1 2631 90 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 2 2503 68 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 3 743 17 EFFECT OF RESTORATIVE YOGA VS. STRETCHING ON DIURNAL CORTISOL DYNAMICS AND PSYCHOSOCIAL OUTCOMES IN INDIVIDUALS WITH THE METABOLIC SYNDROME: THE PRYSMS RANDOMIZED CONTROLLED TRIAL. PURPOSE: CHRONIC STIMULATION AND DYSREGULATION OF THE NEUROENDOCRINE SYSTEM BY STRESS MAY CAUSE METABOLIC ABNORMALITIES. WE ESTIMATED HOW MUCH CORTISOL AND PSYCHOSOCIAL OUTCOMES IMPROVED WITH A RESTORATIVE YOGA (RELAXATION) VERSUS A LOW IMPACT STRETCHING INTERVENTION FOR INDIVIDUALS WITH THE METABOLIC SYNDROME. METHODS: WE CONDUCTED A 1-YEAR MULTI-CENTER RANDOMIZED CONTROLLED TRIAL (6-MONTH INTERVENTION AND 6-MONTH MAINTENANCE PHASE) OF RESTORATIVE YOGA VS. STRETCHING. PARTICIPANTS COMPLETED SURVEYS TO ASSESS DEPRESSION, SOCIAL SUPPORT, POSITIVE AFFECT, AND STRESS AT BASELINE, 6 MONTHS AND 12 MONTHS. FOR EACH ASSESSMENT, WE COLLECTED SALIVA AT FOUR POINTS DAILY FOR THREE DAYS AND COLLECTED RESPONSE TO DEXAMETHASONE ON THE FOURTH DAY FOR ANALYSIS OF DIURNAL CORTISOL DYNAMICS. WE ANALYZED OUR DATA USING MULTIVARIATE REGRESSION MODELS, CONTROLLING FOR STUDY SITE, MEDICATIONS (ANTIDEPRESSANTS, HORMONE THERAPY), BODY MASS INDEX, AND BASELINE CORTISOL VALUES. RESULTS: PSYCHOSOCIAL OUTCOME MEASURES WERE AVAILABLE FOR 171 STUDY PARTICIPANTS AT BASELINE, 140 AT 6 MONTHS, AND 132 AT 1 YEAR. COMPLETE CORTISOL DATA WERE AVAILABLE FOR 136 OF 171 STUDY PARTICIPANTS (72 IN RESTORATIVE YOGA AND 64 IN STRETCHING) AND WERE ONLY AVAILABLE AT BASELINE AND 6 MONTHS. AT 6 MONTHS, THE STRETCHING GROUP HAD DECREASED CORTISOL AT WAKING AND BEDTIME COMPARED TO THE RESTORATIVE YOGA GROUP. THE PATTERN OF CHANGES IN STRESS MIRRORED THIS IMPROVEMENT, WITH THE STRETCHING GROUP SHOWING REDUCTIONS IN CHRONIC STRESS SEVERITY AND PERSEVERATIVE THOUGHTS ABOUT THEIR STRESS. PERCEIVED STRESS DECREASED BY 1.5 POINTS (-0.4; 3.3, P=0.11) AT 6 MONTHS, AND BY 2.0 POINTS (0.1; 3.9, P=0.04) AT 1 YEAR IN THE STRETCHING COMPARED TO RESTORATIVE YOGA GROUPS. POST HOC ANALYSES SUGGEST THAT IN THE STRETCHING GROUP ONLY, PERCEIVED INCREASES IN SOCIAL SUPPORT (PARTICULARLY FEELINGS OF BELONGING), BUT NOT CHANGES IN STRESS WERE RELATED TO IMPROVED CORTISOL DYNAMICS. CONCLUSIONS: WE FOUND SIGNIFICANT DECREASES IN SALIVARY CORTISOL, CHRONIC STRESS SEVERITY, AND STRESS PERCEPTION IN THE STRETCHING GROUP COMPARED TO THE RESTORATIVE YOGA GROUP. GROUP SUPPORT DURING THE INTERACTIVE STRETCH CLASSES MAY HAVE CONTRIBUTED TO THESE CHANGES. 