Janelsins, M.C., Peppone, L.J., Heckler, C.E., Kesler, S.R., Sprod, L.K., Atkins, J., . . . Mustian, K.M. (2015). YOCAS^©® Yoga reduces self-reported memory difficulty in cancer survivors in a nationwide randomized clinical trial: Investigating relationships between memory and sleep. Integrative Cancer Therapies, 15, 263–271. 

To investigate the effect of a combined hatha and restorative yoga intervention on memory in cancer survivors and to explore relationships between memory and sleep

YOCAS^©® (Yoga for Cancer Survivors) is an instructor-guided standardized program that incorporates movement emphasizing restorative poses, breathing exercises, and mindfulness exercises. The intervention was offered twice a week in the late afternoon or evening over 75 minutes for a total of eight sessions. Although all the group trainers were Registered Yoga Alliance Teachers, they were also required to complete a training session, reviewing a detailed YOCAS^©® manual to facilitate standardization across sites.

• N = 328   
• MEAN AGE = 54.62 years
• AGE RANGE = 26–72 years
• MALES: 4%, FEMALES: 96%
• CURRENT TREATMENT: Hormonal therapy in 53% of sample
• KEY DISEASE CHARACTERISTICS: Various cancers but predominantly breast cancer (77%)
• OTHER KEY SAMPLE CHARACTERISTICS: Of the sample, 82% had a partial college education or more. Seventy-four percent of women were postmenopausal.

• SITE: Multi-site  
• SETTING TYPE: Outpatient    
• LOCATION: 12 cities within the United States

PHASE OF CARE: Late effects and survivorship

Secondary analysis of a randomized, clinical trial

• MD Anderson Symptom Inventory (MDASI)—primary outcome was one item regarding perceived memory.
• Pittsburgh Sleep Quality Index (PSQI)—primary outcome was global sleep quality.

At baseline, the average score on the MDASI indicated only a mild level of perceived memory problems overall. Although both groups continued to report memory problems as being mild, a significant decrease (p < 0.05) was observed in patients who completed the intervention. This difference continued to be significant when controlling for differences in age, gender, educational level, past treatment regimen, current hormonal therapy, baseline memory, and baseline sleep scores. Of note, those who received the intervention also had improved sleep (p < 0.05), which accounted for approximately 26% of the improvement in memory (p = 0.039).

Although yoga appeared to decrease perceived memory problems, this outcome was based on a single item of the MDASI. Further longitudinal studies designed specifically to measure the effect of yoga on cognitive function as measured by both objective and subjective measures are warranted.

• Risk of bias (no blinding)
• Measurement validity/reliability questionable

Although this study suggested that yoga may improve patients’ perception of memory problems, some of the benefit was because of better sleep.