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Karen M. Mustian, Ph.D., M.P.H.Assistant Professor
Director PEAK CORE Lab Department of Radiation Oncology
University of Rochester Cancer CenterFunding: NCI U10CA037420
& OCCAM U10 CA037420-20S1
YOCAS® Yoga Significantly Improves Sleep, Fatigue and Quality of Life in 410 Cancer
Survivors : A URCC CCOP Research Base RCT
Study AimsPrimary Aim• To examine the efficacy of yoga
for improving sleep qualitysleep quality in cancer survivors
Secondary Aims• To examine the efficacy of yoga
for improving fatiguefatigue and quality of lifequality of life in cancer survivors
Central Illinois CCOPColumbia River CCOPHematology-Oncology of CNY CCOPSanta Rosa CCOPSoutheast Cancer Control ConsortiumKansas City CCOPGrand Rapids CCOPGreenville CCOPWichita CCOP
URCC
CCOPs
URCC CCOP Research Base: YOCAS ® Recruitment Sites
Eligibility CriteriaStudy participants must:
• Have cancercancer• Have undergone standard treatment for cancer standard treatment for cancer • Have completed all standard treatment completed all standard treatment
between 2 and 24 months priorbetween 2 and 24 months prior• Have sleep disturbance of a level 3 sleep disturbance of a level 3 or greater• Read EnglishEnglish • 21 years 21 years or older• Give written consentconsent
Study participants must not:• Have regularly participated in yoga classes regularly participated in yoga classes
within 3 months prior within 3 months prior • Have sleep apneasleep apnea• Have metastaticmetastatic cancer
• Arm 1: Standard Care
• Arm 2: Yoga plus Standard Care
• EligibilitEligibility• Consent• On-study
forms• Assess
sleep (PSQI), fatigue (MFSI), QOL (FACIT)
• Randomize
• Assess sleep, fatigue, QOL
• End study
Study Week 1(Baseline)
Study Weeks 2–5 (Intervention)
Study Week 6 (Post)
Schema
YOCAS® Intervention• Yoga
– Gentle Hatha Yoga– Restorative Yoga
• Components– Postures (asanas): seated, standing, transitional and supine – Breathing exercises (pranayama): slow, diaphragmatic– Mindfulness (awareness): meditation, visualization &
affirmation
• Duration– 4 weeks– 2 times a week for 75 minutes
• Standardization– URCC CCOP Yoga Consultant– Yoga Alliance-Certified Instructors– Yoga Instructional DVD– Yoga Instructional Manual
YOCAS® Intervention
• Diagnosis– Breast: N =307 (75%)– Other: N =103 (25%)
• Baseline Sleep Quality* – Yoga = 9.0– Control = 9.2
• N = 204 Control, 206 Yoga
• Mean age = 54 years
• Female N = 393 (96%)
• Caucasian N = 383 (93%)
Demographics (N=410)
•Both groups met the clinical cutoff criteria for impaired sleep quality (PSQI >5)
0%
5%
10%
15%
20%
25%
30%
35%
0 1 2 3 4 5 6 7 8
Perc
ent
Compliance (N = 410)86% > 5 sessions
% Y
oga
Ses
sio
ns A
tten
ded
Yoga Sessions
Results (N = 410)
-20 -10 0 10 20 30 40 50
Percent Improvement
Yoga Sleep Medications
Control
Daytime Sleepiness
Control Yoga
Sleep Quality Control Yoga
Fatigue Control Yoga
QOL Control Yoga
P < 0.05
P < 0.05
• Sleep quality–Yoga subjects improved sleep
quality by 22% while control subjects improved by 12% (p<0.05)
Sleep Quality (N = 410)
• Baseline sleep quality– 84% of the yoga subjects and 83% of the
control subjects had clinically impaired sleep quality at baseline (PSQI > 5)
• Sleep quality recovery – 31% of the yoga subjects recovered (PSQI <
5), while only 16% of the control subjects recovered (p<0.05)
Sleep Quality Recovery(N = 410)
• Fatigue– Yoga subjects reduced fatigue by 42%
while control subjects reduced fatigue by 12% (p<0.05)
• Quality of life– Yoga subjects improved quality of life
by 6% while control subjects improved quality of life by 0% (p<0.05)
Fatigue, & QOL (N = 410)
• Daytime sleepiness– Yoga subjects reduced daytime sleepiness
by 29% while control subjects reduced daytime sleepiness by 5% (p<0.05)
• Sleep medication use– Yoga subjects reduced sleep medication use
by 21% while control subjects increased sleep medication use by 5% (p<0.05)
Daytime Sleepiness & Medication Use (N = 410)
• YOCAS® Yoga was found effective for improving– Sleep quality– Fatigue– Quality of life– Daytime sleepiness– Reducing Sleep Medication Use!
Summary
• Gary Morrow, Ph.D., M.S.• Jim Atkins, M.D. • Luke Peppone, Ph.D.• Michelle Janelsins, Ph.D.• Oxana Palesh, Ph.D.,
M.P.H.• Lisa Sprod, Ph.D.• Supriya Mohile, M.D.• Charles Heckler, Ph.D.• Jane Hickok, M.D.
• Marget Braun, R.Y.T.• Leslie Gillies, C.R.C.• Jennifer Yates, M.S.• Jacque Lindke, C.R.C• Ryan Jones• Sebastian Estaque• Ann Wiater• NCI & OCCAM• URCC CCOP Affiliates
Acknowledgments
Yocas pictures