2014 4 851 19 EFFECT OF YOGA ON SLEEP QUALITY AND NEUROENDOCRINE IMMUNE RESPONSE IN METASTATIC BREAST CANCER PATIENTS. BACKGROUND: STUDIES HAVE SHOWN THAT DISTRESS AND ACCOMPANYING NEUROENDOCRINE STRESS RESPONSES AS IMPORTANT PREDICTOR OF SURVIVAL IN ADVANCED BREAST CANCER PATIENTS. SOME PSYCHOTHERAPEUTIC INTERVENTION STUDIES HAVE SHOWN HAVE MODULATION OF NEUROENDOCRINE-IMMUNE RESPONSES IN ADVANCED BREAST CANCER PATIENTS. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGA ON PERCEIVED STRESS, SLEEP, DIURNAL CORTISOL, AND NATURAL KILLER (NK) CELL COUNTS IN PATIENTS WITH METASTATIC CANCER. METHODS: IN THIS STUDY, 91 PATIENTS WITH METASTATIC BREAST CANCER WHO SATISFIED SELECTION CRITERIA AND CONSENTED TO PARTICIPATE WERE RECRUITED AND RANDOMIZED TO RECEIVE "INTEGRATED YOGA BASED STRESS REDUCTION PROGRAM" (N = 45) OR STANDARD "EDUCATION AND SUPPORTIVE THERAPY SESSIONS" (N = 46) OVER A 3 MONTH PERIOD. PSYCHOMETRIC ASSESSMENTS FOR SLEEP QUALITY WERE DONE BEFORE AND AFTER INTERVENTION. BLOOD DRAWS FOR NK CELL COUNTS WERE COLLECTED BEFORE AND AFTER THE INTERVENTION. SALIVA SAMPLES WERE COLLECTED FOR THREE CONSECUTIVE DAYS BEFORE AND AFTER INTERVENTION. DATA WERE ANALYZED USING THE ANALYSIS OF COVARIANCE ON POSTMEASURES USING RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THERE WAS A SIGNIFICANT DECREASE IN SCALES OF SYMPTOM DISTRESS (P < 0.001), SLEEP PARAMETERS (P = 0.02), AND IMPROVEMENT IN QUALITY OF SLEEP (P = 0.001) AND INSOMNIA RATING SCALE SLEEP SCORE (P = 0.001) FOLLOWING INTERVENTION. THERE WAS A DECREASE IN MORNING WAKING CORTISOL IN YOGA GROUP (P = 0.003) ALONE FOLLOWING INTERVENTION. THERE WAS A SIGNIFICANT IMPROVEMENT IN NK CELL PERCENT (P = 0.03) FOLLOWING INTERVENTION IN YOGA GROUP COMPARED TO CONTROL GROUP. CONCLUSION: THE RESULTS SUGGEST MODULATION OF NEUROENDOCRINE RESPONSES AND IMPROVEMENT IN SLEEP IN PATIENTS WITH ADVANCED BREAST CANCER FOLLOWING YOGA INTERVENTION. 2017 5 2850 23 YOGA, MINDFULNESS-BASED STRESS REDUCTION AND STRESS-RELATED PHYSIOLOGICAL MEASURES: A META-ANALYSIS. BACKGROUND AND OBJECTIVES: PRACTICES THAT INCLUDE YOGA ASANAS AND MINDFULNESS-BASED STRESS REDUCTION FOR THE MANAGEMENT OF STRESS ARE INCREASINGLY POPULAR; HOWEVER, THE NEUROBIOLOGICAL EFFECTS OF THESE PRACTICES ON STRESS REACTIVITY ARE NOT WELL UNDERSTOOD. MANY STUDIES INVESTIGATING THE EFFECTS OF SUCH PRACTICES FAIL TO INCLUDE AN ACTIVE CONTROL GROUP. GIVEN THE FREQUENCY WITH WHICH PEOPLE ARE SELECTING SUCH INTERVENTIONS AS A FORM OF SELF-MANAGEMENT, IT IS IMPORTANT TO DETERMINE THEIR EFFECTIVENESS. THUS, THIS REVIEW INVESTIGATES THE EFFECTS OF PRACTICES THAT INCLUDE YOGA ASANAS, WITH AND WITHOUT MINDFULNESS-BASED STRESS REDUCTION, COMPARED TO AN ACTIVE CONTROL, ON PHYSIOLOGICAL