1 1866 143 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 2 1980 55 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 3 261 39 ACUTE AND CHRONIC EFFECTS OF TANTRIC YOGA PRACTICE ON DISTRESS INDEX. OBJECTIVES: TO EVALUATE THE ACUTE AND CHRONIC EFFECTS OF YOGA PRACTICE. DESIGN: QUANTITATIVE STUDY USING A ONE-GROUP PRE-POSTTEST DESIGN. SETTING: VISAO FUTURO INSTITUTE, PORANGABA, SAO PAULO, BRAZIL. PARTICIPANTS: 22 VOLUNTEERS (7 MEN AND 15 WOMEN). INTERVENTION: SIX WEEKS OF A TANTRIC YOGA PROGRAM (TYP), 50 MINUTES PER SESSION, HELD TWICE A WEEK FROM 8 A.M. TO 9 A.M. THE LOCAL ETHICS COMMITTEE APPROVED THE PROTOCOL. OUTCOME MEASURES: DATA WERE COLLECTED IN THE FIRST WEEK AND AT THE END OF THE SIXTH WEEK OF TYP. SALIVARY CORTISOL CONCENTRATION (SCC) WAS USED TO MEASURE PHYSIOLOGY OF DISTRESS AND TO ANALYZE THE SHORT- AND LONG-TERM EFFECTS OF TYP. PSYCHOLOGICAL DISTRESS WAS EVALUATED BY APPLYING A SPECIFIC PERCEIVED STRESS QUESTIONNAIRE (PSQ). RESULTS (MEAN+/-STANDARD DEVIATION) WERE ANALYZED BY WILCOXON TEST (P<0.05). RESULTS: SCC DECREASED 24% AFTER THE FIRST (0.66+/-0.20 MUG/DL VERSUS 0.50+/-0.13 MUG/DL) AND LAST (1.01+/-0.37 VERSUS 0.76+/-0.31 MUG/DL) SESSIONS, SHOWING THE SHORT-TERM EFFECT OF YOGA. LONG-TERM EFFECTS WERE ANALYZED BY DAILY RHYTHM OF CORTISOL PRODUCTION. IN THE BEGINNING, VOLUNTEERS SHOWED ALTERED SCC DURING THE DAY, WITH NIGHTTIME VALUES (0.42+/-0.28) HIGHER THAN THOSE AT NOON (0.30+/-0.06). AFTER THE TYP, SCC WAS HIGHER IN THE MORNING (1.01+/-0.37) AND DECREASED DURING THE DAY, WITH LOWER VALUES BEFORE SLEEP (0.30+/-0.13). THE TYP WAS ALSO EFFICIENT TO REDUCE PSQ SCORES (0.45+/-0.13 VERSUS 0.39+/-0.07). SPECIFICALLY, THE IRRITABILITY, TENSION, AND FATIGUE DOMAINS ON THE PSQ DECREASED (0.60+/-0.20 VERSUS 0.46+/-0.13), AS DID THE FEAR AND ANXIETY DOMAINS (0.54+/-0.30 VERSUS 0.30+/-0.20). CONCLUSION: OVER THE SHORT TERM, TYP LED TO THE DECREASE OF CORTISOL PRODUCTION. OVER THE LONG TERM, TYP INDUCED HIGHER CORTISOL PRODUCTION IN THE MORNING AND LOWER PRODUCTION IN THE EVENING. THOSE EFFECTS CONTRIBUTED TO THE PHYSICAL AND MENTAL WELL-BEING OF THE PARTICIPANTS. 2015 4 1194 43 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 5 1750 27 PILOT STUDY OF YOGA FOR BREAST CANCER SURVIVORS WITH POOR QUALITY OF LIFE. INTRODUCTION: STUDIES SHOW BENEFITS OF YOGA FOR BREAST CANCER PATIENTS WITH POOR QUALITY OF LIFE (QOL); HOWEVER, NONE EXCLUSIVELY FOCUS ON SURVIVORS. THIS STUDY ADDRESSES WHETHER HATHA YOGA IMPROVES BREAST CANCER SURVIVORS' QOL. METHODS: 25 BREAST CANCER SURVIVORS COMPLETED SIX WEEKS OF YOGA. OUTCOME MEASURES WERE 5 QOL CATEGORIES EVALUATED USING THE FACT-B SURVEY