Protective Effect of Aerobic Physical Activity on Sleep Behavior in Breast Cancer Survivors

Abstract

Hypotheses. Sleep disorders are associated with an increased risk of cancer, including breast cancer (BC). Physical activity (PA) can produce beneficial effects on sleep. Study design. We designed a randomized controlled trial to test the effect of 3 months of physical activity on sleep and circadian rhythm activity level evaluated by actigraphy. Methods. 40 BC women, aged 35-70 years, were randomized into an intervention (IG) and a control group (CG). IG performed a 3 month of aerobic exercise. At baseline and after 3 months, the following parameters were evaluated both for IG and CG: anthropometric and body composition measurements, energy expenditure and motion level; sleep parameters (Actual Sleep Time-AST, Actual Wake Time-AWT, Sleep Efficiency-SE, Sleep Latency-SL, Mean Activity Score-MAS, Movement and Fragmentation Index-MFI and Immobility Time-IT) and activity level circadian rhythm using the Actigraph Actiwatch. Results. The CG showed a deterioration of sleep, whereas the IG showed a stable pattern. In the CG the SE, AST and IT decreased and the AWT, SL, MAS and MFI increased. In the IG, the SE, IT, AWT, SL, and MAS showed no changes and AST and MFI showed a less pronounced change in the IG than in the CG. The rhythmometric analysis revealed a significant circadian rhythm in two groups. After 3 months of PA, IG showed reduced fat mass %, while CG had improved weight and BMI. Conclusion. Physical activity may be beneficial against sleep disruption. Indeed, PA prevented sleep worsening in IG. PA can represent an integrative intervention therapy able to modify sleep behaviour.

Physical Activity and Sleep Quality in Breast Cancer Survivors

“…The inability of this meta-analysis to detect sleep quality benefits is not unexpected given that currently published randomized controlled trials (RCTs) of aerobic exercise (e.g., home-based walking, supervised aerobic exercise) in breast cancer survivors specifically have not consistently reported beneficial intervention effects on sleep (10,22,27,30–32,34,37). In the seven trials measuring self-report, significant intervention effects were reported for overall sleep quality in four studies (two occurred during chemotherapy/radiation) (10,22,27,37), efficiency in one study (during chemotherapy) (10), latency in two studies (one during chemotherapy) (10,31), and sleep duration in one (post-chemotherapy/radiation) (30).…”

“…In the seven trials measuring self-report, significant intervention effects were reported for overall sleep quality in four studies (two occurred during chemotherapy/radiation) (10,22,27,37), efficiency in one study (during chemotherapy) (10), latency in two studies (one during chemotherapy) (10,31), and sleep duration in one (post-chemotherapy/radiation) (30). Another post chemotherapy/radiation trial reported beneficial effects on accelerometer measured efficiency, latency, and awake time (34). The three trials using both accelerometer and self-report measures did not occur during chemotherapy or radiation and reported no effect on accelerometer efficiency and latency even when global self-report sleep quality benefits were found (27,30,31).…”

“…The three trials using both accelerometer and self-report measures did not occur during chemotherapy or radiation and reported no effect on accelerometer efficiency and latency even when global self-report sleep quality benefits were found (27,30,31). Importantly, 5 of the 8 trials available in breast cancer survivors, to date, were post-primary treatment (i.e., participants had completed surgery, chemotherapy, and/or radiation) yet enrolled ≤ 46 participants per trial reducing their study power (27,30–32,34). The only large trial (301 participants) was carried out during chemotherapy (limiting generalizability to post-primary treatment survivors) and did not include an accelerometer or objective measure of sleep quality (10).…”

Effect of aerobic exercise intervention on markers of insulin resistance in breast cancer women

“…In March 2014, 42 women volunteered to participate in the AEI trial (Roveda et al., ). The trial design follows the CONSORT 2010 guidelines (Schulz, Altman, & Moher, ) and it is summarised in Figure .…”

“…Women included in the IG attended a supervised AEI for 3 months (from April to June 2013) with an expert sport therapist (Roveda et al., ). In addition, women were also invited to do a moderate‐intensity exercise at home (walking or other aerobic activity) for at least 30 min every day as suggested by WCRF/AICR (World Cancer Research Fund & American Institute for Cancer Research ).…”