Physical Activity and Sleep Quality in Breast Cancer Survivors

Abstract

Purpose Data from large randomized controlled trials confirming sleep quality improvements with aerobic physical activity have heretofore been lacking for post-primary treatment breast cancer survivors. Our primary purpose for this report was to determine the effects of a physical activity behavior change intervention, previously reported to significantly increase physical activity behavior, on sleep quality in post-primary treatment breast cancer survivors. Methods Post-primary treatment breast cancer survivors (n=222) were randomized to a 3-month physical activity behavior change intervention (BEAT Cancer) or usual care. Self-report (Pittsburgh Sleep Quality Index [PSQI]) and actigraphy (latency and efficiency) sleep outcomes were measured at baseline, 3 months (M3), and 6 months (M6). Results After adjusting for covariates, BEAT Cancer significantly improved PSQI global sleep quality when compared with usual care at M3 (mean between group difference [M] = −1.4; 95% CI = −2.1 to −0.7; p < .001) and M6 (M = −1.0; 95% CI = −1.7 to −0.2; P = .01). BEAT Cancer improved several PSQI subscales at M3 (sleep quality M = −0.3; 95% CI = −0.4 to −0.1; P = .002; sleep disturbances M = −0.2; 95% CI = −0.3 to −0.03; P = .016; daytime dysfunction M = −0.2; 95% CI = −0.4 to −0.02; P = .027) but not M6. A non-significant increase in percent of participants classified as good sleepers occurred. No significant between group difference was noted for accelerometer latency or efficiency. Conclusion A physical activity intervention significantly reduced perceived global sleep dysfunction at 3 and 6 months, primarily due to improvements in sleep quality aspects not detected with accelerometer.

Meta‐analysis: Exercise intervention for sleep problems in cancer patients

“…Of the 1,833 cancer patients, 1,324 were women, and 509 were men, (study sample sizes ranged from 19 to 277; Over half of the studies were performed in America (n = 13; Brown et al, 2018;Cheville et al, 2013;Coleman et al, 2012;Hacker et al, 2011;Ligibel et al, 2016;Mock et al, 1997;Payne et al, 2008;Rogers et al, 2017Rogers et al, , 2015Rogers et al, , 2013Rogers et al, , 2009Sprod et al, 2010;Wenzel et al, 2013), three were performed in Taiwan (Chen et al, 2016;Tang et al, 2010;Wang et al, 2011), two were investigated in Canada (Adams et al, 2018;Courneya et al, 2012), and four trials each were conducted in the UK (Donnelly et al, 2011), Netherlands (Kampshoff et al, 2015), Germany (Schmidt et al, 2015) and Iran (Shobeiri, Masoumi, Nikravesh, Heidari Moghadam, & Karami, 2016). Of the 1,833 cancer patients, 1,324 were women, and 509 were men, (study sample sizes ranged from 19 to 277; Over half of the studies were performed in America (n = 13; Brown et al, 2018;Cheville et al, 2013;Coleman et al, 2012;Hacker et al, 2011;Ligibel et al, 2016;Mock et al, 1997;Payne et al, 2008;Rogers et al, 2017Rogers et al, , 2015Rogers et al, , 2013Rogers et al, , 2009Sprod et al, 2010;Wenzel et al, 2013), three were performed in Taiwan (Chen et al, 2016;Tang et al, 2010;…”

“…Most RCTs recruited patients from one center (n = 21); only one investigation was a multicentre trial design (Rogers et al, 2017). All studies compared exercise intervention and usual care, with at least two follow-up visits.…”

“…Five of 11 articles reported patients who had sports physicians, exercise specialists or physiotherapists to discuss or adjust the prescribed exercise during supervised exercise (Kampshoff et al, 2015;Rogers et al, 2017Rogers et al, , 2015Rogers et al, , 2013Schmidt et al, 2015). Five of 11 articles reported patients who had sports physicians, exercise specialists or physiotherapists to discuss or adjust the prescribed exercise during supervised exercise (Kampshoff et al, 2015;Rogers et al, 2017Rogers et al, , 2015Rogers et al, , 2013Schmidt et al, 2015).…”

“…The most widely used instrument was the PSQI (used in 15 articles The objective sleep quality was measured in six articles, but only five articles reported computable data (Chen et al, 2016;Coleman et al, 2012;Rogers et al, 2017Rogers et al, , 2015Rogers et al, , 2013. Two different actigraphy brands, Ambulatory Monitoring and GT3X+ were used, and the results of sleep efficiency (the time it takes to fall asleep divided by total bedtime) and sleep onset latency would be pooled.…”

“…However, the effect reached statistical significance in only 10 (47.6%) RCTs (Brown et al, 2018;Chen et al, 2016;Cheville et al, 2013;Donnelly et al, 2011;Mock et al, 1997;Payne et al, 2008;Rogers et al, 2017;Shobeiri et al, 2016;Tang et al, 2010;Wang et al, 2011). However, the effect reached statistical significance in only 10 (47.6%) RCTs (Brown et al, 2018;Chen et al, 2016;Cheville et al, 2013;Donnelly et al, 2011;Mock et al, 1997;Payne et al, 2008;Rogers et al, 2017;Shobeiri et al, 2016;Tang et al, 2010;Wang et al, 2011).…”