PRE AND POST-INTERVENTION AND AFTER 6 MONTHS. RESULTS: EACH CATEGORY WAS EVALUATED INDEPENDENTLY, INCLUDING: PHYSICAL (PWB), SOCIAL (SWB), EMOTIONAL (EWB), FUNCTIONAL (FWB), BREAST CANCER SPECIFIC WELL-BEING (BCS), TRIAL OUTCOME INDEX (TOI), FACT-G, AND FACT-B. SIGNIFICANT IMPROVEMENT WAS FOUND IN ALL CATEGORIES EXCEPT SOCIAL WELL-BEING (PWB P = .013, EWB P = .005, FWB P = .003, BCS P < .001, TOI P < .001, FACT-G P = .004, FACT-B P < .001). PATIENTS WITH BELOW AVERAGE PRE-INTERVENTION INDEX SCORES (N = 13) SHOWED GREATER IMPROVEMENT IN EWB AND FWB, WHILE THOSE WITH ABOVE AVERAGE PRE-INTERVENTION SCORES (N = 9) SHOWED GREATER IMPROVEMENT IN PWB. CONCLUSIONS: YOGA MAY BE FEASIBLE AND CLINICALLY USEFUL FOR BREAST CANCER SURVIVORS WITH POOR QOL. 2012 6 2762 42 YOGA PROGRAM FOR HIGH-GRADE GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS. BACKGROUND: DESPITE THEIR HIGH SYMPTOM BURDEN AND POOR PROGNOSIS, EVIDENCE-BASED SUPPORTIVE CARE INTERVENTIONS FOR ADULTS WITH HIGH-GRADE GLIOMA (HGG) AND THEIR CAREGIVERS ARE LACKING. THUS, WE AIMED TO ESTABLISH FEASIBILITY OF A PATIENT-CAREGIVER DYADIC YOGA PROGRAM (DYP) FOR NEWLY DIAGNOSED HGG PATIENTS AND THEIR FAMILY CAREGIVERS TARGETING QUALITY-OF-LIFE (QOL) OUTCOMES. METHOD: IN THIS SINGLE-ARM PILOT TRIAL, DYADS PARTICIPATED IN A 12-SESSION DYP PROGRAM ACROSS THE COURSE OF PATIENTS' RADIOTHERAPY. THE INTERVENTION FOCUSED ON BREATHING EXERCISES, GENTLE MOVEMENTS, AND GUIDED MEDITATIONS. WE TRACKED FEASIBILITY DATA AND ASSESSED LEVELS OF CANCER-RELATED SYMPTOMS (MD ANDERSON SYMPTOM INVENTORY [MDASI]), DEPRESSIVE SYMPTOMS (CENTERS FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION SCALE), FATIGUE (BRIEF FATIGUE INVENTORY), SLEEP DISTURBANCES (PITTSBURGH SLEEP QUALITY INDEX [PSQI]), AND OVERALL MENTAL AND PHYSICAL QOL (36-ITEM SHORT-FORM SURVEY [SF-36]) AT BASELINE AND POST-DYP, WHICH WAS AT THE END OF RADIOTHERAPY. RESULTS: WE APPROACHED 6 DYADS OF WHICH 5 DYADS (86%) CONSENTED AND COMPLETED ALL 12 SESSIONS AND PRE/POST ASSESSMENTS. ALL PATIENTS (MEAN AGE: 52 YEARS, 80% FEMALE, 80% GRADE IV) AND CAREGIVERS (MEAN AGE: 58 YEARS, 80% FEMALE, 60% SPOUSES) PERCEIVED BENEFIT FROM THE PROGRAM. PAIRED T TESTS REVEALED A MARGINALLY SIGNIFICANT, YET CLINICALLY MEANINGFUL, DECREASE IN PATIENT'S CANCER SYMPTOMS ( T = 2.32, P = .08; MDASI MEAN; PRE = 1.75, POST = 1.04). THERE WERE CLINICALLY SIGNIFICANT REDUCTIONS IN PATIENT SLEEP DISTURBANCES (PSQI MEAN: PRE = 10.75, POST = 8.00) AND IMPROVEMENTS IN PATIENT AND CAREGIVER MENTAL QOL (MCS OF SF-36 MEAN: PRE = 42.35, POST = 52.34, AND PRE = 45.14, POST = 51.43, RESPECTIVELY). CONCLUSIONS: THIS NOVEL SUPPORTIVE CARE PROGRAM APPEARS TO BE SAFE, FEASIBLE, ACCEPTABLE, AND SUBJECTIVELY USEFUL FOR HGG PATIENTS AND THEIR CAREGIVERS. THERE WAS ALSO PRELIMINARY EVIDENCE REGARDING QOL TREATMENT GAINS FOR BOTH PATIENTS AND CAREGIVERS. 