Skip to main content

Advertisement

SpringerLink
Log in

Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial

  • Clinical trial
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

To examine the effects of different doses and types of exercise on sleep quality in breast cancer patients receiving chemotherapy. A multicenter trial in Canada randomized 301 breast cancer patients between 2008 and 2011 to thrice weekly, supervised exercise during chemotherapy consisting of either a standard dose of 25–30 min of aerobic exercise (STAN; n = 96), a higher dose of 50–60 min of aerobic exercise (HIGH; n = 101), or a combined dose of 50–60 min of aerobic and resistance exercise (COMB; n = 104). The secondary sleep outcomes in the trial were assessed by the Pittsburgh Sleep Quality Index (PSQI) at baseline, twice during chemotherapy, and postchemotherapy. We analyzed the global PSQI and the component scores. Repeated measures analyses of variance indicated that the HIGH group was statistically superior to the STAN group for global sleep quality (mean group difference = −0.90; 95 % CI −0.05 to −1.76; p = 0.039) as well as subjective sleep quality (p = 0.028) and sleep latency (p = 0.049). The COMB group was borderline statistically superior to the STAN group for global sleep quality (mean group difference = −0.76; 95 % CI +0.11 to −1.62; p = 0.085) as well as sleep duration (p = 0.051); and statistically superior for sleep efficiency (p = 0.040), and percentage of poor sleepers (p = 0.045). Compared to a standard volume of aerobic exercise, higher volumes of both aerobic and combined exercise improved some aspects of sleep quality during breast cancer chemotherapy. Exercise may be an attractive option to manage sleep dysfunction in cancer patients during chemotherapy.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Savard J, Ivers H, Villa J et al (2011) Natural course of insomnia comorbid with cancer: an 18-month longitudinal study. J Clin Oncol 29:3580–3586

    Article  PubMed  Google Scholar 

  2. Palesh O, Peppone L, Innominato PF et al (2012) Prevalence, putative mechanisms, and current management of sleep problems during chemotherapy for cancer. Nat Sci Sleep 4:151–162

    Article  PubMed Central  PubMed  Google Scholar 

  3. Berger AM (2009) Update on the state of the science: sleep-wake disturbances in adult patients with cancer. Oncol Nurs Forum 36:E165–E177

    Article  PubMed  Google Scholar 

  4. Kripke DF, Langer RD, Kline LE (2012) Hypnotics’ association with mortality or cancer: a matched cohort study. BMJ Open 2(1):e000850

    Article  PubMed Central  PubMed  Google Scholar 

  5. Mishra SI, Scherer RW, Snyder C et al (2012) Exercise interventions on health-related quality of life for people with cancer during active treatment. Cochrane Database Syst Rev 8:CD008465

    PubMed  Google Scholar 

  6. Mishra SI, Scherer RW, Geigle PM et al (2012) Exercise interventions on health-related quality of life for cancer survivors. Cochrane Database Syst Rev 8:CD007566

    PubMed  Google Scholar 

  7. Tang M-, Liou T-, Lin C- (2010) Improving sleep quality for cancer patients: benefits of a home-based exercise intervention. Support Care Cancer 18:1329–1339

    Article  PubMed  Google Scholar 

  8. Youngstedt SD (2005) Effects of exercise on sleep. Clin Sports Med 24:355–365

    Article  PubMed  Google Scholar 

  9. Courneya KS, McKenzie DC, Mackey JR, et al (2013) Effects of exercise dose and type on physical functioning and symptom management in breast cancer patients receiving chemotherapy: A multicenter randomized trial. JCNI 105:1821–1832

    Google Scholar 

  10. Kline CE, Sui X, Hall MH, et al (2012) Dose-response effects of exercise training on the subjective sleep quality of postmenopausal women: Exploratory analyses of a randomized controlled trial. BMJ Open 2(4)

  11. United States Department of Health and Human Services (USDHHS) (2008) Physical Activity Guidelines for Americans. USDHHS, Washington, DC

    Google Scholar 

  12. Schmitz KH, Courneya KS, Matthews C et al (2010) American college of sports medicine roundtable on exercise guidelines for cancer survivors. Med Sci Sports Exerc 42:1409–1426

    Article  PubMed  Google Scholar 

  13. Rock CL, Doyle C, Demark-Wahnefried W et al (2012) Nutrition and physical activity guidelines for cancer survivors. CA Cancer J Clin 62:242–274

    Article  Google Scholar 

  14. Buysse DJ, Reynolds CF III, Monk TH et al (1989) The Pittsburgh sleep quality index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213

    Article  CAS  PubMed  Google Scholar 

  15. Beck SL, Schwartz AL, Towsley G et al (2004) Psychometric evaluation of the Pittsburgh sleep quality index in cancer patients. J Pain Symptom Manag 27:140–148

    Article  Google Scholar 

  16. Courneya KS, McKenzie DC, Mackey JR et al (2008) Moderators of the effects of exercise training in breast cancer patients receiving chemotherapy: a randomized controlled trial. Cancer 112:1845–1853

    Article  PubMed  Google Scholar 

  17. Courneya KS, Sellar CM, Stevinson C et al (2009) Moderator effects in a randomized controlled trial of exercise training in lymphoma patients. Cancer Epidemiol Biomark Prev 18:2600–2607