MARKERS OF STRESS. MATERIALS AND METHODS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF RANDOMISED CONTROLLED TRIALS PUBLISHED IN ENGLISH COMPARED PRACTICES THAT INCLUDED YOGA ASANAS, WITH AND WITHOUT MINDFULNESS-BASED STRESS REDUCTION, TO AN ACTIVE CONTROL, ON STRESS-RELATED PHYSIOLOGICAL MEASURES. THE REVIEW FOCUSED ON STUDIES THAT MEASURED PHYSIOLOGICAL PARAMETERS SUCH AS BLOOD PRESSURE, HEART RATE, CORTISOL AND PERIPHERAL CYTOKINE EXPRESSION. MEDLINE, AMED, CINAHL, PSYCINFO, SOCINDEX, PUBMED, AND SCOPUS WERE SEARCHED IN MAY 2016 AND UPDATED IN DECEMBER 2016. RANDOMISED CONTROLLED TRIALS WERE INCLUDED IF THEY ASSESSED AT LEAST ONE OF THE FOLLOWING OUTCOMES: HEART RATE, BLOOD PRESSURE, HEART RATE VARIABILITY, MEAN ARTERIAL PRESSURE, C-REACTIVE PROTEIN, INTERLEUKINS OR CORTISOL. RISK OF BIAS ASSESSMENTS INCLUDED SEQUENCE GENERATION, ALLOCATION CONCEALMENT, BLINDING OF ASSESSORS, INCOMPLETE OUTCOME DATA, SELECTIVE OUTCOME REPORTING AND OTHER SOURCES OF BIAS. META-ANALYSIS WAS UNDERTAKEN USING COMPREHENSIVE META-ANALYSIS SOFTWARE VERSION 3. SENSITIVITY ANALYSES WERE PERFORMED USING 'ONE-STUDY-REMOVED' ANALYSIS. SUBGROUP ANALYSIS WAS CONDUCTED FOR DIFFERENT YOGA AND CONTROL GROUP TYPES, INCLUDING MINDFULNESS-BASED STRESS REDUCTION VERSUS NON-MINDFULNESS-BASED STRESS REDUCTION BASED INTERVENTIONS, DIFFERENT POPULATIONS, LENGTH OF INTERVENTION, AND METHOD OF DATA ANALYSIS. A RANDOM-EFFECTS MODEL WAS USED IN ALL ANALYSES. RESULTS: FORTY TWO STUDIES WERE INCLUDED IN THE META-ANALYSIS. INTERVENTIONS THAT INCLUDED YOGA ASANAS WERE ASSOCIATED WITH REDUCED EVENING CORTISOL, WAKING CORTISOL, AMBULATORY SYSTOLIC BLOOD PRESSURE, RESTING HEART RATE, HIGH FREQUENCY HEART RATE VARIABILITY, FASTING BLOOD GLUCOSE, CHOLESTEROL AND LOW DENSITY LIPOPROTEIN, COMPARED TO ACTIVE CONTROL. HOWEVER, THE REPORTED INTERVENTIONS WERE HETEROGENEOUS. CONCLUSIONS: PRACTICES THAT INCLUDE YOGA ASANAS APPEAR TO BE ASSOCIATED WITH IMPROVED REGULATION OF THE SYMPATHETIC NERVOUS SYSTEM AND HYPOTHALAMIC-PITUITARY-ADRENAL SYSTEM IN VARIOUS POPULATIONS. 2017 6 1460 28 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 7 2627 28 YOGA FOR THE MANAGEMENT OF CANCER TREATMENT-RELATED TOXICITIES. PURPOSE OF REVIEW: TO (1) EXPLAIN WHAT YOGA IS, (2) SUMMARIZE PUBLISHED LITERATURE ON THE EFFICACY OF YOGA FOR MANAGING CANCER TREATMENT-RELATED TOXICITIES, (3) PROVIDE CLINICAL RECOMMENDATIONS ON THE USE OF YOGA FOR ONCOLOGY PROFESSIONALS, AND (4) SUGGEST PROMISING AREAS FOR FUTURE RESEARCH. RECENT FINDINGS: BASED ON A TOTAL OF 24 PHASE II AND ONE PHASE III CLINICAL TRIALS, LOW-INTENSITY FORMS OF YOGA, SPECIFICALLY GENTLE