Mercier, J., Savard, J., & Bernard, P. (2016). Exercise interventions to improve sleep in cancer patients: A systematic review and meta-analysis. Sleep Medicine Reviews. Advance online publication. 

DOI Link

Purpose

STUDY PURPOSE: To summarize the available evidence regarding the extent to which exercise improves sleep in patients with cancer

TYPE OF STUDY: Meta-analysis and systematic review

Search Strategy

DATABASES USED: PbuMed, EMBASE, PsycINFO, SportDiscus, Cochrane Library
 
INCLUSION CRITERIA: Randomized, controlled trial or nonrandomized trial; adult patients with nonmetastatic disease; comparing exercise to usual care or an alternative intervention; English or French language
 
EXCLUSION CRITERIA: Yoga interventions

Literature Evaluated

TOTAL REFERENCES RETRIEVED: 243
 
EVALUATION METHOD AND COMMENTS ON LITERATURE USED: Risk of bias was evaluated. Most studies had low risk of bias, although a few had small sample sizes and less than half reported exercise program adherence.

Sample Characteristics

  • FINAL NUMBER STUDIES INCLUDED = 21
  • TOTAL PATIENTS INCLUDED IN REVIEW = 2,077
  • SAMPLE RANGE ACROSS STUDIES: 23-301
  • KEY SAMPLE CHARACTERISTICS: Sample mean ages ranged from 47-64 years. Varied tumor types were included. Breast cancer was most prevalent. Four studies had a quasiexperimental design.

Phase of Care and Clinical Applications

PHASE OF CARE: Multiple phases of care

Results

Sleep outcomes improved in 10 studies (47.6%). Interventions included home-based programs, supervised exercise, or a combination of these two approaches. Aerobic and resistance exercise were employed individually or in combination. Meta-analysis of 12 randomized, controlled trials showed no significant effect of interventions compared to control groups.

Conclusions

Analysis showed no clear significant effects of exercise interventions on sleep outcomes among patients with cancer.

Nursing Implications

Evidence from this analysis does not show an effect of exercise interventions on sleep quality. However, a large body of evidence regarding numerous other benefits of exercise for people with cancer exists. The analysis and most research have included patients who do not necessarily have clinical insomnia, so it would not be expected that interventions would improve sleep. Future research needs to be conducted among patients with clinically relevant insomnia.

Legacy ID

6300