Tibetan yoga modestly improves fatigue and sleep quality in women with breast cancer undergoing chemotherapy

Reference

Chaoul A, Milbury K, Spelman A, et al. Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy. Cancer 2018;124(1):36-45.

Synopsis

These authors identified women with stage I to stage III breast cancer who were within their first 2 cycles of chemotherapy and randomized them into 1 of 3 groups: Tibetan yoga (n = 74), stretching (n = 68), or usual care (n = 85). They excluded women with lymphedema, thought disorder, cognitive impairment, severe functional impairments, and those who were already yoga practitioners. (Okay, I confess. I have no idea how Tibetan yoga differs from any other flavor of yoga. And don't get me started on goat yoga!) Although most of the outcomes were self-reported, the researchers used validated instruments to assess sleep quality and fatigue and gave the patients wrist-worn actigraphs to capture sleep and physical activity parameters for up to a year. During the period of chemotherapy treatment, the yoga and stretching groups attended 4 classes that lasted 75 minutes to 90 minutes each. Additionally, the patients were asked to attend 3 "booster" sessions during the 6 months after completing chemotherapy. Finally, the researchers encouraged the women to practice yoga or stretching between sessions. At the end of a year, the researchers lost approximately one third of the patients, a serious threat to the validity of their data. The authors appropriately adjusted for the number of assessments. After doing a whole boatload of comparisons, they found not much difference in the groups over time, but the patients participating in yoga had less fatigue and slightly better sleep 1 week after treatment. The authors report that patients who completed more yoga sessions had greater improvements, but this is likely biased (not an intention-to-treat outcome).