HATHA AND RESTORATIVE, ARE FEASIBLE, SAFE, AND EFFECTIVE FOR TREATING SLEEP DISRUPTION, CANCER-RELATED FATIGUE, COGNITIVE IMPAIRMENT, PSYCHOSOCIAL DISTRESS, AND MUSCULOSKELETAL SYMPTOMS IN CANCER PATIENTS RECEIVING CHEMOTHERAPY AND RADIATION AND CANCER SURVIVORS. CLINICIANS SHOULD CONSIDER PRESCRIBING YOGA FOR THEIR PATIENTS SUFFERING WITH THESE TOXICITIES BY REFERRING THEM TO QUALIFIED YOGA PROFESSIONALS. MORE DEFINITIVE PHASE III CLINICAL TRIALS ARE NEEDED TO CONFIRM THESE FINDINGS AND TO INVESTIGATE OTHER TYPES, DOSES, AND DELIVERY MODES OF YOGA FOR TREATING CANCER-RELATED TOXICITIES IN PATIENTS AND SURVIVORS. 2018 8 1404 23 IMPACT OF YOGA ON COGNITION AND MENTAL HEALTH AMONG ELDERLY: A SYSTEMATIC REVIEW. BACKGROUND: COGNITIVE DECLINE AND PSYCHOLOGICAL HEALTH PROBLEMS ARE THE MOST FREQUENTLY OBSERVED AND UNDER-TREATED ISSUES AMONG THE ELDERLY. MANY STUDIES HAVE ASSESSED THE EFFICACY OF YOGA ON COGNITIVE AND MENTAL HEALTH PARAMETERS AMONG THE ELDERLY. HOWEVER, UP TO DATE, THERE IS NO SYSTEMATIC REVIEW DONE TO EVALUATE THE ROLE OF YOGA-BASED INTERVENTIONS ON COGNITION AND MENTAL HEALTH IN THE ELDERLY. OBJECTIVE: THIS REVIEW EVALUATES THE BENEFICIAL EFFECT OF YOGA IN IMPROVING COGNITIVE AND MENTAL HEALTH IN THE ELDERLY. METHODOLOGY: A COMPREHENSIVE SEARCH HAS PERFORMED ON MEDLINE, GOOGLE SCHOLAR, PUBMED, AND PSYCINFO ELECTRONIC DATABASE FROM THEIR INCEPTION TO JANUARY 2019. THE LITERATURE SEARCH WAS CONSTRUCTED AROUND SEARCH TERM FOR "MENTAL HEALTH", "COGNITION", "YOGA" AND "ELDERLY". OUT OF 3388 RECORDS, WE WERE CONSIDERED ONLY RANDOMIZED CONTROL TRIALS (RCTS) WITH YOGA-BASED INTERVENTIONS ON THE OLDER PEOPLE FOR THIS REVIEW. RISK OF BIAS WAS ASSESSED USING DELPHI LIST AND PEDRO CRITERIA. RESULTS: AFTER FILTERING OUT IRRELEVANT STUDIES, IN OUR SEARCH, WE COME ACROSS 13 RCTS, AND THEY INCLUDED IN THIS SYSTEMATIC REVIEW. OF 13 RCTS, FOUR STUDIES ASSESSED ONLY COGNITIVE PARAMETERS AND FIVE STUDIES ASSESSED ONLY PSYCHOLOGICAL PARAMETERS, AND FOUR STUDIES EVALUATED BOTH. STUDY QUALITY WAS FAIR TO MODERATE OF INCLUDED RCTS ON THE DELPHI LIST AND PEDRO CRITERIA. MAXIMUM STUDIED VARIABLES IN COGNITION WERE EXECUTIVE FUNCTIONS, MEMORY, ATTENTION, AND LANGUAGE WHILE IN MENTAL HEALTH DEPRESSION, ANXIETY, STRESS, AND MOOD. YOGA-BASED INTERVENTIONS HAVE SOME BENEFICIAL EFFECTS ON ATTENTION, EXECUTIVE FUNCTIONS AMONG COGNITIVE VARIABLES, AND DEPRESSION AMONG MENTAL HEALTH PARAMETERS AMONG THE ELDERLY. CONCLUSION: THE PRESENT REVIEW INDICATES THAT YOGA-BASED INTERVENTIONS HAVE SOME POSITIVE EVIDENCE IN IMPROVING ATTENTION, EXECUTIVE FUNCTIONS AND MEMORY OF COGNITION, WHILE DEPRESSION IN MENTAL