Skip to main content

Advertisement

SpringerLink
Log in

Improving sleep quality for cancer patients: benefits of a home-based exercise intervention

  • Original Article
  • Published:
Supportive Care in Cancer Aims and scope Submit manuscript

Abstract

Purpose

1) To determine the effect of a home-based walking exercise program on the sleep quality and quality of life of cancer patients, as well as 2) to determine if enhanced sleep quality was associated with improvement in quality of life over time.

Methods

This is a prospective, longitudinal, two-armed, randomized clinical trial. Participants were recruited from oncology outpatient clinics in two university-based medical centers and were allocated to either usual care (n = 35) or a home-based walking exercise intervention for 8 weeks (n = 36). Measurements included the Taiwanese version of the Pittsburgh Sleep Quality Index, the Medical Outcomes Study Short Form-36, the Taiwanese Version Ratings of the Perceived Exertion Scale, and a walking exercise log. This study was analyzed on an intention-to-treat basis. Effects of the walking exercise program on sleep quality and quality of life were analyzed by the generalized estimating equation method.

Results

Patients in the exercise group reported significant improvements in sleep quality (β = −3.54, p < 0.01) and the mental health dimension of quality of life (β = 10.48, p < 0.01). Among patients who exercised, enhanced sleep quality also corresponded with reduced bodily pain (β = 0.98, p = 0.04) and improvements over time in the mental health dimension of quality of life (β = −3.87, p < 0.01).

Conclusions

A home-based walking exercise program can be easily incorporated into care for cancer patients who are suffering from sleep disturbances.

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

Access this article

Log in via an institution

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

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Espie CA, Fleming L, Cassidy J et al (2008) Randomized controlled clinical effectiveness trial of cognitive behavior therapy compared with treatment as usual for persistent insomnia in patients with cancer. J Clin Oncol 26:4651–4658

    Article  PubMed  Google Scholar 

  2. Andrykowski MA, Curran SL, Lightner R (1998) Off-treatment fatigue in breast cancer survivors: a controlled comparison. J Behav Med 21:1–18

    Article  CAS  PubMed  Google Scholar 

  3. Carpenter JS, Elam JL, Ridner SH, Carney PH, Cherry GJ, Cucullu HL (2004) Sleep, fatigue, and depressive symptoms in breast cancer survivors and matched healthy women experiencing hot flashes. Oncol Nurs Forum 31:591–598

    Article  PubMed  Google Scholar 

  4. Mock V, Dow KH, Meares CJ et al (1997) Effects of exercise on fatigue, physical functioning, and emotional distress during radiation therapy for breast cancer. Oncol Nurs Forum 24:991–1000

    CAS  PubMed  Google Scholar 

  5. Redeker NS, Lev EL, Ruggiero J (2000) Insomnia, fatigue, anxiety, depression, and quality of life of cancer patients undergoing chemotherapy. Sch Inq Nurs Pract 14:275–298

    CAS  PubMed  Google Scholar 

  6. Wang RC, Wang SJ, Chang YC, Lin CC (2007) Mood state and quality of sleep in cancer pain patients: a comparison to chronic daily headache. J Pain Symptom Manage 33:32–39

    Article  PubMed  Google Scholar 

  7. Sateia MJ, Nowell PD (2004) Insomnia. Lancet 364:1959–1973

    Article  PubMed  Google Scholar 

  8. Savard J, Morin CM (2001) Insomnia in the context of cancer: a review of a neglected problem. J Clin Oncol 19:895–908

    CAS  PubMed  Google Scholar 

  9. Bélanger L, Vallières A, Ivers H, Moreau V, Lavigne G, Morin CM (2007) Meta-analysis of sleep changes in control groups of insomnia treatment trials. J Sleep Res 16(1):77–84

    Article  PubMed  Google Scholar 

  10. Sherrill DL, Kotchou K, Quan SF (1998) Association of physical activity and human sleep disorders. Arch Intern Med 158:1894–1898

    Article  CAS  PubMed  Google Scholar 

  11. Shapiro CM, Bachmayer D (1988) Epidemiological aspects of sleep in general public and hospital outpatient samples. Acta Physiol Scand Suppl 574:41–43

    CAS  PubMed  Google Scholar 

  12. Vuori I, Urponen H, Hasan J, Partinen M (1988) Epidemiology of exercise effects on sleep. Acta Physiol Scand Suppl 574:3–7

    CAS  PubMed  Google Scholar 

  13. Singh NA, Clements KM, Fiatarone MA (1997) A randomized controlled trial of the effect of exercise on sleep. Sleep 20:95–101

    CAS  PubMed  Google Scholar 

  14. King AC, Oman RF, Brassington GS, Bliwise DL, Haskell WL (1997) Moderate-intensity exercise and self-rated quality of sleep in older adults. A randomized controlled trial. JAMA 277:32–37

