Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

 

By John M. de Castro, Ph.D.

 

“Tai Chi and Qigong are ancient forms of exercise that fit the bill for helping patients with cancer get moving and improve their overall sense of well-being. Tai Chi practice can help with pain conditions, especially pain involving muscles and joints; it can also reduce stress and anxiety and improve the quality of sleep.” – Susan Yaguda

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbancefear, and anxiety and depression. Mind-body practices such as Tai Chi or Qigong, and yoga have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. These practices work to relieve the emotional distress of cancer survivors.

 

A potential mechanism by which mind-body practices may relieve emotional distress is by altering the balance in the autonomic nervous system. A measure of this balance is Heart Rate Variability (HRV). It refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Increased heart rate variability signals greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This all signals greater physiological relaxation.

 

In today’s Research News article “Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/ ) Larkey and colleagues recruited female breast cancer survivors and randomly assigned them to receive 12 weeks of either Tai Chi or Sham-Tai Chi practice. Sham-Tai Chi used the same movements but did not incorporate breath control or meditative states. They were measured before and after training for fatigue, sleep, and depression and the electrocardiogram was measured and analyzed for Heart Rate Variability (HRV).

 

They found that after Tai Chi Practice, but not Sham-Tai Chi, there were significant reductions in fatigue and depression and significant improvements in sleep. In addition, in the Tai Chi group there was a significant reduction in low coherence Heart Rate Variability (HRV). Also, the greater the change, over training, in high coherence HRV the greater the reduction in depression levels.

 

This study replicates previous findings that Tai Chi practice reduces fatigue, and depression, and improves sleep. And produces changes in Heart Rate Variability (HRV). But this study used a unique control, comparison, condition of Sham-Tai Chi that had the same movements but lacked the breath control and meditative state of true Tai Chi practice. This suggests that it is not the movements of Tai Chi that produces the benefits but the mindfulness components that are essential.

 

The study also presents some evidence as to the mechanism by which Tai Chi practice improves that physical and psychological state of cancer survivors. The observed changes in Heart Rate Variability (HRV) are indicative of greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This suggests that Tai Chi practice results in a physiological relaxation that in turn may be responsible for the physical and psychological benefits of the practice.

 

Some advantages of Tai Chi practice include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve the physical and psychological symptoms experienced by cancer survivors.

 

So, improve autonomic nervous system function and well-being in cancer survivors with mind-body practices.

 

Research in breast cancer patients has shown that tai chi may help to increase strength, balance, flexibility, heart and lung function, [and] feelings of well-being.” – Breast Cancer.org

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Larkey, L., Kim, W., James, D., Kishida, M., Vizcaino, M., Huberty, J., & Krishnamurthi, N. (2020). Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integrative cancer therapies, 19, 1534735420949677. https://doi.org/10.1177/1534735420949677

 

Abstract

Background:

Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization.

Methods:

HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction.

Results:

HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states.

Conclusion:

Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/

 

Spirituality is Associated with Better Psychological Health of Adolescents with Cancer

Spirituality is Associated with Better Psychological Health of Adolescents with Cancer

 

By John M. de Castro, Ph.D.

 

“Spirituality plays a significant role for adolescents with cancer as it contributes to increased comfort and calmness, and better coping mechanisms when confronted with the illness, which indirectly improves the adolescent’s quality of life.” – Sembiring Lina Mahayati

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis. Adolescents with cancer are particularly vulnerable with high levels of anxiety, depression, fatigue, and pain interference.

 

Religion and spirituality become much more important to people when they’re diagnosed with cancer or when living with cancer. It is thought that people take comfort in the spiritual when facing mortality. Hence, spirituality and mindfulness may be useful tools for the survivors of cancer to cope with their illness. Thus, there is a need to study the relationships of spirituality on the ability of adolescent cancer survivors to positively adjust to their situation.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298609/ ) Grossoehme and colleagues recruited adolescents, aged 14 to 21 years, who were diagnosed with cancer. They had them complete measures of spirituality, feeling God’s presence; praying privately; attending religious services; identifying as religious; identifying as spiritual, emotional distress–anxiety; emotional distress–depressive symptoms; fatigue; and pain interference, health-related quality of life

 

They found that the higher the levels of feeling God’s presence and identifying as a very religious person the lower the levels of anxiety, depressive symptoms, and fatigue. Structural equation modelling revealed that the levels of feeling God’s presence and identifying as a very religious person also were indirectly associated with anxiety, depressive symptoms, and fatigue via a positive association with a sense of meaning and peace. That is, the greater the feelings God’s presence and religiosity the greater the feelings of peace and meaningfulness in life and these feelings were in turn negatively associated with negative emotional states.

