TY - JOUR
T1 - Effects and moderators of exercise on sleep in adults with cancer: Individual patient data and aggregated meta-analyses
AU - Bernard, P.
AU - Savard, J.
AU - Steindorf, K.
AU - Sweegers, M.G.
AU - Courneya, K.S.
AU - Newton, R.U.
AU - Aaronson, N.K.
AU - Jacobsen, P.B.
AU - May, A.M.
AU - Galvao, D.A.
AU - Chinapaw, M.J.
AU - Stuiver, M.M.
AU - Griffith, K.A.
AU - Mesters, I.
AU - Knoop, H.
AU - Goedendorp, M.M.
AU - Bohus, M.
AU - Thorsen, L.
AU - Schmidt, M.E.
AU - Ulrich, C.M.
AU - Sonke, G.S.
AU - van Harten, W.
AU - Winters-Stone, K.M.
AU - Velthuis, M.J.
AU - Taaffe, D.R.
AU - van Mechelen, W.
AU - Kersten, M.J.
AU - Nollet, F.
AU - Wenzel, J.
AU - Wiskemann, J.
AU - Verdonck-de Leeuw, I.M.
AU - Brug, J.
AU - Buffart, L.M.
N1 - With supplementary file.
PY - 2019/9
Y1 - 2019/9
N2 - 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.
AB - 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.
KW - Cancer
KW - Physical activity
KW - Treatment
KW - sleep
U2 - 10.1016/j.jpsychores.2019.109746
DO - 10.1016/j.jpsychores.2019.109746
M3 - Review article
C2 - 31443811
SN - 0022-3999
VL - 124
JO - Journal of Psychosomatic Research
JF - Journal of Psychosomatic Research
M1 - 109746
ER -