    Article  CAS  PubMed  Google Scholar 

  15. Yeh GY, Mietus JE, Peng CK et al (2008) Enhancement of sleep stability with Tai Chi exercise in chronic heart failure: preliminary findings using an ECG-based spectrogram method. Sleep Med 9:527–536

    Article  PubMed  Google Scholar 

  16. Tworoger SS, Yasui Y, Vitiello MV et al (2003) Effects of a yearlong moderate-intensity exercise and a stretching intervention on sleep quality in postmenopausal women. Sleep 26:830–836

    PubMed  Google Scholar 

  17. Savard J, Simard S, Ivers H, Morin CM (2005) Randomized study on the efficacy of cognitive-behavioral therapy for insomnia secondary to breast cancer, part I: sleep and psychological effects. J Clin Oncol 23:6083–6096

    Article  PubMed  Google Scholar 

  18. Berger AM, Kuhn BR, Farr LA et al (2009) Behavioral therapy intervention trial to improve sleep quality and cancer-related fatigue. Psychooncology 18(6):634–646

    Article  PubMed  Google Scholar 

  19. Payne JK, Held J, Thorpe J, Shaw H (2008) Effect of exercise on biomarkers, fatigue, sleep disturbances, and depressive symptoms in older women with breast cancer receiving hormonal therapy. Oncol Nurs Forum 35:635–642

    Article  PubMed  Google Scholar 

  20. Bland M (2000) An introduction to medical statistics. Oxford University Press, Oxford

    Google Scholar 

  21. Schwartz AL (2000) Daily fatigue patterns and effect of exercise in women with breast cancer. Cancer Pract 8:16–24

    Article  CAS  PubMed  Google Scholar 

  22. Schwartz AL (2000) Exercise and weight gain in breast cancer patients receiving chemotherapy. Cancer Pract 8:231–237

    Article  CAS  PubMed  Google Scholar 

  23. Guilleminault C, Clerk A, Black J, Labanowski M, Pelayo R, Claman D (1995) Nondrug treatment trials in psychophysiologic insomnia. Arch Intern Med 155:838–844

    Article  CAS  PubMed  Google Scholar 

  24. Buysse DJ, Reynolds CF III, Monk TH, Berman SR, Kupfer DJ (1989) The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 28:193–213

    Article  CAS  PubMed  Google Scholar 

  25. Ware JE, Sherbourne CD (1992) The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care 30:473–483

    Article  PubMed  Google Scholar 

  26. Lu JR, Tseng HM, Tsai YJ (2003) Assessment of health-related quality of life in Taiwan (I): development and psychometric testing of SF-36 Taiwan version. Taiwan J Public Health 22:501–511 (in Chinese)

    Google Scholar 

  27. Tseng HM, Lu JR, Tsai YJ (2003) Assessment of health-related quality of life in Taiwan (II): norming and validation of SF-36 Taiwan version. Taiwan J Public Health 22:512–518 (in Chinese)

    Google Scholar 

  28. Borg GA (1982) Psychophysical bases of perceived exertion. Med Sci Sports Exerc 14:377–381

    CAS  PubMed  Google Scholar 

  29. Borg G, Linderholm H (1967) Perceived exertion and pulse rate during graded exercise in various age group. Acta Med Scand Suppl 472:194–206

    Google Scholar 

  30. Skinner JS, Hutsler R, Bergsteinova V, Buskirk ER (1973) The validity and reliability of a rating scale of perceived exertion. Med Sci Sports 5:94–96

    CAS  PubMed  Google Scholar 

  31. Ulmer H, Janz U, Loogen H (1977) Aspects of the validity of Borg's scale, is it measuring stress or strain? In: Borg G (ed) Physical work and effort. Pergamon Press, New York, pp 181–196

    Google Scholar 

  32. Liang KY, Zeger SL (1986) Longitudinal data analysis using generalized liner models. Biometrika 73:13–22

    Article  Google Scholar 

  33. Liang KY, Zeger SL, Qaqish B (1992) Multivariate regression analyses for categorical data. J R Stat Soc 54:3–40

    Google Scholar 

  34. Zeger SL, Liang KY (1986) Longitudinal data analysis for discrete and continuous outcomes. Biometrics 42:121–130

    Article  CAS  PubMed  Google Scholar 

  35. Berger AM, Farr L (1999) The influence of daytime inactivity and nighttime restlessness on cancer-related fatigue. Oncol Nurs Forum 26(10):1663–1671

