The effects of mind-body interventions on sleep in cancer patients: a meta-analysis of randomized controlled trials

OBJECTIVE: To examine the effect of mind-body interventions (MBIs) on sleep quality among cancer patients, the moderating effects of the intervention components, subject characteristics, and methodological features of the relationship between MBIs and sleep. DATA SOURCES: Electronic databases, including PubMed, Cochrane Library, PsycINFO, and CINAHL, containing data with English-language restriction recorded up to September 15, 2013 were searched thoroughly using keywords related to various types of MBI and sleep. STUDY SELECTION: Of the 114 identified citations, 99 were ineligible. Fifteen studies that followed 1,405 patients with cancer met the inclusion criteria and were analyzed. DATA EXTRACTION: The primary outcome was change in the sleep parameter. Other variables related to components of MBIs, subject characteristics, and methodological features of the studies were also extracted. DATA SYNTHESIS: The weighted mean effect size (ES) was -0.43 (95% confidence interval [CI], -0.24 to -0.62) and the long-term effect size (up to 3 months) was -0.29 (95% CI, -0.52 to -0.06). The sensitivity analysis revealed that MBIs had a significant effect on sleep (g = -0.33, P .05). CONCLUSIONS: This meta-analysis confirms that the MBIs yielded a medium effect size on sleep quality and the effect was maintained for up to 3 months. The findings support the implementation of MBIs into the multimodal approach to managing sleep quality in patients with cancer.