    Article  Google Scholar 

  18. Cella D, Eton DT, Lai J- et al (2002) Combining anchor and distribution-based methods to derive minimal clinically important differences on the functional assessment of cancer therapy (FACT) anemia and fatigue scales. J Pain Symptom Manag 24:547–561

    Article  Google Scholar 

  19. Diggle P, Heagerty P, Liang K et al (2002) Analysis of longitudinal data, 2nd edn. NY, Oxford University Press, New York

    Google Scholar 

  20. Mustian KM, Sprod LK, Janelsins M et al (2013) Multicenter randomized controlled trial of yoga for sleep quality among cancer survivors. J Clin Oncol 31:3233–3241

    Article  PubMed  Google Scholar 

  21. Yang P-, Ho K-, Chen H- et al (2012) Exercise training improves sleep quality in middle-aged and older adults with sleep problems: a systematic review. J Physiother 58:157–163

    Article  PubMed  Google Scholar 

  22. Courneya KS, Sellar CM, Trinh L et al (2012) A randomized trial of aerobic exercise and sleep quality in lymphoma patients receiving chemotherapy or no treatments. Cancer Epidemiol Biomark Prev 21:887–894

    Article  Google Scholar 

  23. Sanford SD, Wagner LI, Beaumont JL et al (2013) Longitudinal prospective assessment of sleep quality: before, during, and after adjuvant chemotherapy for breast cancer. Support Care Cancer 21:959–967

    Article  PubMed  Google Scholar 

  24. Savard J, Simard S, Blanchet J et al (2001) Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep 24:583–590

    CAS  PubMed  Google Scholar 

  25. LeBlanc M, Mérette C, Savard J et al (2009) Incidence and risk factors of insomnia in a population-based sample. Sleep 32:1027–1037

    PubMed Central  PubMed  Google Scholar 

  26. Sharma N, Hansen CH, OConnor M et al (2012) Sleep problems in cancer patients: prevalence and association with distress and pain. Psycho-Oncology 21:1003–1009

    Article  PubMed  Google Scholar 

  27. King AC, Oman RF, Brassington GS et al (1997) Moderate-intensity exercise and self-rated quality of sleep in older adults: a randomized controlled trial. J Am Med Assoc 277:32–37

    Article  CAS  Google Scholar 

  28. Tworoger SS, Yasui Y, Vitiello MV et al (2003) Effects of a yearlong moderate-intensity exercise and a stretching intervention on sleep quality in postmenopausal women. Sleep 26:830–836

    PubMed  Google Scholar 

Download references

Acknowledgments

This work was supported by a Grant from the Canadian Breast Cancer Research Alliance. KSC and YY are supported by the Canada Research Chairs Program. YY is also supported by the Alberta Innovates-Health Solutions. CMF is supported by a Health Senior Scholar Award from Alberta Innovates-Health Solutions and through the Alberta Cancer Foundation’s Weekend to End Women’s Cancers Breast Cancer Chair. LT was supported by a Health Studentship from Alberta Innovates-Health Solutions.

Disclosures

None. The authors report no financial relationship with the Canadian Breast Cancer Research Alliance who sponsored the research.

Author information

Authors and Affiliations

  1. Faculty of Physical Education and Recreation, University of Alberta, E-488 Van Vliet Center, Edmonton, AB, T6G 2H9, Canada

    Kerry S. Courneya, John R. Mackey, Yutaka Yasui, Diane Cook, Linda Trinh & Cynthia C. Forbes

  2. The Ottawa Hospital Cancer Center, Ottawa, ON, Canada

    Roanne J. Segal, Carolyn Proulx & Evyanne Wooding

  3. Ottawa Hospital Research Institute, Ottawa, ON, Canada

    Roanne J. Segal & Evyanne Wooding

  4. Cross Cancer Institute, Edmonton, AB, Canada

    John R. Mackey

  5. University of British Columbia, Vancouver, BC, Canada

    Karen Gelmon, Diana Jespersen, Lianne B. Dolan & Donald C. McKenzie

  6. British Columbia Cancer Agency, Vancouver, BC, Canada

    Karen Gelmon

  7. Alberta Health Services, Calgary, AB, Canada

    Christine M. Friedenreich

  8. University of Ottawa Heart Institute, Ottawa, ON, Canada

    Robert D. Reid

Authors
  1. Kerry S. Courneya
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Roanne J. Segal
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John R. Mackey
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Karen Gelmon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Christine M. Friedenreich
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yutaka Yasui
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Robert D. Reid
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Diana Jespersen
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Diane Cook
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Carolyn Proulx
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Linda Trinh
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Lianne B. Dolan
    View author publications

    You can also search for this author in PubMed Google Scholar

  13. Evyanne Wooding
    View author publications

    You can also search for this author in PubMed Google Scholar

  14. Cynthia C. Forbes
    View author publications

    You can also search for this author in PubMed Google Scholar

  15. Donald C. McKenzie
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kerry S. Courneya.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Courneya, K.S., Segal, R.J., Mackey, J.R. et al. Effects of exercise dose and type on sleep quality in breast cancer patients receiving chemotherapy: a multicenter randomized trial. Breast Cancer Res Treat 144, 361–369 (2014). https://doi.org/10.1007/s10549-014-2883-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-014-2883-0

Keywords

Search

Navigation