    CAS  PubMed  Google Scholar 

  36. Mystakidou K, Parpa E, Tsilika E et al (2007) Sleep quality in advanced cancer patients. J Psychosom Res 62:527–533

    Article  PubMed  Google Scholar 

  37. Verster JC, Veldhuijzen DS, Volkerts ER (2004) Residual effects of sleep medication on driving ability. Sleep Med Rev 8:309–325

    Article  PubMed  Google Scholar 

  38. Lawlor DA, Hopker SW (2001) The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomized controlled trials. BMJ 322:763–767

    Article  CAS  PubMed  Google Scholar 

  39. Driver HS, Taylor SR (2000) Exercise and sleep. Sleep Med Rev 4:387–402

    Article  PubMed  Google Scholar 

  40. Youngstedt SD, Kline CE (2006) Epidemiology of exercise and sleep. Sleep Biol Rhythms 4:215–221

    Article  Google Scholar 

  41. Mereles D, Ehlken N, Kreuscher S et al (2006) Exercise and respiratory training improve exercise capacity and quality of life in patients with severe chronic pulmonary hypertension. Circulation 114:1482–1489

    Article  PubMed  Google Scholar 

  42. Segal R, Evans W, Johnson D et al (2001) Structured exercise improves physical functioning in women with stages I and II breast cancer: results of a randomized controlled trial. J Clin Oncol 19:657–665

    CAS  PubMed  Google Scholar 

  43. McGinty D, Szymusiak R (1990) Keeping cool: a hypothesis about the mechanisms and functions of slow-wave sleep. Trends Neurosci 13:480–487

    Article  CAS  PubMed  Google Scholar 

  44. Kräuchi K, Cajochen C, Werth E, Wirz-Justice A (1999) Warm feet promote the rapid onset of sleep. Nature 401:36–37

    Article  PubMed  Google Scholar 

  45. Horne JA, Moore VJ (1985) Sleep EEG effects of exercise with and without additional body cooling. Electroencephalogr Clin Neurophysiol 60:33–38

    Article  CAS  PubMed  Google Scholar 

  46. Berger RJ, Phillips NH (1988) Comparative aspects of energy metabolism, body temperature and sleep. Acta Physiol Scand Suppl 574:21–27

    CAS  PubMed  Google Scholar 

  47. Adam K, Oswald I (1983) Protein synthesis, bodily renewal and the sleep–wake cycle. Clin Sci (Lond) 65:561–567

    CAS  Google Scholar 

  48. Naylor E, Penev PD, Orbeta L et al (2000) Daily social and physical activity increases slow-wave sleep and daytime neuropsychological performance in the elderly. Sleep 23:87–95

    CAS  PubMed  Google Scholar 

  49. Blanco-Centurion CA, Shiromani PJ (2006) Beneficial effects of regular exercise on sleep in old F344 rats. Neurobiol Aging 27(12):1859–1869

    Article  CAS  PubMed  Google Scholar 

  50. Courneya KS, Friedenreich CM (1997) Determinants of exercise during colorectal cancer treatment: an application of the theory of planned behavior. Oncol Nurs Forum 24:1715–1723

    CAS  PubMed  Google Scholar 

  51. Courneya KS, Friedenreich CM (1997) Relationship between exercise during treatment and current quality of life among survivors of breast cancer. J Psychosoc Oncol 15:35–57

    Article  Google Scholar 

  52. Courneya KS, Blanchard CM, Laing DM (2001) Exercise adherence in breast cancer survivors training for a dragon boat race competition: a preliminary investigation. Psychooncology 10:444–452

    Article  CAS  PubMed  Google Scholar 

  53. Courneya KS, Keats MR, Turner AR (2000) Social cognitive determinants of hospital-based exercise in cancer patients following high dose chemotherapy and bone marrow transplantation. Int J Behav Med 7:189–203

    Article  Google Scholar 

  54. Jones LW, Courneya KS (2002) Exercise counseling and programming preferences of cancer survivors. Cancer Pract 10:208–215

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Ms. Denise Dipert for her expertise in editing this paper.

Author information

Authors and Affiliations

  1. Taipei Medical University - Wan-Fang Hospital, Taipei, Taiwan

    Mei-Feng Tang & Chia-Chin Lin

  2. Taipei Medical University - Shuang-Ho Hosptial, Taipei, Taiwan

    Tsan-Hon Liou

  3. School of Nursing, Taipei Medical University, 250 Wu-Hsing Street, Taipei, 110, Taiwan

    Chia-Chin Lin

Authors
  1. Mei-Feng Tang
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tsan-Hon Liou
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Chia-Chin Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Chia-Chin Lin.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tang, MF., Liou, TH. & Lin, CC. Improving sleep quality for cancer patients: benefits of a home-based exercise intervention. Support Care Cancer 18, 1329–1339 (2010). https://doi.org/10.1007/s00520-009-0757-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00520-009-0757-5

Keywords

Search

Navigation