Roxanne Nelson

November 01, 2013

VANCOUVER, British Columbia — Sleep disturbances are common in cancer patients and survivors, but mind–body interventions can help, according to a randomized study.

Researchers found that 2 strategies, mind–body bridging (MBB) and mindfulness meditation (MM), improved sleep disturbance and comorbid symptoms in cancer survivors. MBB was better than sleep hygiene education for decreasing self-reported sleep disturbances (P = .0029), as was MM (P = .0499).

In addition, self-reported symptoms of depression decreased in patients in the MBB group, compared with the education group (P = .040), and overall levels of mindfulness (P = .018), self-compassion (P = .028), and well-being (P = .019) improved.

"The management of sleep problems in survivors is a high-priority issue that should demand more attention in cancer survivorship," said lead author Yoshio Nakamura, PhD, from the Department of Anesthesiology at the Pain Research Center at University of Utah School of Medicine in Salt Lake City.

Dr. Nakamura presented the study results here at 10th International Conference of the Society for Integrative Oncology.

"Brief sleep-focused mind–body bridge building and mindfulness meditation are promising interventions for sleep disturbance in cancer survivors," he said.

Because MBB produced additional secondary benefits, it might be a promising multipurpose intervention for post-treatment cancer survivors, explained Dr. Nakamura. "Integrating mind–body bridging or mindfulness meditation into post-treatment supportive plans should enhance the care of cancer survivors with sleep disturbance."

Improving Sleep

Mindfulness-based interventions are mind–body interventions that focus on the power of mental training in regulating health conditions, and use mental training to facilitate awareness, attention, intention, and attitude, the researchers note. These interventions include mindfulness-based stress reduction, mindfulness-based cognitive therapy, and the more recent MBB.

MBB teaches awareness skills to help a person calm the mind, relax the body, improve health, and reach a state of well being. Bridging is the primary technique that facilitates the healing process and aims to reduce the impact of negative thought patterns that contribute to stress in the body.

There has been an explosion of interest in mindfulness, which "does not require any particular religious or cultural belief system," said Dr. Nakamura.

He pointed out that several recent studies investigated the effectiveness of mindfulness-based interventions in managing symptoms in cancer patients and post-treatment survivors. Results have been largely positive and promising. However, the ability of these strategies to specifically improve sleep needed to be demonstrated conclusively, he noted.

Study Details

To address that issue, Dr. Nakamura and colleagues conducted a randomized trial to see whether short-term mindfulness-based intervention programs would help improve sleep and decrease comorbid symptoms in cancer survivors with self-reported sleep disturbance.

The 57 cancer survivors who participated in the study had clinically significant self-reported sleep disturbance. They were randomly assigned to MBB, MM, or sleep hygiene education (control group). All interventions were conducted in 3 sessions, once per week, and patient-reported outcomes were assessed using the Medical Outcomes Study Sleep Scale and other indicators of psychosocial functioning relevant to quality of life, stress, depression, mindfulness, self-compassion, and well-being.

The data suggest that both MBB and MM can serve as effective interventions for sleep management in post-treatment cancer survivors.

"Mindfulness is an is an important tool that is gaining interest and acceptance," said Jun J. Mao, MD, MSCE, director of the integrative oncology initiative at the Abramson Cancer Center at the Perelman School of Medicine, University of Pennsylvania, who was not involved in the study. "The evidence presented will eventually lead to integration into appropriate therapies that will help cancer survivors deal with issues such as sleep disturbances and chronic pain."

"These are important preliminary results and need to be verified in larger studies with more follow-up," he told Medscape Medical News.

Dr. Nakamura has disclosed no relevant financial relationships.

10th International Conference of the Society for Integrative Oncology (SIO): Abstract 71. Presented October 20, 2013.

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