 

These results are correlational and as such no conclusions about causation can be definitively made. But the results clearly show that there are relationships between being spiritual and religious and better emotional states in adolescent cancer victims. They also suggest that this relationship is mediated by feelings of meaningfulness and peace. It could be speculated that these relationships occur due to causal connections and interpreted that being spiritual produces a state of peacefulness and meaning in life that counteracts the negative emotions associated with cancer. It remains for future research to determine if increasing spirituality would lead to better emotional adjustments to a cancer diagnosis.

 

Hence, spirituality is associated with better psychological health of adolescents with cancer.

 

As is true with older cancer survivors, spirituality is related to many aspects of well-being for AYA survivors, but relations are more consistent for meaning/peace and struggle.” – Crystal Park

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Grossoehme, D. H., Friebert, S., Baker, J. N., Tweddle, M., Needle, J., Chrastek, J., Thompkins, J., Wang, J., Cheng, Y. I., & Lyon, M. E. (2020). Association of Religious and Spiritual Factors With Patient-Reported Outcomes of Anxiety, Depressive Symptoms, Fatigue, and Pain Interference Among Adolescents and Young Adults With Cancer. JAMA network open, 3(6), e206696. https://doi.org/10.1001/jamanetworkopen.2020.6696

 

Key Points

Question

Among adolescents and young adults with cancer, is there an association between spirituality and patient-reported outcomes, and are these outcomes associated with a sense of meaning, peace, and comfort provided by faith?

Findings

In this cross-sectional study of 126 adolescents and young adults with cancer, structural equation modeling revealed that meaning and peace were associated with aspects of spirituality and religiousness as well as anxiety, depressive, and fatigue symptoms.

Meaning

In this study, participants’ sense of meaning and peace was associated with religiousness and with anxiety and depression, possibly representing an underappreciated intervention target.

Question

Among adolescents and young adults with cancer, is there an association between spirituality and patient-reported outcomes, and are these outcomes associated with a sense of meaning, peace, and comfort provided by faith?

Findings

In this cross-sectional study of 126 adolescents and young adults with cancer, structural equation modeling revealed that meaning and peace were associated with aspects of spirituality and religiousness as well as anxiety, depressive, and fatigue symptoms.

Meaning

In this study, participants’ sense of meaning and peace was associated with religiousness and with anxiety and depression, possibly representing an underappreciated intervention target.

Go to:

Abstract

Importance

The associations of spiritual and religious factors with patient-reported outcomes among adolescents with cancer are unknown.

Objective

To model the association of spiritual and religious constructs with patient-reported outcomes of anxiety, depressive symptoms, fatigue, and pain interference.

Design, Setting, and Participants

This cross-sectional study used baseline data, collected from 2016 to 2019, from an ongoing 5-year randomized clinical trial being conducted at 4 tertiary-referral pediatric medical centers in the US. A total of 366 adolescents were eligible for the clinical trial, and 126 were randomized; participants had to be aged 14 to 21 years at enrollment and be diagnosed with any form of cancer. Exclusion criteria included developmental delay, scoring greater than 26 on the Beck Depression Inventory II, non-English speaking, or unaware of cancer diagnosis.

Exposures

Spiritual experiences, values, and beliefs; religious practices; and overall self-ranking of spirituality’s importance.

Main Outcomes and Measures

Variables were taken from the Brief Multidimensional Measurement of Religiousness/Spirituality (ie, feeling God’s presence, daily prayer, religious service attendance, being very religious, and being very spiritual) and the spiritual well-being subscales of the Functional Assessment of Chronic Illness Therapy (meaning/peace and faith). Predefined outcome variables were anxiety, depressive symptoms, fatigue, and pain interference from Patient-Reported Outcomes Measurement Information System pediatric measures.