2018 7 2654 46 YOGA IMPROVES QUALITY OF LIFE AND BENEFIT FINDING IN WOMEN UNDERGOING RADIOTHERAPY FOR BREAST CANCER. THIS STUDY EXAMINED THE EFFECTS OF YOGA ON QUALITY OF LIFE (QOL) AND PSYCHOSOCIAL OUTCOMES IN WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. SIXTY-ONE WOMEN WERE RANDOMLY ASSIGNED TO EITHER A YOGA OR A WAIT-LIST GROUP. YOGA CLASSES WERE TAUGHT BIWEEKLY DURING THE 6 WEEKS OF RADIOTHERAPY. PARTICIPANTS COMPLETED MEASURES OF QOL, FATIGUE, BENEFIT FINDING (FINDING MEANING IN THE CANCER EXPERIENCE), INTRUSIVE THOUGHTS, SLEEP DISTURBANCES, DEPRESSIVE SYMPTOMS, AND ANXIETY BEFORE RADIOTHERAPY AND THEN AGAIN 1 WEEK, 1 MONTH, AND 3 MONTHS AFTER THE END OF RADIOTHERAPY. GENERAL LINEAR MODEL ANALYSES REVEALED THAT COMPARED TO THE CONTROL GROUP, THE YOGA GROUP REPORTED SIGNIFICANTLY BETTER GENERAL HEALTH PERCEPTION (P = .005) AND PHYSICAL FUNCTIONING SCORES (P = .04) 1 WEEK POSTRADIOTHERAPY; HIGHER LEVELS OF INTRUSIVE THOUGHTS 1 MONTH POSTRADIOTHERAPY (P = .01); AND GREATER BENEFIT FINDING 3 MONTHS POSTRADIOTHERAPY (P = .01). THERE WERE NO OTHER GROUP DIFFERENCES IN OTHER QOL SUBSCALES FOR FATIGUE, DEPRESSION, OR SLEEP SCORES. EXPLORATORY ANALYSES INDICATED THAT INTRUSIVE THOUGHTS 1 MONTH AFTER RADIOTHERAPY WERE SIGNIFICANTLY POSITIVELY CORRELATED WITH BENEFIT FINDING 3 MONTHS AFTER RADIOTHERAPY (R = .36, P = .011). OUR RESULTS INDICATED THAT THE YOGA PROGRAM WAS ASSOCIATED WITH STATISTICALLY AND CLINICALLY SIGNIFICANT IMPROVEMENTS IN ASPECTS OF QOL. 2010 8 1517 40 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 1868 54 RANDOMIZED, CONTROLLED TRIAL OF YOGA IN WOMEN WITH BREAST CANCER UNDERGOING RADIOTHERAPY. PURPOSE: PREVIOUS RESEARCH INCORPORATING YOGA (YG) INTO RADIOTHERAPY (XRT) FOR WOMEN WITH BREAST CANCER FINDS IMPROVED QUALITY OF LIFE (QOL). HOWEVER, SHORTCOMINGS IN THIS RESEARCH LIMIT THE FINDINGS. PATIENTS AND METHODS: PATIENTS WITH STAGES 0 TO III BREAST CANCER WERE RECRUITED BEFORE STARTING XRT AND WERE RANDOMLY ASSIGNED TO YG (N = 53) OR STRETCHING (ST; N = 56) THREE TIMES A WEEK FOR 6 WEEKS DURING XRT OR WAITLIST (WL; N = 54) CONTROL. SELF-REPORT MEASURES OF QOL (MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM SURVEY; PRIMARY OUTCOMES), FATIGUE, DEPRESSION, AND SLEEP QUALITY, AND FIVE SALIVA SAMPLES PER DAY FOR 3 CONSECUTIVE DAYS WERE COLLECTED AT BASELINE, END OF TREATMENT, AND 1, 3, AND 6 MONTHS LATER. RESULTS: THE YG GROUP HAD