Skip to main content
Log in

Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients

  • Published:
International Journal of Behavioral Medicine Aims and scope Submit manuscript

Abstract

Sleep disturbance is a very common problem for cancer patients that has largely not been addressed in the clinical intervention literature. Mindfulness meditation has demonstrated clinical benefits for a variety of patient populations in other areas of functioning. This study examined the effects of an 8-week Mindfulness-Based Stress Reduction (MBSR) program on the sleep quality of a heterogeneous sample of 63 cancer patients. Overall sleep disturbance was significantly reduced (p < .001) and participants reported that their sleep quality had improved (p < .001). There was also a significant reduction in stress (p < .001), mood disturbance (p = .001), and fatigue (p < .001). The associations among these changes and implications for improving quality of life of cancer patients are discussed.

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

Access this article

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

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Ancoli-Israel, S., Moore, P. J., & Jones, V. (2001). The relationship between fatigue and sleep in cancer patients: A review. European Journal of Cancer Care, 10, 245–255.

    Article  PubMed  Google Scholar 

  • Barnes, E. A., & Bruera, A. (2002). Fatigue in patients with advanced cancer: A review. International Journal of Gynecological Cancer, 12, 424–428.

    Article  PubMed  Google Scholar 

  • Beck, S. L., Schwartz, A. L., Towsley, G., Dudley, W., & Barsevick, A. (2004). Psychometric evaluation of the Pittsburgh Sleep Quality Index in cancer patients. Journal of Pain and Symptom Management, 27, 140–148.

    Article  PubMed  Google Scholar 

  • Berger, A. (2003). Treating fatigue in cancer patients. Oncologist, 8 Suppl 1, 10–14.

    Article  Google Scholar 

  • Berger, A. M., & Higginbotham, P. (2000). Correlates of fatigue during and following adjuvant breast cancer chemotherapy: A pilot study. Oncology Nursing Forum, 27, 1443–1448.

    PubMed  Google Scholar 

  • Bishop, S. R., Lau, M. A., Shapiro, S. L., Carlson, L. E., Anderson, N. D., Carmody, J. F., et al. (2004). Mindfulness: A proposed operational definition. Clinical Psychology: Science and Practice, 11, 230–241.

    Article  Google Scholar 

  • Buysse, D. J., Reynolds, C. F., III, Monk, T. H., Berman, S. R., & Kupfer, D. J. (1989). The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Research, 28, 193–213.

    Article  PubMed  Google Scholar 

  • Carlson, L. E., Angen, M., Cullum, J., Goodey, E., Koopmans, J., Lamont, L., et al. (2004). High levels of untreated distress and fatigue in cancer patients. British Journal of Cancer, 90, 2297–2304.

    PubMed  Google Scholar 

  • Carlson, L. E., Speca, M., Patel, K. D., & Goodey, E. (2003). Mindfulness-based stress reduction in relation to quality of life, mood, symptoms of stress, and immune parameters in breast and prostate cancer outpatients. Psychosomatic Medicine, 65, 571–581.

    Article  PubMed  Google Scholar 

  • Carlson, L. E., Ursuliak, Z., Goodey, E., Angen, M., & Speca, M. (2001). The effects of a mindfulness meditation based stress reduction program on mood and symptoms of stress in cancer outpatients: Six month follow-up. Supportive Care in Cancer, 9, 112–123.

    Article  PubMed  Google Scholar 

  • Carpenter, J. S., & Andrykowski, M. A. (1998). Psychometric evaluation of the Pittsburgh Sleep Quality Index. Journal of Psychosomatic Research, 45, 5–13.

    Article  PubMed  Google Scholar 

  • Cella, D., Davis, K., Breitbart, W., & Curt, G. (2001). Cancer-related fatigue: Prevalence of proposed diagnositic criteria in a United States sample of cancer survivors. Journal of Clinical Oncology, 19, 3385–3391.

    PubMed  Google Scholar 

  • Courneya, K. S., Friedenreich, C. M., Sela, R. A., Quinney, H. A., Rhodes, R. E., & Handman, M. (2003). The group psychotherapy and home-based physical exercise (group-hope) trial in cancer survivors: Physical fitness and quality of life outcomes. Psycho-Oncology, 12, 357–374.

    Article  PubMed  Google Scholar 

  • Engstrom, C. A., Strohl, R. A., Rose, L., Lewandowski, L., & Stefanek, M. E. (1999). Sleep alterations in cancer patients. Cancer Nursing, 22, 143–148.

    Article  PubMed  Google Scholar 

  • Hall, M., Baum, A., Buysse, D. J., Prigerson, H. G., Kupfer, D. J., & Reynolds, C. F., III (1998). Sleep as a mediator of the stress-immune relationship. Psychosomatic Medicine, 60, 48–51.

    PubMed  Google Scholar 

  • Hall, M., Buysse, D. J., Nowell, P. D., Nofzinger, E. A., Houck, P., Reynolds, C. F., III, et al. (2000). Symptoms of stress and depression as correlates of sleep in primary insomnia. Psychosomatic Medicine, 62, 227–230.

    PubMed  Google Scholar 

  • Kabat-Zinn, J. (1990). Full catastrophe living: Using the wisdom of your body and mind to face stress, pain and illness. New York: Delacourt.

    Google Scholar 

  • Kabat-Zinn, J., Lipworth, L., & Burney, R. (1985). The clinical use of mindfulness meditation for the self-regulation of chronic pain. Journal of Behavioral Medicine, 8, 163–190.

