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New research suggests
that regular practice of yoga can lead to significant improvements in sleep for
people who have undergone cancer treatment. For patients with cancer, sleep
problems are common. Research indicates
that people coping with cancer are at significantly higher risk for sleep
disorders than the general population. Lack of sleep contributes to fatigue,
and can increase the risk of developing depression
for people coping with cancer. Poor sleep and disrupted circadian rhythms are
also associated
with hormone dysregulation and immune system dysfunction. Among people with
cancer, disrupted sleep can occur as a result of a number of factors,
including physical pain or discomfort that interferes with falling asleep or
staying asleep, side effects from medications and treatments, as well as stress
and anxiety. And once triggered, problems with sleep are often difficult
to reverse
: disrupted sleep patterns that develop during cancer treatment
can persist long after treatment has concluded.
Finding ways to help people coping with cancer to sleep
better is an important goal of sleep research and clinical treatment. While
short-term use of sleep medication may be useful, it’s critical to identify
strategies for improving sleep that don’t rely on long-term use of sleep

Researchers investigated the
effectiveness of yoga to improve sleep as part of a post-treatment care program
and found that the mind-body exercise brought significant improvements to sleep
quality and sleep efficiency. Yoga also helped to reduce patients’ reliance on
prescription sleep medication. The study included 410 patients with cancer, all
of whom had undergone one or more types of treatment—including surgery,
radiation and chemotherapy—within the past 24 months. Most of the participants
(96%) were women, with an average age of 54, and 75% of participants had breast
cancer. All were suffering from at least moderate levels of sleep problems.
Researchers divided the participants into 2 groups, both of which followed the
same standard post-treatment care plan. In addition, one group also
participated in a 4-week yoga program, consisting of 2 75-minute sessions each
week. The yoga regimen included physical postures as well as meditation,
breathing and relaxation exercises. At the beginning and the end of the 4-week
study period, researchers measured sleep for both groups using questionnaires
and wrist sensors worn during the night. They found both groups had improved
their sleep during the 4-week period. However, the yoga group experienced
significantly greater improvements to sleep compared to the non-yoga group:

  • Using
    a scale of sleep quality with a range of 21-0, with lower numbers
    representing fewer sleep problems, the group that practiced yoga
    demonstrated more significant boost to sleep quality. The yoga group saw
    their average sleep quality score improve from 9.2 at the beginning of the
    study to 7.2 at the end. The non-yoga group’s average score improved to a
    lesser degree, from 9.0 to 7.9.
  • Yoga
    practitioners also improved their sleep efficiency—the amount of time
    spent actually sleeping relative to the total amount of time in bed—to a
    greater degree than the non-yoga group.
  • The
    yoga-group experienced more significant improvements to daytime tiredness
    than the non-yoga group.
  • The
    yoga group reduced their use of sleep medication by 21% per week during
    the course of the study. The non-yoga group, on the other hand, increased
    their sleep medication use by 5% per week.

This last finding is especially encouraging, that the group
practicing yoga improved their sleep while also reducing their reliance on
sleep medication. We know from the CDC’s first-ever investigation
of prescription sleep medication that reliance on prescription sleep aids is
alarmingly high, with 4% of the adult population of the U.S. taking medication
to sleep. Long-term use of sleep medication is not the best method of improving
sleep for anyone. For cancer patients–who may already be taking one or more
other medications–effective, non-chemical treatments for sleep problems are
particularly welcome and important. To date, we’ve not seen a great deal of
research attention paid to the potential benefits of yoga for patients with
cancer. But there are other studies that suggest that yoga and other types of
gentle, mind-body exercises can help improve sleep among cancer patients:

  • With a
    group of lymphoma patients, researchers examined
    the effects on sleep of Tibetan yoga, a form that incorporates breathing,
    visualization, mindfulness and physical postures. After 3 months, patients
    who did yoga reported significant decreases in sleep disturbances,
    increased sleep duration, and less reliance on sleep medication, compared
    to a group that did not participate in the yoga regimen.
  • A
    group of patients with a variety of cancers experienced improvements
    to sleep and decreases to levels of stress and fatigue after an 8-week
    program of mindfulness-based stress reduction (MBSR). MBSR
    includes meditation practices designed to address both physical and
    psychological difficulties.
  • A review
    of research into mind-body therapies for cancer patients found that
    several forms of mind-body treatment had positive effects on sleep, as
    well as on pain and fatigue.

These latest results provide important additional
evidence that yoga and mind-body practices can play a constructive role in
treating sleep problems among cancer patients.
I am a proponent of yoga and mind-body exercise as a treatment
for sleep problems, and as part of a healthy-sleep routine. I hope we’ll see
additional research explore the possible benefits of these practices for people
living with cancer.

Sweet Dreams,

Michael J. Breus, PhD
The Sleep Doctor®

The Sleep Doctor’s Diet
Plan:  Lose Weight Through Better Sleep

Everything you do, you do better with a good night’s sleep™
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Michael Breus, Ph.D - The Sleep Doctor is a Diplomate of the American Board of Sleep Medicine and a Fellow of The American Academy of Sleep Medicine and one of only 168 psychologists to pass the Sleep Medical Specialty Board without going to medical school. Dr. Breus is a sought after lecturer and his knowledge is shared daily in major national media worldwide including Today, Dr. Oz, Oprah, and for fourteen years as the sleep expert on WebMD. Dr. Breus is the bestselling author of The Power of When, The Sleep Doctor’s Diet Plan and Good Night!

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