SIGNIFICANTLY GREATER INCREASES IN PHYSICAL COMPONENT SCALE SCORES COMPARED WITH THE WL GROUP AT 1 AND 3 MONTHS AFTER XRT (P = .01 AND P = .01). AT 1, 3, AND 6 MONTHS, THE YG GROUP HAD GREATER INCREASES IN PHYSICAL FUNCTIONING COMPARED WITH BOTH ST AND WL GROUPS (P < .05), WITH ST AND WL DIFFERENCES AT ONLY 3 MONTHS (P < .02). THE GROUP DIFFERENCES WERE SIMILAR FOR GENERAL HEALTH REPORTS. BY THE END OF XRT, THE YG AND ST GROUPS ALSO HAD A REDUCTION IN FATIGUE (P < .05). THERE WERE NO GROUP DIFFERENCES FOR MENTAL HEALTH AND SLEEP QUALITY. CORTISOL SLOPE WAS STEEPEST FOR THE YG GROUP COMPARED WITH THE ST AND WL GROUPS AT THE END (P = .023 AND P = .008) AND 1 MONTH AFTER XRT (P = .05 AND P = .04). CONCLUSION: YG IMPROVED QOL AND PHYSIOLOGICAL CHANGES ASSOCIATED WITH XRT BEYOND THE BENEFITS OF SIMPLE ST EXERCISES, AND THESE BENEFITS APPEAR TO HAVE LONG-TERM DURABILITY. 2014 10 962 37 EFFECTS OF A YOGA PROGRAM ON CORTISOL RHYTHM AND MOOD STATES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY: A RANDOMIZED CONTROLLED TRIAL. UNLABELLED: OBJECTIVES. THIS STUDY COMPARES THE EFFECTS OF AN INTEGRATED YOGA PROGRAM WITH BRIEF SUPPORTIVE THERAPY IN BREAST CANCER OUTPATIENTS UNDERGOING ADJUVANT RADIOTHERAPY AT A CANCER CENTER. METHODS: EIGHTY-EIGHT STAGE II AND III BREAST CANCER OUTPATIENTS ARE RANDOMLY ASSIGNED TO RECEIVE YOGA (N = 44) OR BRIEF SUPPORTIVE THERAPY (N = 44) PRIOR TO RADIOTHERAPY TREATMENT. ASSESSMENTS INCLUDE DIURNAL SALIVARY CORTISOL LEVELS 3 DAYS BEFORE AND AFTER RADIOTHERAPY AND SELF-RATINGS OF ANXIETY, DEPRESSION, AND STRESS COLLECTED BEFORE AND AFTER 6 WEEKS OF RADIOTHERAPY. RESULTS: ANALYSIS OF COVARIANCE REVEALS SIGNIFICANT DECREASES IN ANXIETY (P < .001), DEPRESSION (P = .002), PERCEIVED STRESS (P < .001), 6 A.M. SALIVARY CORTISOL (P = .009), AND POOLED MEAN CORTISOL (P = .03) IN THE YOGA GROUP COMPARED WITH CONTROLS. THERE IS A SIGNIFICANT POSITIVE CORRELATION BETWEEN MORNING SALIVARY CORTISOL LEVEL AND ANXIETY AND DEPRESSION. CONCLUSION: YOGA MIGHT HAVE A ROLE IN MANAGING SELF-REPORTED PSYCHOLOGICAL DISTRESS AND MODULATING CIRCADIAN PATTERNS OF STRESS HORMONES IN EARLY BREAST CANCER PATIENTS UNDERGOING ADJUVANT RADIOTHERAPY. 2009 11 117 39 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 12 648 38 DYADIC YOGA PROGRAM FOR PATIENTS UNDERGOING THORACIC RADIOTHERAPY AND THEIR FAMILY CAREGIVERS: RESULTS OF A PILOT RANDOMIZED CONTROLLED TRIAL. OBJECTIVE: THORACIC RADIOTHERAPY (TRT) MAY RESULT IN TOXICITIES THAT ARE ASSOCIATED WITH PERFORMANCE DECLINES AND POOR QUALITY OF LIFE (QOL) FOR PATIENTS AND THEIR FAMILY CAREGIVERS. THE PURPOSE OF THIS RANDOMIZED CONTROLLED TRIAL WAS TO