Results

A total of 126 individuals participated (72 [57.1%] female participants; 100 [79.4%] white participants; mean [SD] age, 16.9 [1.9] years). Structural equation modeling showed that meaning and peace were inversely associated with anxiety (β = –7.94; 95% CI, –12.88 to –4.12), depressive symptoms (β = –10.49; 95% CI, –15.92 to –6.50), and fatigue (β = –8.90; 95% CI, –15.34 to –3.61). Feeling God’s presence daily was indirectly associated with anxiety (β = –3.37; 95% CI, –6.82 to –0.95), depressive symptoms (β = –4.50; 95% CI, –8.51 to –1.40), and fatigue (β = –3.73; 95% CI, –8.03 to –0.90) through meaning and peace. Considering oneself very religious was indirectly associated with anxiety (β = –2.81; 95% CI, –6.06 to –0.45), depressive symptoms (β = −3.787; 95% CI, –7.68 to –0.61), and fatigue (β = –3.11, 95% CI, –7.31 to –0.40) through meaning and peace. Considering oneself very spiritual was indirectly associated with anxiety (β = 2.11; 95% CI, 0.05 to 4.95) and depression (β = 2.8, 95% CI, 0.07 to 6.29) through meaning and peace. No associations were found between spiritual scales and pain interference.

Conclusions and Relevance

In this study, multiple facets of spirituality and religiousness were associated with anxiety, depression, and fatigue, all of which were indirectly associated with the participant’s sense of meaning and peace, which is a modifiable process. Although these results do not establish a causal direction, they do suggest palliative interventions addressing meaning-making, possibly including a spiritual or religious dimension, as a novel focus for intervention development.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298609/Importance

 

Improve Medically Unexplained Symptoms with Mindfulness

Improve Medically Unexplained Symptoms with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindful people might have lower blood pressure, lower blood sugar, and better heart health. One study found that people who got a flu vaccine after 8 weeks of mindfulness training developed more antibodies against the flu than those who only got the vaccine. It may relieve symptoms of irritable bowel syndrome and cut down on migraines, too.” – WebMD

 

Over the last several decades, research and anecdotal experiences have accumulated an impressive evidential case that the development of mindfulness has positive benefits for the individual’s mental, physical, and spiritual life. Mindfulness appears to be beneficial both for healthy people and for people suffering from a myriad of illnesses. It appears to be beneficial across ages, from children to the elderly. And it appears to be beneficial across genders, personalities, race, and ethnicity. The breadth and depth of benefits is unprecedented. There is no other treatment or practice that has been shown to come anyway near the range of mindfulness’ positive benefits.

 

A number of patients come to see a physician with long-lasting subjective symptoms that do not have a clear medical explanation. Examples are fibromyalgia, chronic fatigue syndrome, and irritable bowel syndrome. It is important to establish if mindfulness may also be effective for these medically unexplained symptoms. The evidence has been accumulating. It is important, then, to step back and summarize what has been learned.

 

In today’s Research News article “What Works in Mindfulness Interventions for Medically Unexplained Symptoms? A Systematic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373253/) Billones and Saligan review and summarize the published research studies on the effectiveness of mindfulness training for the treatment of patients with medically unexplained symptoms including fibromyalgia, chronic fatigue syndrome, irritable bowel syndrome and post-traumatic stress disorder. They identified 24 controlled trials which included a total of 2126 participants who were primarily female (98%).

 

They report that the published studies found that in comparison to control conditions and baseline, mindfulness-based interventions produced significant reductions in symptom severity with moderate to large effect sizes. There were also significant improvements in pain, anxiety, and depression. The results suggest that mindfulness training is highly effective in reducing the symptoms of medically unexplained symptoms.

 

So, improve medically unexplained symptoms with mindfulness.

 

“it’s encouraging to know that something that can be taught and practiced can have an impact on our overall health—not just mental but also physical—more than 2,000 years after it was developed. That’s reason enough to give mindfulness meditation a try.” – Jill Suttie

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Billones, R., & Saligan, L. (2020). What Works in Mindfulness Interventions for Medically Unexplained Symptoms? A Systematic Review. Asian/Pacific Island Nursing Journal, 5(1), 1–11. https://doi.org/10.31372/20200501.1082

 

Abstract

Background/Purpose: Mindfulness-based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. Methods: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis Guidelines (PRISMA) and the modified Oxford Quality Scoring System (Jadad score) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or Fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. Results/Conclusions: MBIs showed large effects on: symptom severity (d  = 0.82), pain intensity (d  = 0.79), depression (d  = 0.62), and anxiety (d  = 0.67). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the nonjudgmental observance of the experience in the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7373253/

 

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are. “ – Breast Cancer Now

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbancefear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based stress reduction for women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/), Schell and colleagues review, summarize, and perform a meta-analysis of the published research studies investigating the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program for the treatment of the psychological problems that occur in women who survive breast cancer. MBSR includes meditation, body scan, yoga practices, and discussion along with daily home practice. They identified 14 randomized controlled trials.

