Sprod, L.K., Palesh, O.G., Janelsins, M.C., Peppone, L.J., Heckler, C.E., Adams, M.J., . . . Mustian, K.M. (2010). Exercise, sleep quality, and mediators of sleep in breast and prostate cancer patients receiving radiation therapy. Community Oncology, 7, 463–471.

To assess the effect of home-based exercise on sleep quality and proinflammatory cytokines in patients with breast and prostate cancer receiving radiation therapy

Patients randomly were assigned to the home-based exercise or control group. Patients in the control group received standard care and were encouraged to remain only as active as they were prior to study inclusion. Patients in the intervention group were given 45 minutes of instruction by an exercise physiologist and given an exercise kit that contained written instructions, a pedometer, and resistance bands. The exercise prescription followed the American College of Sports Medicine guidelines for progressive walking at moderate intensity. Resistance band use was designed for low to moderate intensity, focusing on upper extremities. Patients wore pedometers during the first week. All patients were followed weekly for four weeks. Study measures were obtained at baseline and after the intervention.

• N = 38
• MEAN AGE = 60.1 years (SD = 12.1 years)
• MALES: 29%, FEMALES: 71%
• KEY DISEASE CHARACTERISTICS: All had breast or prostate cancer and were in treatment with radiation therapy; none had recurrent disease or distant metastases.
• OTHER KEY SAMPLE CHARACTERISTICS: 61% were married, 90% were Caucasian, 50% had previous chemotherapy, and 74% had at least some college education. Inclusion criteria included a sedentary lifestyle.

• SITE: Single site  
• SETTING TYPE: Outpatient  
• LOCATION: Canada

• PHASE OF CARE: Active antitumor treatment

• RCT
  • This report is a secondary analysis of the initial RCT.

• Pittsburgh Sleep Quality Index
• ELISA for IL-6, TNF–α, and s-TNF-R

Fifteen of the 19 patients in the exercise group reported increased daily steps walked and at follow-up at three months walked significantly more than patients in the control group (p < .05). Twelve of the 19 patients in the intervention group reported doing resistance training for an average of 17 minutes three days per week. Overall sleep quality improved over time in both groups, and no significant difference was seen between groups. Post-intervention levels of IL-6 and TNF-α increased slightly in both groups. Both of these were lower in the exercise group, but the difference was not significant.

These findings do not demonstrate an impact of a home-based exercise program on sleep quality.

• Small sample (less than 30)
• Risk of bias (no blinding)
• Unintended interventions or applicable interventions not described that would influence results
• Other limitations/explanation: Although use of sleep medications is mentioned in the report, no data are provided regarding this or differences in other interventions between groups.

Findings show that patients being provided with training and materials to do a home-based exercise program was associated with good adherence by patients. However, findings did not show an effect of this exercise on sleep quality. Exercise is beneficial and should be encouraged but does not appear to have a beneficial effect on sleep-wake disturbance.