ESTABLISH FEASIBILITY AND PRELIMINARY EFFICACY OF A DYADIC YOGA (DY) INTERVENTION AS A SUPPORTIVE CARE STRATEGY. METHODS: PATIENTS WITH STAGE I TO III NON-SMALL CELL LUNG OR ESOPHAGEAL CANCER UNDERGOING TRT AND THEIR CAREGIVERS (N = 26 DYADS) WERE RANDOMIZED TO A 15-SESSION DY OR A WAITLIST CONTROL (WLC) GROUP. PRIOR TO TRT AND RANDOMIZATION, BOTH GROUPS COMPLETED MEASURES OF QOL (SF-36) AND DEPRESSIVE SYMPTOMS (CES-D). PATIENTS ALSO COMPLETED THE 6-MINUTE WALK TEST (6MWT). DYADS WERE REASSESSED ON THE LAST DAY OF TRT AND 3 MONTHS LATER. RESULTS: A PRIORI FEASIBILITY CRITERIA WERE MET REGARDING CONSENT (68%), ADHERENCE (80%), AND RETENTION (81%) RATES. CONTROLLING FOR RELEVANT COVARIATES, MULTILEVEL MODELING ANALYSES REVEALED SIGNIFICANT CLINICAL IMPROVEMENTS FOR PATIENTS IN THE DY GROUP COMPARED WITH THE WLC GROUP FOR THE 6MWT (MEANS: DY = 473 M VS WLC = 397 M, D = 1.19) AND SF-36 PHYSICAL FUNCTION (MEANS: DY = 38.77 VS WLC = 30.88; D = .66) AND SOCIAL FUNCTION (MEANS: DY = 45.24 VS WLC = 39.09; D = .44) ACROSS THE FOLLOW-UP PERIOD. CAREGIVERS IN THE DY GROUP REPORTED MARGINALLY CLINICALLY SIGNIFICANT IMPROVEMENTS IN SF-36 VITALITY (MEANS: DY = 53.05 VS WLC = 48.84; D = .39) AND ROLE PERFORMANCE (MEANS: DY = 52.78 VS WLC = 48.59; D = .51) RELATIVE TO THOSE IN THE WLC GROUP. CONCLUSIONS: THIS NOVEL SUPPORTIVE CARE PROGRAM APPEARS TO BE FEASIBLE AND BENEFICIAL FOR PATIENTS UNDERGOING TRT AND THEIR CAREGIVERS. A LARGER EFFICACY TRIAL WITH A MORE STRINGENT CONTROL GROUP IS WARRANTED. 2019 13 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 14 1748 40 PILOT RANDOMIZED, CONTROLLED TRIAL OF A DYADIC YOGA PROGRAM FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR FAMILY CAREGIVERS. BACKGROUND: WHILE THE USE OF BEHAVIORAL MEDICINE IN MANAGING GLIOMA PATIENTS' SYMPTOMS IS NOT WELL STUDIED, THE HIGH SYMPTOM BURDEN IN PATIENTS AND THEIR FAMILY CAREGIVERS IS WELL ESTABLISHED. WE CONDUCTED A PILOT RANDOMIZED, CONTROLLED TRIAL TO EXAMINE THE FEASIBILITY AND PRELIMINARY EFFICACY OF A DYADIC YOGA (DY) INTERVENTION AS A SUPPORTIVE CARE STRATEGY. METHODS: GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS WERE RANDOMIZED TO A 12-SESSION DY OR WAITLIST CONTROL (WLC) GROUP. PRIOR TO RADIOTHERAPY AND RANDOMIZATION, BOTH GROUPS COMPLETED MEASURES OF CANCER-RELATED SYMPTOMS (MD ANDERSON SYMPTOM INVENTORY-BRAIN TUMOR MODULE), DEPRESSIVE SYMPTOMS (CENTER FOR EPIDEMIOLOGICAL STUDIES-DEPRESSION MEASURE), FATIGUE (BRIEF FATIGUE INVENTORY), AND OVERALL QUALITY OF LIFE (QOL; MEDICAL OUTCOMES STUDY 36-ITEM SHORT-FORM SURVEY). DYADS WERE REASSESSED AT THE LAST DAY OF RADIOTHERAPY. RESULTS: TWENTY PATIENTS (MEAN