALEXITHYMIA IN THESE PATIENTS. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012. 2019
14 2521 42 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
15 1087 37 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
16 451 39 CHANGES IN FATIGUE, AUTONOMIC FUNCTIONS, AND BLOOD BIOMARKERS DUE TO SITTING ISOMETRIC YOGA IN PATIENTS WITH CHRONIC FATIGUE SYNDROME. BACKGROUND: IN A PREVIOUS RANDOMIZED CONTROLLED TRIAL, WE FOUND THAT SITTING ISOMETRIC YOGA IMPROVES FATIGUE IN PATIENTS WITH CHRONIC FATIGUE SYNDROME (CFS) WHO ARE RESISTANT TO CONVENTIONAL THERAPY. THE AIM OF THIS STUDY WAS TO INVESTIGATE POSSIBLE MECHANISMS BEHIND THIS FINDING, FOCUSING ON THE SHORT-TERM FATIGUE-RELIEVING EFFECT, BY COMPARING AUTONOMIC NERVOUS FUNCTION AND BLOOD BIOMARKERS BEFORE AND AFTER A SESSION OF ISOMETRIC YOGA. METHODS: FIFTEEN PATIENTS WITH CFS WHO REMAINED SYMPTOMATIC DESPITE AT LEAST 6 MONTHS OF CONVENTIONAL THERAPY PRACTICED SITTING ISOMETRIC YOGA (BIWEEKLY 20 MIN PRACTICE WITH A YOGA INSTRUCTOR AND DAILY HOME PRACTICE) FOR EIGHT WEEKS. ACUTE EFFECTS OF SITTING ISOMETRIC YOGA ON FATIGUE, AUTONOMIC FUNCTION, AND BLOOD BIOMARKERS WERE INVESTIGATED AFTER THE FINAL SESSION WITH AN INSTRUCTOR. THE EFFECT OF A SINGLE SESSION OF SITTING ISOMETRIC YOGA ON FATIGUE WAS ASSESSED BY THE PROFILE OF MOOD STATUS (POMS) QUESTIONNAIRE IMMEDIATELY BEFORE AND AFTER THE SESSION. AUTONOMIC NERVOUS FUNCTION (HEART RATE (HR) VARIABILITY) AND BLOOD BIOMARKERS (CORTISOL, DHEA-S, TNF-ALPHA, IL-6, IFN-GAMMA, IFN-ALPHA, PROLACTIN, CARNITINE, TGF-BETA1, BDNF, MHPG, AND HVA) WERE COMPARED BEFORE AND AFTER THE SESSION. RESULTS: SITTING ISOMETRIC YOGA SIGNIFICANTLY REDUCED THE POMS FATIGUE SCORE (P < 0.01) AND INCREASED THE VIGOR SCORE (P < 0.01). IT ALSO REDUCED HR (P < 0.05) AND INCREASED THE HIGH FREQUENCY POWER (P < 0.05) OF HR VARIABILITY. SITTING ISOMETRIC YOGA INCREASED SERUM LEVELS OF DHEA-S (P < 0.05), REDUCED LEVELS OF CORTISOL (P < 0.05) AND TNF-ALPHA (P < 0.05), AND HAD A TENDENCY TO REDUCE SERUM LEVELS OF PROLACTIN (P < 0.1). DECREASES IN FATIGUE SCORES CORRELATED WITH CHANGES IN PLASMA LEVELS OF TGF-BETA1 AND BDNF. IN CONTRAST, INCREASED VIGOR POSITIVELY CORRELATED WITH HVA. CONCLUSIONS: A SINGLE SESSION OF SITTING ISOMETRIC YOGA REDUCED FATIGUE AND INCREASED VIGOR IN PATIENTS WITH CFS. YOGA ALSO INCREASED VAGAL NERVE FUNCTION AND CHANGED BLOOD BIOMARKERS IN A PATTERN THAT SUGGESTED ANTI-STRESS AND ANTI-INFLAMMATORY EFFECTS. THESE CHANGES APPEAR TO BE RELATED TO THE SHORT-TERM FATIGUE-RELIEVING EFFECT OF SITTING ISOMETRIC YOGA IN PATIENTS WITH CFS. FURTHERMORE, DOPAMINERGIC NERVOUS SYSTEM ACTIVATION MIGHT ACCOUNT FOR SITTING ISOMETRIC YOGA-INDUCED INCREASES IN ENERGY IN THIS PATIENT POPULATION. TRIAL REGISTRATION: UNIVERSITY HOSPITAL MEDICAL INFORMATION NETWORK (UMIN CTR) UMIN000009646. REGISTERED DEC 27, 2012. 2018
