1. Cancer. 2018 Jan 1;124(1):36-45. doi: 10.1002/cncr.30938. Epub 2017 Sep 20.

Randomized trial of Tibetan yoga in patients with breast cancer undergoing
chemotherapy.

Chaoul A(1), Milbury K(1), Spelman A(1), Basen-Engquist K(2), Hall MH(3), Wei
Q(1), Shih YT(4), Arun B(5), Valero V(5), Perkins GH(6), Babiera GV(7), Wangyal
T(8), Engle R(1), Harrison CA(2), Li Y(9), Cohen L(1).

Author information: 
(1)Department of Palliative, Rehabilitation, and Integrative Medicine, The
University of Texas MD Anderson Cancer Center, Houston, Texas.
(2)Department of Behavioral Science, The University of Texas MD Anderson Cancer
Center, Houston, Texas.
(3)Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania.
(4)Department of Health Services Research, The University of Texas MD Anderson
Cancer Center, Houston, Texas.
(5)Department of Breast Medical Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Texas.
(6)Department of Radiation Oncology, The University of Texas MD Anderson Cancer
Center, Houston, Texas.
(7)Department of Breast Surgical Oncology, The University of Texas MD Anderson
Cancer Center, Houston, Texas.
(8)Ligmincha Institute, Shipman, Virginia.
(9)Department of Biostatistics, The University of Texas MD Anderson Cancer
Center, Houston, Texas.

BACKGROUND: The current randomized trial examined the effects of a Tibetan yoga
program (TYP) versus a stretching program (STP) and usual care (UC) on sleep and 
fatigue in women with breast cancer who were undergoing chemotherapy.
METHODS: Women with stage (American Joint Committee on Cancer (AJCC) TNM) I to
III breast cancer who were undergoing chemotherapy were randomized to TYP (74
women), STP (68 women), or UC (85 women). Participants in the TYP and STP groups 
participated in 4 sessions during chemotherapy, followed by 3 booster sessions
over the subsequent 6 months, and were encouraged to practice at home.
Self-report measures of sleep disturbances (Pittsburgh Sleep Quality Index),
fatigue (Brief Fatigue Inventory), and actigraphy were collected at baseline; 1
week after treatment; and at 3, 6, and 12 months.
RESULTS: There were no group differences noted in total sleep disturbances or
fatigue levels over time. However, patients in the TYP group reported fewer daily
disturbances 1 week after treatment compared with those in the STP (difference,
-0.43; 95% confidence interval [95% CI], -0.82 to -0.04 [P = .03]) and UC
(difference, -0.41; 95% CI, -0.77 to -0.05 [P = .02]) groups. Group differences
at the other time points were maintained for TYP versus STP. Actigraphy data
revealed greater minutes awake after sleep onset for patients in the STP group 1 
week after treatment versus those in the TYP (difference, 15.36; 95% CI,
7.25-23.48 [P = .0003]) and UC (difference, 14.48; 95% CI, 7.09-21.87
[P = .0002]) groups. Patients in the TYP group who practiced at least 2 times a
week during follow-up reported better Pittsburgh Sleep Quality Index and
actigraphy outcomes at 3 months and 6 months after treatment compared with those 
who did not and better outcomes compared with those in the UC group.
CONCLUSIONS: Participating in TYP during chemotherapy resulted in modest
short-term benefits in sleep quality, with long-term benefits emerging over time 
for those who practiced TYP at least 2 times a week. Cancer 2018;124:36-45. ©
2017 American Cancer Society.

© 2017 American Cancer Society.

DOI: 10.1002/cncr.30938 
PMCID: PMC5735004
PMID: 28940301  [Indexed for MEDLINE]