By John M. de Castro, Ph.D.
“The mindfulness elements of accepting things as they are, turning towards rather than away from difficult emotional experience, and embracing change as a constant are helpful for cancer patients who are may be facing difficult realities. The emotion-regulation strategies practiced in mindfulness interventions help to prevent worry about the future and rumination over past events, and allow patients to live more fully in the present moment, regardless of what lies ahead.” – Tracey Aaron
People who are cancer survivors face a myriad of issues including sleep difficulties. It is estimated that one third to one half of cancer survivors experience sleep problems. About 12.5% of women in the U.S. develop invasive breast cancer over their lifetimes and every year about 40,000 women die. Indeed, more women in the U.S. die from breast cancer than from any other cancer, besides lung cancer. It is encouraging, however, that the death rates have been decreasing for decades from improved detection and treatment of breast cancer. Five-year survival rates are now at around 95%.
The improved survival rates mean that more women are now living with cancer. This can be difficult as breast cancer survivors can have to deal with the consequences of chemotherapy, and often experience increased fatigue, pain, and bone loss, reduced fertility, difficulty with weight maintenance, damage to the lymphatic system, heightened fear of reoccurrence, and an alteration of their body image. As a result, survivors often develop sleep problems, including difficulties initiating and maintaining sleep. These sleep disturbances can interfere with recovery as they can contribute to stress, fatigue, depression, and poorer treatment outcomes. So, it is important to address sleep disturbance in cancer survivors.
Mindfulness training has shown promise in treating sleep disorders. It has also been shown to be helpful with cancer treatment and recovery. So, it would make sense to test whether mindfulness training might be effective in treating sleep disturbances in breast cancer survivors. In today’s Research News article “The Effects of Mindfulness-Based Stress Reduction (MBSR(BC)) on Objective and Subjective Sleep Parameters in Women with Breast Cancer: A Randomized Controlled Trial.” See:
or below or view the full text of the study at:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487655/
Lengacher and colleagues performed a randomized controlled trial of the effects of an 8-week Mindfulness Based Stress Reduction (MBSR) program on the sleep of breast cancer survivors. Patients completed a questionnaire regarding their sleep and a sleep diary. They also wore and activity monitor for three days as an objective measure of sleep. Measurements were obtained before treatment and again at 6 and 12 weeks after treatment.
They found that MBSR training produced a significant improvement in sleep as assessed with the objective measure (activity monitor) at both 6 and 12 weeks after treatment. The improvements included better sleep efficiency and percentage of time asleep, and also fewer waking bouts. The self-report measures of sleep also showed improvement but were not statistically significant. Since direct, objective measures do not rely on memory or judgement, they are considered more accurate. Thus, the results show that MBSR training improves sleep in breast cancer survivors.
These are interesting and potentially important useful results. Improving sleep in cancer survivors may contribute to their health and well-being and their ability to stay in remission. How MBSR has this effect on sleep was not investigated. It can, however, be speculated that MBSR may effect sleep by reducing the patients psychological and physiological responses to stress. This would help to relax the patients making it easier for them to fall asleep and stay asleep. Alternatively, MBSR has been shown to improve emotion regulation, improving the individual’s ability to completely feel the emotion, yet respond to it adaptively. This may help sleep by allowing the individual to better cope with the anxiety, fear, and worry associated with being a cancer survivor.
So, improve breast cancer survivor sleep with mindfulness
“I am now more easily able to mindfully feel both the difficult and the pleasant emotions of this journey—the uncertainty, the worries and the fear, the relief as I recover, the acceptance of a new normal, and noticing my strength and resilience—each informing the other. Writing about it now I see that having experienced cancer brought with it some gifts: a new sense of integration, a new sense of knowing myself—grounded in the present—with hope for the future.” – Esther Brandon
CMCS – Center for Mindfulness and Contemplative Studies
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Study Summary
Lengacher, C. A., Reich, R. R., Paterson, C. L., Jim, H. S., Ramesar, S., Alinat, C. B., … Kip, K. E. (2015). The Effects of Mindfulness-Based Stress Reduction (MBSR(BC)) on Objective and Subjective Sleep Parameters in Women with Breast Cancer: A Randomized Controlled Trial. Psycho-Oncology,24(4), 424–432. http://doi.org/10.1002/pon.3603
Abstract
Objective: The purpose of this study was to investigate the effects of MBSR(BC) on multiple measures of objective and subjective sleep parameters among breast cancer survivors (BCS).
Methods: Data were collected using a two-armed randomized controlled design among BCS enrolled in either a six week MBSR(BC) program or a Usual Care (UC) group with a 12-week follow-up. The present analysis is a subset of the larger parent trial (ClinicalTrials.gov Identifier: NCT01177124). Seventy-nine BCS participants (mean age 57 years), stages 0-III, were randomly assigned to either the formal (in-class) six week MBSR(BC) program or UC. Subjective sleep parameters (SSP) (i.e., sleep diaries and the Pittsburg Sleep Quality Index (PSQI)) and objective sleep parameters (OSP) (i.e., actigraphy) were measured at baseline, six weeks and 12 weeks after completing the MBSR(BC) or UC program.
Results: Results showed indications of a positive effect of MBSR(BC) on OSP at 12 weeks on sleep efficiency (78.2% MBSR(BC) group vs. 74.6% UC group, p=0.04), percent of sleep time (81.0% MBSR(BC) vs. 77.4% UC, p=0.02) and less number waking bouts (93.5 in MBSR(BC) vs. 118.6 in the UC group, p<0.01). Small non-significant improvements were found in SSP in the MBSR(BC) group from baseline to 6 weeks (PSQI total score, p=0.09). No significant relationship was observed between minutes of MBSR(BC) practice and SSP or OSP.
Conclusions: These data suggest that MBSR(BC) may be an efficacious treatment to improve objective and subjective sleep parameters in BCS.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4487655/