Cohen, L., Warneke, C., Foulacli, R.T., Rodriguez, M.A., & Chaoul-Reich, A. (2004). Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer, 100, 2253–2260.

Yoga intervention was a seven-week Tibetan yoga (TY) program provided to patients with lymphoma who were undergoing active treatment or who had concluded treatments within the past 12 months. The TY intervention consisted of stress-reduction techniques, including:

• Regulated breathing
• Visual imagery
• Meditation and mindfulness techniques
• Various low-impact postures.

TY classes were conducted by an experienced TY instructor. After each class, participants were given an audiotape that walked them through all of the techniques. They were encouraged to practice the techniques at least once per day.

Patient characteristics used for group assignment were the type of cancer (Hodgkin or non-Hodgkin lymphoma), the status of treatment (active treatment or completed), gender, age, and baseline state anxiety scores. The allocation process was concealed from investigators. Patients were randomized and notified of their group assignment by telephone. Three separate cohorts of patients were assigned to either the TY group (n = 20) or the wait group (n = 19). The wait group was offered the program three months after the last follow-up assessment was completed. (One participant dropped out of study before attending any classes; therefore, 19 were evaluated.)

Measures were taken at baseline, one week, one month, and three months after the last session.

The study reported on 39 patients with lymphoma.

A randomized controlled trial design was used.

• Impact of Event Scale (IES)
• State-Trait Anxiety Inventor (STAI)
• Center for Epidemiologic Studies Depression Scale (CESD)
• Brief Fatigue Inventory (BFI)
• Pittsburgh Sleep Quality Index (PSQI)

There were no statistical differences between groups on the measures of psychological adjustment (intrusion or avoidance, state anxiety and depression) and fatigue. However, the TY program reduced patients’ sleep disturbances (p < 0.004).

• The study had a small sample size.
• The study used a mixed sample of patients with cancer undergoing active treatment as well as cancer survivors 12 months after treatment.
• The study had special costs associated with training (TY instructor and audiotapes).