AGE: 46 YEARS, 50% FEMALE, 80% WHO GRADE IV AND CAREGIVERS (MEAN AGE: 50 YEARS, 70% FEMALE, 50% SPOUSES) PARTICIPATED IN THE TRIAL. A PRIORI FEASIBILITY CRITERIA WERE MET REGARDING CONSENT (70%), ADHERENCE (88%), AND RETENTION (95%) RATES. CONTROLLING FOR RELEVANT COVARIATES, CHANGE SCORE ANALYSES REVEALED CLINICALLY SIGNIFICANT IMPROVEMENTS FOR PATIENTS IN THE DY COMPARED WITH THE WLC GROUP FOR OVERALL CANCER SYMPTOM SEVERITY (D = 0.96) AND SYMPTOM INTERFERENCE (D = 0.74), DEPRESSIVE SYMPTOMS (D = 0.71), AND MENTAL QOL (D = 0.69). CAREGIVERS IN THE DY GROUP REPORTED CLINICALLY SIGNIFICANT IMPROVEMENTS IN DEPRESSIVE SYMPTOMS (D = 1.12), FATIGUE (D = 0.89), AND MENTAL QOL (D = 0.49) RELATIVE TO THOSE IN THE WLC GROUP. CONCLUSION: A DY INTERVENTION APPEARS TO BE A FEASIBLE AND BENEFICIAL SYMPTOM AND QOL MANAGEMENT STRATEGY FOR GLIOMA PATIENTS UNDERGOING RADIOTHERAPY AND THEIR CAREGIVERS. AN EFFICACY TRIAL WITH A MORE STRINGENT CONTROL GROUP IS WARRANTED. CLINICAL TRIAL NUMBER: NCT02481349. 2019 15 189 48 A RANDOMIZED STUDY OF YOGA FOR FATIGUE AND QUALITY OF LIFE IN WOMEN WITH BREAST CANCER UNDERGOING (NEO) ADJUVANT CHEMOTHERAPY. OBJECTIVES: TO COMPARE THE EFFECTIVENESS OF YOGA ADDED TO STANDARD CARE (SC) VERSUS SC ONLY, IN WOMEN WITH BREAST CANCER DURING CHEMOTHERAPY. DESIGN: A MULTICENTER PRAGMATIC, RANDOMIZED CONTROLLED STUDY. SETTINGS/LOCATION: THREE HOSPITALS IN THE NETHERLANDS. SUBJECTS: WOMEN WITH STAGE I-III BREAST CANCER UNDERGOING CHEMOTHERAPY. INTERVENTIONS: WOMEN WERE RANDOMIZED EITHER TO A PROGRAM BASED ON DRU YOGA, ONCE A WEEK YOGA SESSIONS FOR 12 WEEKS (N = 47), OR SC ONLY (N = 36). OUTCOME MEASURES: PRIMARY OUTCOME FATIGUE (MULTIDIMENSIONAL FATIGUE INVENTORY [MFI]; GENERAL FATIGUE) AND SECONDARY OUTCOMES FATIGUE (MFI, FATIGUE QUALITY LIST [FQL]), QUALITY OF LIFE (30-ITEM QUALITY OF LIFE QUESTIONNAIRE-C OF THE EUROPEAN ORGANIZATION FOR RESEARCH AND TREATMENT OF CANCER [EORTC-QLQ-C-30]) AND PSYCHOLOGICAL DISTRESS (HOSPITAL ANXIETY DEPRESSION SCALE [HADS], IMPACT OF EVENTS SCALE [IES]) WERE MEASURED AT BASELINE (T0), 3 MONTHS (T1), AND 6 MONTHS (T2) AND ANALYZED ON OBSERVED CASES. OTHER OUTCOMES WERE ADEQUATE RELIEF, REINTEGRATION TO WORK, AND ADVERSE EVENTS. RESULTS: NO SIGNIFICANT DIFFERENCES WERE FOUND IN GENERAL FATIGUE AT T1 (MFI: YOGA; 14.6 +/- 4.5 VS. SC; 14.2 +/- 4.2, P = 0.987). SIMILAR FINDINGS WERE OBSERVED FOR OTHER FATIGUE (SUB)SCALES OF MFI AND FQL AND FUNCTIONAL DOMAINS OF EORTC. WITH RESPECT TO EORTCS SYMPTOM SCALES, WOMEN IN THE YOGA GROUP REPORTED SIGNIFICANTLY LESS NAUSEA AND VOMITING COMPARED WITH SC AT T2 (P = 0.004), BUT NOT AT T1 (P = 0.807). DEPRESSIVE SYMPTOMS