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The prevalence of sleep disturbance is high among cancer patients, and the sleep problems tend to last for years after the end of treatment. As part of a large randomized controlled clinical trial (the MICA trial, NCT00990977) of the effect of mindfulness-based stress reduction (MBSR) on psychological and somatic symptoms among breast cancer patients, the aim of the current study was to evaluate the effect of MBSR on the secondary outcome, 'sleep quality '. Material and methods. A total of 336 women operated on for breast cancer stage I-III 3-18 months previously were randomized to MBSR (n = 168) or treatment as usual (n = 168); both groups received standard clinical care. The intervention consisted of an eight-week MBSR program (psycho-education, meditation and gentle yoga). Sleep quality was assessed on the Medical Outcome Study sleep scale at baseline, after the intervention and at six-and 12-months ' follow-up. Results. The mean sleep problem scores were significantly lower in the MBSR group than in controls immediately after the intervention. Quantile regression analyses showed that the effect was statistically significant only for the participants represented by the lower percentile of change between baseline and post-intervention, i.e. those who had more sleep problems; the MBSR group had a significantly smaller increase in sleep problems than the control group. After the 12-month follow-up, there was no significant between-group effect of MBSR on sleep quality in intention-to-treat analyses. Conclusion. MBSR had a statistically significant effect on sleep quality just after the intervention but no long-term effect among breast cancer patients. Future trials in which participation is restricted to patients with significant sleep problems are recommended for evaluating the effect of MBSR on sleep quality.

Objective: The use of mindfulness-based therapy (MBT) in oncology settings has become increasingly popular, and research in the field has rapidly expanded. The objective was by means of a systematic review and meta-analysis to evaluate the current evidence for the effect of MBT on symptoms of anxiety and depression in adult cancer patients and survivors. Method: Electronic databases were searched, and researchers were contacted for further relevant studies. Twenty-two independent studies with a total of 1,403 participants were included. Studies were coded for quality (range: 0–4), and overall effect size analyses were performed separately for nonrandomized studies (K = 13, n = 448) and randomized controlled trials (RCTs; K = 9, n = 955). Effect sizes were combined using the random-effects model. Results: In the aggregated sample of nonrandomized studies (average quality score: 0.5), MBT was associated with significantly reduced symptoms of anxiety and depression from pre- to posttreatment corresponding to moderate effect sizes (Hedges\'s g) of 0.60 and 0.42, respectively. The pooled controlled effect sizes (Hedges\'s g) of RCTs (average quality score: 2.9) were 0.37 for anxiety symptoms (p < .001) and 0.44 for symptoms of depression (p < .001). These effect sizes appeared robust. Furthermore, in RCTs, MBT significantly improved mindfulness skills (Hedges\'s g = 0.39). Conclusion: While the overall quality of existing clinical trials varies considerably, there appears to be some positive evidence from relatively high-quality RCTs to support the use of MBT for cancer patients and survivors with symptoms of anxiety and depression.