17 1981 36 SLEEP QUALITY AND BODY COMPOSITION VARIATIONS IN OBESE MALE ADULTS AFTER 14 WEEKS OF YOGA INTERVENTION: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: OBESITY IS A BIG CHALLENGE ALL OVER THE WORLD. IT IS ASSOCIATED WITH MANY NONCOMMUNICABLE DISEASES. YOGA KNOWN TO BE ADD-ON TREATMENT MAY BE EFFECTIVE FOR OBESITY CONTROL. AIM: TO ASSESS THE EFFECT OF INTEGRATED APPROACH OF YOGA THERAPY (IAYT) FOR BODY COMPOSITION AND QUALITY OF SLEEP IN ADULT OBESE MALE. SUBJECTS AND METHODS: A RANDOMIZED CONTROLLED TRIAL WAS CONDUCTED FOR 14 WEEKS ON OBESE MALE OF URBAN SETTING. EIGHTY INDIVIDUALS WERE RANDOMLY DIVIDED INTO TWO GROUPS, I.E., YOGA GROUP (N = 40; AGE; 40.03 +/- 8.74 YEARS, BODY MASS INDEX [BMI] 28.7 +/- 2.35 KG/M(2)) AND CONTROL GROUP (AGE; 42.20 +/- 12.06 YEARS, BMI 27.70 +/- 2.05 KG/M(2)). THE IAYT WAS IMPARTED TO YOGA GROUP FOR 1(1/2) HOUR FOR 5 DAYS IN A WEEK FOR 14 WEEKS. THE CONTROL GROUP CONTINUED THEIR REGULAR ACTIVITIES. THE BODY COMPOSITION BY INBODY R20 AND SLEEP QUALITY BY PITTSBURGH SLEEP QUALITY INDEX (PSQI) WERE ASSESSED. STATISTICAL ANALYSIS WAS DONE FOR WITHIN AND BETWEEN GROUPS USING SPSS VERSION 21. THE CORRELATION ANALYSIS WAS DONE ON THE DIFFERENCE IN PRE-POST VALUES. RESULTS: THE RESULTS SHOWED THAT WEIGHT (P = 0.004), BMI (P = 0.008), BONE MASS (P = 0.017), OBESITY DEGREE (P = 0.005), AND MINERAL MASS (P = 0.046) WERE IMPROVED IN YOGA GROUP AND NO CHANGE IN CONTROL GROUP (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
18 493 23 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
19 1460 37 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
20 2782 35 YOGA THERAPY AS AN ADD-ON TREATMENT IN THE MANAGEMENT OF PATIENTS WITH SCHIZOPHRENIA--A RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: TREATMENT OF SCHIZOPHRENIA HAS REMAINED UNSATISFACTORY DESPITE THE AVAILABILITY OF ANTIPSYCHOTICS. THIS STUDY EXAMINED THE EFFICACY OF YOGA THERAPY (YT) AS AN ADD-ON TREATMENT TO THE ONGOING ANTIPSYCHOTIC TREATMENT. METHOD: SIXTY-ONE MODERATELY ILL SCHIZOPHRENIA PATIENTS WERE RANDOMLY ASSIGNED TO YT (N = 31) AND PHYSICAL EXERCISE THERAPY (PT; N = 30) FOR 4 MONTHS. THEY WERE ASSESSED AT BASELINE AND 4 MONTHS AFTER THE START OF INTERVENTION, BY A RATER WHO WAS BLIND TO THEIR GROUP STATUS. RESULTS: FORTY-ONE SUBJECTS (YT = 21; PT = 20) WERE AVAILABLE AT THE END OF 4 MONTHS FOR ASSESSMENT. SUBJECTS IN THE YT GROUP HAD SIGNIFICANTLY LESS PSYCHOPATHOLOGY THAN THOSE IN THE PT GROUP AT THE END OF 4 MONTHS. THEY ALSO HAD SIGNIFICANTLY GREATER SOCIAL AND OCCUPATIONAL FUNCTIONING AND QUALITY OF LIFE. CONCLUSION: BOTH NON-PHARMACOLOGICAL INTERVENTIONS CONTRIBUTE TO REDUCTION IN SYMPTOMS, WITH YT HAVING BETTER EFFICACY. 2007