HEALTH COMPARED TO ACTIVE CONTROL AMONG THE ELDERLY. HOWEVER, METHODOLOGICAL LIMITATIONS AND SMALL NUMBER OF STUDIES PRECLUDE CONFIRMING THE POTENTIAL BENEFITS OF YOGA-BASED INTERVENTIONS ON COGNITION AND MENTAL HEALTH AMONG THE ELDERLY. FURTHER, THIS REVIEW STRONGLY RECOMMENDS MORE RANDOMIZED CONTROL TRIALS WITH STANDARD STUDY METHODOLOGY, USE OF VALIDATED MODULES OF YOGA INTERVENTION, AND LONG TERM FOLLOW UP TO HAVE DEFINITE CONCLUSIONS. 2020 9 1036 20 EFFECTS OF YOGA IN MANAGING FATIGUE IN BREAST CANCER PATIENTS: A RANDOMIZED CONTROLLED TRIAL. BACKGROUND: CANCER-RELATED FATIGUE IS WIDELY PREVALENT IN CANCER PATIENTS AND AFFECTS QUALITY OF LIFE IN ADVANCED CANCER PATIENTS. FATIGUE IS CAUSED DUE TO BOTH PSYCHOLOGIC DISTRESS AND PHYSIOLOGICAL SEQUEL FOLLOWING CANCER PROGRESSION AND ITS TREATMENT. IN THIS STUDY, WE EVALUATE THE EFFECTS OF YOGIC INTERVENTION IN MANAGING FATIGUE IN METASTATIC BREAST CANCER PATIENTS. METHODS: NINETY-ONE PATIENTS WITH METASTATIC BREAST CANCER WERE RANDOMIZED TO RECEIVE INTEGRATED YOGA PROGRAM (N = 46) OR SUPPORTIVE THERAPY AND EDUCATION (N = 45) OVER A 3-MONTH PERIOD. ASSESSMENTS SUCH AS PERCEIVED STRESS, FATIGUE SYMPTOM INVENTORY, DIURNAL SALIVARY CORTISOL, AND NATURAL KILLER CELL COUNTS WERE CARRIED OUT BEFORE AND AFTER INTERVENTION. ANALYSIS WAS DONE USING AN INTENTION-TO-TREAT APPROACH. POSTMEASURES FOR THE ABOVE OUTCOMES WERE ASSESSED USING ANCOVA WITH RESPECTIVE BASELINE MEASURE AS A COVARIATE. RESULTS: THE RESULTS SUGGEST THAT YOGA REDUCES PERCEIVED STRESS (P = 0.001), FATIGUE FREQUENCY (P < 0.001), FATIGUE SEVERITY (P < 0.001), INTERFERENCE (P < 0.001), AND DIURNAL VARIATION (P < 0.001) WHEN COMPARED TO SUPPORTIVE THERAPY. THERE WAS A POSITIVE CORRELATION OF CHANGE IN FATIGUE SEVERITY WITH 9 A.M. SALIVARY CORTISOL LEVELS. CONCLUSION: THE RESULTS SUGGEST THAT YOGA REDUCES FATIGUE IN ADVANCED BREAST CANCER PATIENTS. 2017 10 2110 25 THE EFFECT OF YOGA ON SLEEP QUALITY AND INSOMNIA IN WOMEN WITH SLEEP PROBLEMS: A SYSTEMATIC REVIEW AND META-ANALYSIS. BACKGROUND: TO EXAMINE THE EFFECTIVENESS AND SAFETY OF YOGA OF WOMEN WITH SLEEP PROBLEMS BY PERFORMING A SYSTEMATIC REVIEW AND META-ANALYSIS. METHODS: MEDLINE/PUBMED, CLINICALKEY, SCIENCEDIRECT, EMBASE, PSYCINFO, AND THE COCHRANE LIBRARY WERE SEARCHED THROUGHOUT THE MONTH OF JUNE, 2019. RANDOMIZED CONTROLLED TRIALS COMPARING YOGA GROUPS WITH CONTROL GROUPS IN WOMEN WITH SLEEP PROBLEMS WERE INCLUDED. TWO REVIEWERS INDEPENDENTLY EVALUATED RISK OF BIAS BY USING THE RISK OF BIAS TOOL SUGGESTED BY THE COCHRANE COLLABORATION FOR PROGRAMMING AND CONDUCTING SYSTEMATIC REVIEWS AND META-ANALYSES. THE MAIN OUTCOME