    Article  PubMed  Google Scholar 

  • Kaplan, K. H., Goldenberg, D. L., & Galvin-Nadeau, M. (1993). The impact of a meditation-based stress reduction program on fibromyalgia. General Hospital Psychiatry, 15, 284–289.

    Article  PubMed  Google Scholar 

  • Koopman, C., Nouriani, B., Erickson, V., Anupindi, R., Butler, L. D., Bachmann, M. H., et al. (2002). Sleep disturbances in women with metastatic breast cancer. The Breast Journal, 8, 362–370.

    Article  PubMed  Google Scholar 

  • Lavidor, M., Weller, A., & Babkoff, H. (2003). How sleep is related to fatigue. British Journal of Health Psychology, 8, 95–105.

    Article  PubMed  Google Scholar 

  • Leckie, M. S. & Thompson, E. (1979). Symptoms of stress inventory. Seattle: University of Washington.

    Google Scholar 

  • Malone, M., Harris, A. L., & Luscombe, D. K. (1994). Assessment of the impact of cancer on work, recreation, home meanagement and sleep using a general health status measure. Journal of the Royal Society of Medicine, 87, 386–389.

    PubMed  Google Scholar 

  • McNair, D. A., Lorr, M., & Droppelman, L. F. (1971). Profile of mood states. San Diego, CA: Educational and Industrial Testing Service.

    Google Scholar 

  • Mendoza, T. R., Wang, X. S., Cleeland, C. S., Morrissey, M., Johnson, B. A., Wendt, J. K., et al. (1999). The rapid assessment of fatigue severity in cancer patients: Use of the Brief Fatigue Inventory. Cancer, 85, 1186–1196.

    Article  PubMed  Google Scholar 

  • Miller, J. J., Fletcher, K., & Kabat-Zinn, J. (1995). Three-year follow-up and clinical implications of a mindfulness meditation-based stress reduction intervention in the treatment of anxiety disorders. General Hospital Psychiatry, 17, 192–200.

    Article  PubMed  Google Scholar 

  • Reibel, D. K., Greeson, J. M., Brainard, G. C., & Rosenzweig, S. (2001). Mindfulness-based stress reduction and health-related quality of life in a heterogeneous patient population. General Hospital Psychiatry, 23, 183–192.

    Article  PubMed  Google Scholar 

  • Savard, J., Miller, S. M., Mills, M., O’Leary, A., Harding, H., Douglas, S., et al. (1999). Association between subjective sleep quality and depression on immunocompetence in low-income women at risk for cervical cancer. Psychosomatic Medicine, 61, 496–507.

    PubMed  Google Scholar 

  • Savard, J., & Morin, C. M. (2001). Insomnia in the context of cancer: A review of a neglected problem. Journal of Clinical Oncology, 19, 895–908.

    PubMed  Google Scholar 

  • Savard, J., Simard, S., Blanchet, J., Ivers, H., & Morin, C. M. (2001). Prevalence, clinical characteristics, and risk factors for insomnia in the context of breast cancer. Sleep, 24, 583–590.

    PubMed  Google Scholar 

  • Schwartz, A. L. (2000). Daily fatigue patterns and effect of exercise in women with breast cancer. Cancer Practice, 8, 16–24.

    Article  PubMed  Google Scholar 

  • Schwartz, A. L., Mori, M., Gao, R., Nail, L. M., & King, M. E. (2001). Exercise reduces daily fatigue in women with breast cancer receiving chemotherapy. Medicine & Science in Sports & Exercise, 33, 718–723.

    Article  Google Scholar 

  • Shapiro, S. L., Astin, J. A., & Carlson, L. E. (2004) Mechanisms of mindfulness: A new way of seeing. Psychological Review.

  • Shapiro, S. L., Bootzin, R. R., Figueredo, A. J., Lopez, A. M., & Schwartz, G. E. (2003). The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: An exploratory study. Journal of Psychosomatic Research, 54, 85–91.

    Article  PubMed  Google Scholar 

  • Speca, M., Carlson, L. E., Goodey, E., & Angen, M. (2000). A randomized, wait-list controlled clinical trial: The effect of a mindfulness meditation-based stress reduction program on mood and symptoms of stress in cancer outpatients. Psychosomatic Medicine, 62, 613–622.

    PubMed  Google Scholar 

  • Tacon, A. M. (2003). Meditation as a complementary therapy in cancer. Family Community Health, 26, 64–73.

    PubMed  Google Scholar 

  • Weissbecker, I., Salmon, P., Studts, J. L., Floyd, A. R., Dedert, E. A., & Sephton, S. E. (2002). Mindfulness-based stress reduction and sense of coherence among women with fibromyalgia. Journal of Clinical Psychology in Medical Settings, 9, 297–307.

    Article  Google Scholar 

  • Yellen, S. B., Cella, D. F., Webster, K., Blendowski, C., & Kaplan, E. (1997). Measuring fatigue and other anemia-related symptoms with the Functional Assessment of Cancer Therapy (FACT) measurement system. Journal of Pain and Symptom Management, 13, 63–74.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Linda E. Carlson.

Additional information

Dr. Linda Carlson is funded by a Canadian Institutes of Health Research New Investigator Award. We would like to thank all of the participants in the MBSR program who have diligently completed questionnaires, and encourage their quest for healing and personal growth.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carlson, L.E., Garland, S.N. Impact of mindfulness-based stress reduction (MBSR) on sleep, mood, stress and fatigue symptoms in cancer outpatients. Int. J. Behav. Med. 12, 278–285 (2005). https://doi.org/10.1207/s15327558ijbm1204_9

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1207/s15327558ijbm1204_9

Key words

Navigation