Effects and moderators of exercise on sleep in adults with cancer: Individual patient data and aggregated meta-analyses

P. Bernard, J. Savard, K. Steindorf, M.G. Sweegers, K.S. Courneya, R.U. Newton, N.K. Aaronson, P.B. Jacobsen, A.M. May, D.A. Galvao, M.J. Chinapaw, M.M. Stuiver, K.A. Griffith, I. Mesters, H. Knoop, M.M. Goedendorp, M. Bohus, L. Thorsen, M.E. Schmidt, C.M. UlrichG.S. Sonke, W. van Harten, K.M. Winters-Stone, M.J. Velthuis, D.R. Taaffe, W. van Mechelen, M.J. Kersten, F. Nollet, J. Wenzel, J. Wiskemann, I.M. Verdonck-de Leeuw, J. Brug, L.M. Buffart

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    OBJECTIVES: To evaluate the effects of exercise interventions on sleep disturbances and sleep quality in patients with mixed cancer diagnoses, and identify demographic, clinical, and intervention-related moderators of these effects.

    METHODS: Individual patient data (IPD) and aggregated meta-analyses of randomized controlled trials (RCTs). Using data from the Predicting OptimaL cAncer RehabIlitation and Supportive care project, IPD of 2173 adults (mean age = 54.8) with cancer from 17 RCTs were analyzed. A complementary systematic search was conducted (until November 2018) to study the overall effects and test the representativeness of analyzed IPD. Effect sizes of exercise effects on self-reported sleep outcomes were calculated for all included RCTs. Linear mixed-effect models were used to evaluate the effects of exercise on post-intervention outcome values, adjusting for baseline values. Moderator effects were studied by testing interactions for demographic, clinical and intervention-related characteristics.

    RESULTS: For all 27 eligible RCTs from the updated search, exercise interventions significantly decreased sleep disturbances in adults with cancer (g = -0.09, 95% CI [-0.16; -0.02]). No significant effect was obtained for sleep quality. RCTs included in IPD analyses constituted a representative sample of the published literature. The intervention effects on sleep disturbances were not significantly moderated by any demographic, clinical, or intervention-related factor, nor by sleep disturbances.

    CONCLUSIONS: This meta-analysis provides some evidence that, compared to control conditions, exercise interventions may improve sleep disturbances, but not sleep quality, in cancer patients, although this effect is of a small magnitude. Among the investigated variables, none was found to significantly moderate the effect of exercise interventions on sleep disturbances.

    Original languageEnglish
    Article number109746
    Number of pages9
    JournalJournal of Psychosomatic Research
    Publication statusPublished - Sept 2019


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