MEASURE WAS SLEEP QUALITY OR THE SEVERITY OF INSOMNIA, WHICH WAS MEASURED USING SUBJECTIVE INSTRUMENTS, SUCH AS THE PITTSBURGH SLEEP QUALITY INDEX (PSQI), INSOMNIA SEVERITY INDEX (ISI), OR OBJECTIVE INSTRUMENTS SUCH AS POLYSOMNOGRAPHY, ACTIGRAPHY, AND SAFETY OF THE INTERVENTION. FOR EACH OUTCOME, A STANDARDIZED MEAN DIFFERENCE (SMD) AND CONFIDENCE INTERVALS (CIS) OF 95% WERE DETERMINED. RESULTS: NINETEEN STUDIES IN THIS SYSTEMATIC REVIEW INCLUDED 1832 PARTICIPANTS. THE META-ANALYSIS OF THE COMBINED DATA CONDUCTED ACCORDING TO COMPREHENSIVE META-ANALYSIS SHOWED A SIGNIFICANT IMPROVEMENT IN SLEEP (SMD = - 0.327, 95% CI = - 0.506 TO - 0.148, P < 0.001). META-ANALYSES REVEALED POSITIVE EFFECTS OF YOGA USING PSQI SCORES IN 16 RANDOMIZED CONTROL TRIALS (RCTS), COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY AMONG WOMEN USING PSQI (SMD = - 0.54; 95% CI = - 0.89 TO - 0.19; P = 0.003). HOWEVER, THREE RCTS REVEALED NO EFFECTS OF YOGA COMPARED TO THE CONTROL GROUP IN REDUCING INSOMNIA AMONG WOMEN USING ISI (SMD = - 0.13; 95% CI = - 0.74 TO 0.48; P = 0.69). SEVEN RCTS REVEALED NO EVIDENCE FOR EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING SLEEP QUALITY FOR WOMEN WITH BREAST CANCER USING PSQI (SMD = - 0.15; 95% CI = - 0.31 TO 0.01; P = 0.5). FOUR RCTS REVEALED NO EVIDENCE FOR THE EFFECTS OF YOGA COMPARED WITH THE CONTROL GROUP IN IMPROVING THE SLEEP QUALITY FOR PERI/POSTMENOPAUSAL WOMEN USING PSQI (SMD = - 0.31; 95% CI = - 0.95 TO 0.33; P = 0.34). YOGA WAS NOT ASSOCIATED WITH ANY SERIOUS ADVERSE EVENTS. DISCUSSION: THIS SYSTEMATIC REVIEW AND META-ANALYSIS DEMONSTRATED THAT YOGA INTERVENTION IN WOMEN CAN BE BENEFICIAL WHEN COMPARED TO NON-ACTIVE CONTROL CONDITIONS IN TERM OF MANAGING SLEEP PROBLEMS. THE MODERATOR ANALYSES SUGGEST THAT PARTICIPANTS IN THE NON-BREAST CANCER SUBGROUP AND PARTICIPANTS IN THE NON-PERI/POSTMENOPAUSAL SUBGROUP WERE ASSOCIATED WITH GREATER BENEFITS, WITH A DIRECT CORRELATION OF TOTAL CLASS TIME WITH QUALITY OF SLEEP AMONG OTHER RELATED BENEFITS. 2020 11 2608 17 YOGA FOR PSYCHIATRIC DISORDERS: FROM FAD TO EVIDENCE-BASED INTERVENTION? THERE IS GROWING EVIDENCE FOR YOGA'S NEUROBIOLOGICAL EFFECTS IN PEOPLE WITH PSYCHIATRIC DISORDERS. POSTULATED MECHANISMS OF ACTION INCLUDE: (A) MODULATION OF THE HYPOTHALAMIC-PITUITARY-ADRENAL (HPA) AXIS; (B) ENHANCEMENT OF GABAERGIC NEUROTRANSMISSION; (C) AUTONOMIC MODULATION; AND (D) NEUROENDOCRINOLOGICAL EFFECTS. YOGA AS A THERAPEUTIC INTERVENTION IN PSYCHIATRIC DISORDERS APPEARS PROMISING AND MERITS FURTHER ATTENTION IN CLINICAL PRACTICE AND RESEARCH. 2020 12 1650 36 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