 

They report that the published research studies provide evidence that the Mindfulness-Based Stress Reduction (MBSR) program improves the quality of life and sleep and reduces anxiety, depression, and fatigue in breast cancer patients. The effect sizes are small and the effects were no longer present at long-term follow-up a year after the end of treatment. MBSR is a complex of practices and the research to date cannot differentiate which components or which combination of components are responsible for the benefits.

 

There is substantial evidence that mindfulness training improves quality of life and sleep and reduces anxiety, depression, and fatigue in a wide variety of healthy and ill individuals. The present results suggest that it also has these benefits for women suffering with breast cancer. Hence, MBSR may be recommended to improve the psychological health of breast cancer patients.

 

So, improve the psychological health in breast cancer patients with mindfulness.

 

Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane database of systematic reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

 

Abstract

Background

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness‐based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non‐judgmental, accepting moment‐by‐moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer.

Objectives

To assess the effects of mindfulness‐based stress reduction (MBSR) in women diagnosed with breast cancer.

Search methods

In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization’s International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings.

Selection criteria

Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta‐analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention).

Main results

Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta‐analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta‐analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.

MBSR may improve quality of life slightly at the end of the intervention (based on low‐certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low‐certainty evidence from three studies involving 428 participants). Long‐term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT‐B, 95% CI −5.82 to 5.82; low‐certainty evidence).

In the short term, MBSR probably reduces fatigue (SMD −0.50, 95% CI −0.86 to −0.14; moderate‐certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD −0.29, 95% CI −0.50 to −0.08; moderate‐certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD −0.54, 95% CI −0.86 to −0.22; high‐certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD −0.38, 95% CI −0.79 to 0.04; moderate‐certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short‐term depression) are compatible with both an improvement and little to no difference.

In the medium term, MBSR probably results in little to no difference in medium‐term fatigue (SMD −0.31, 95% CI −0.84 to 0.23; moderate‐certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD −0.28, 95% CI −0.49 to −0.07; moderate‐certainty evidence; 7 studies; 1094 participants), depression (SMD −0.32, 95% CI −0.58 to −0.06; moderate‐certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD −0.27, 95% CI −0.63 to 0.08; moderate‐certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.

In the long term, moderate‐certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD −0.09, 95% CI −0.35 to 0.16; 2 studies; 360 participants) or depression (SMD −0.17, 95% CI −0.40 to 0.05; 2 studies; 352 participants). No long‐term data were available for fatigue or quality of sleep.

No study reported data on survival or adverse events.

Authors’ conclusions

MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/

 

Mindfulness Reduces Fatigue with Breast Cancer Patients Directly and Indirectly by Improving Psychological Health

Mindfulness Reduces Fatigue with Breast Cancer Patients Directly and Indirectly by Improving Psychological Health

 

By John M. de Castro, Ph.D.

 

Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro

 

Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery . Mindfulness practice have been shown to improve the residual symptoms in cancer survivors. So, it’s reasonable to further explore the potential benefits of mindfulness practice to relieve fatigue in patients who have survived breast cancer.

 

In today’s Research News article “The relation between mindfulness and the fatigue of women with breast cancer: path analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011601/), Ikeuchi and colleagues recruited adult women who had undergone surgery for breast cancer and 6 or more months had passed since their last cancer treatment. They completed self-report measures of fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance.

 

They found that the higher the levels of mindfulness the lower the levels of fatigue, anxiety, depression, pain, loneliness, and sleep disturbance and the higher the levels of anxiety, depression, pain, loneliness, and sleep disturbance the higher the levels of fatigue. They then applied path modelling to examine the relationships of the variables. They found that high levels of mindfulness were not only directly associated with low levels of fatigue but also indirectly associated by way of high mindfulness being associated with low levels of anxiety, depression, pain, loneliness, and sleep disturbance. These variables that were, in turn, associated with fatigue levels.