WERE SIGNIFICANTLY LOWER WITH YOGA AT T1 (HADS: YOGA; 4.7 +/- 4.1 VS. SC; 5.1 +/- 4.2, P = 0.031). MORE WOMEN IN THE YOGA GROUP EXPERIENCED ADEQUATE RELIEF COMPARED WITH SC AT T1 (YOGA; 51% VS. SC; 19%) AND HAD RETURNED TO WORK AT T2 (YOGA; 53% VS. SC; 23%). NO ADVERSE EVENTS WERE REPORTED WITH YOGA. CONCLUSIONS: A DRU-BASED YOGA PROGRAM FAILED TO DEMONSTRATE A SIGNIFICANT BENEFICIAL EFFECT ON FATIGUE. POSSIBLE FAVORABLE EFFECTS OF THE YOGA PROGRAM ON NAUSEA AND VOMITING AND EARLY RETURN TO WORK IN BREAST CANCER SURVIVORS WARRANT FURTHER RESEARCH. 2018 16 2529 37 YOGA EFFECTIVELY REDUCES FATIGUE AND SYMPTOMS OF DEPRESSION IN PATIENTS WITH DIFFERENT TYPES OF CANCER. PURPOSE: EXAMINE THE EFFECTS OF AN 8-WEEK YOGA THERAPY ON FATIGUE IN PATIENTS WITH DIFFERENT TYPES OF CANCER. METHODS: A TOTAL OF 173 CANCER PATIENTS SUFFERING FROM MILD TO SEVERE FATIGUE WERE RANDOMLY ALLOCATED TO YOGA INTERVENTION (N = 84) (IG) VERSUS WAITLIST CONTROL GROUP (CG) (N = 88). YOGA THERAPY CONSISTED OF EIGHT WEEKLY SESSIONS WITH 60 MIN EACH. THE PRIMARY OUTCOME WAS SELF-REPORTED FATIGUE SYMPTOMS. SECONDARY OUTCOMES WERE SYMPTOMS OF DEPRESSION AND QUALITY OF LIFE (QOL). DATA WERE ASSESSED USING QUESTIONNAIRES BEFORE (T0) AND AFTER YOGA THERAPY FOR IG VERSUS WAITING PERIOD FOR CG (T1). RESULTS: A STRONGER REDUCTION OF GENERAL FATIGUE (P = .033), PHYSICAL FATIGUE (P = .048), AND DEPRESSION (P < .001) AS WELL AS A STRONGER INCREASE IN QOL (P = .002) WAS FOUND FOR PATIENTS WHO ATTENDED 7 OR 8 SESSIONS COMPARED WITH CONTROLS. WITHIN THE YOGA GROUP, BOTH HIGHER ATTENDANCE RATE AND LOWER T0-FATIGUE WERE SIGNIFICANT PREDICTORS OF LOWER T1-FATIGUE (P /= 80% OF YOGA PARTICIPANTS REPORTING AVERAGE SLEEP ONSET LATENCY < 30 MINUTES AND SLEEP EFFICIENCY > 80% AT 6-MONTH FOLLOW-UP. FOR OVER 50% OF YOGA PARTICIPANTS, THE INSOMNIA SEVERITY INDEX DECREASED BY AT LEAST 8 POINTS AT END OF TREATMENT AND FOLLOW-UP. CONCLUSIONS: YOGA, TAUGHT IN A SELF-CARE FRAMEWORK WITH MINIMAL INSTRUCTOR BURDEN, WAS ASSOCIATED WITH SELF-REPORTED IMPROVEMENTS ABOVE AND BEYOND AN ACTIVE SLEEP HYGIENE COMPARISON, SUSTAINED AT 6-MONTH FOLLOW-UP. FOLLOW-UP STUDIES ARE NEEDED TO ASSESS ACTIGRAPHY AND POLYSOMNOGRAPHY OUTCOMES, AS WELL AS POSSIBLE MECHANISMS OF CHANGE. CLINICAL TRIAL REGISTRATION: REGISTRY: CLINICALTRIALS.GOV; NAME: YOGA AS A TREATMENT FOR INSOMNIA; URL: HTTPS://CLINICALTRIALS.GOV/CT2/SHOW/NCT00033865; IDENTIFIER: NCT00033865. CITATION: KHALSA SBS, GOLDSTEIN MR. TREATMENT OF CHRONIC PRIMARY SLEEP ONSET INSOMNIA WITH KUNDALINI YOGA: A RANDOMIZED CONTROLLED TRIAL WITH ACTIVE SLEEP HYGIENE COMPARISON. J CLIN SLEEP MED. 2021;17(9):1841-1852. 2021