 

These results are correlational and as such caution must be exercised in inferring causation. Previous research, though, has demonstrated that mindfulness is causally related to lower levels of fatigue, anxiety, depression, pain, loneliness, and sleep. So, the present correlative results probably are due to these causal connections. Given this inference, then, the results suggest that mindfulness lowers fatigue in breast cancer patients by directly lowering fatigue and also by improving the psychological and physical health of the patients which also improves fatigue levels.

 

These results are important. After cancer treatment there are substantial and troubling residual physical and psychological symptoms. The findings suggest that mindfulness may be an important means to improve these symptoms and markedly improve the quality of life of patients who have been treated for breast cancer.

 

So, mindfulness reduces fatigue with breast cancer patients directly and indirectly by improving psychological health.

 

mindfulness meditation can reduce stress and anxiety in the general population as well as in breast cancer survivors.” – Kathleen Doheny

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Ikeuchi, K., Ishiguro, H., Nakamura, Y., Izawa, T., Shinkura, N., & Nin, K. (2020). The relation between mindfulness and the fatigue of women with breast cancer: path analysis. BioPsychoSocial medicine, 14, 1. https://doi.org/10.1186/s13030-020-0175-y

 

Abstract

Background

Although fatigue is a common and distressing symptom in cancer survivors, the mechanism of fatigue is not fully understood. Therefore, this study aims to investigate the relation between the fatigue and mindfulness of breast cancer survivors using anxiety, depression, pain, loneliness, and sleep disturbance as mediators.

Methods

Path analysis was performed to examine direct and indirect associations between mindfulness and fatigue. Participants were breast cancer survivors who visited a breast surgery department at a university hospital in Japan for hormonal therapy or regular check-ups after treatment. The questionnaire measured cancer-related-fatigue, mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance. Demographic and clinical characteristics were collected from medical records.

Results

Two-hundred and seventy-nine breast cancer survivors were registered, of which 259 answered the questionnaire. Ten respondents with incomplete questionnaire data were excluded, resulting in 249 participants for the analyses. Our final model fit the data well (goodness of fit index = .993; adjusted goodness of fit index = .966; comparative fit index = .999; root mean square error of approximation = .016). Mindfulness, anxiety, depression, pain, loneliness, and sleep disturbance were related to fatigue, and mindfulness had the most influence on fatigue (β = − .52). Mindfulness affected fatigue not only directly but also indirectly through anxiety, depression, pain, loneliness, and sleep disturbance.

Conclusions

The study model helps to explain the process by which mindfulness affects fatigue. Our results suggest that mindfulness has both direct and indirect effects on the fatigue of breast cancer survivors and that mindfulness can be used to more effectively reduce their fatigue. It also suggests that health care professionals should be aware of factors such as anxiety, depression, pain, loneliness, and sleep disturbance in their care for fatigue of breast cancer survivors.

Trial registration

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7011601/

 

Enhance Relaxation and Reduce Stress with a Brief Sound Meditation

Enhance Relaxation and Reduce Stress with a Brief Sound Meditation

By John M. de Castro, Ph.D.

 

“Sound meditation is the use of therapeutic instruments played in an intuitive way.  It’s an extremely effective and powerful tool for physical and energetic healing/self care. You don’t just hear the vibrations but you FEEL them within your body.” – Babeskills

 

Meditation training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, meditation training has been called the third wave of therapies. One problem with understanding meditation effects is that there are, a wide variety of meditation techniques and it is not known which work best for improving different conditions.

 

There are a number of different types of meditation. Many can be characterized on a continuum with the degree and type of attentional focus. In focused attention meditation, the individual practices paying attention to a single meditation object, learns to filter out distracting stimuli, including thoughts, and learns to stay focused on the present moment, filtering out thoughts centered around the past or future. There are a variety of objects of focused meditation, the most common of which is focusing on the breath. But focusing on sounds can also be very effective.

 

In today’s Research News article “Didgeridoo Sound Meditation for Stress Reduction and Mood Enhancement in Undergraduates: A Randomized Controlled Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769210/), Philips and colleagues recruited meditation naïve college students and randomly assigned them to a single 30 minute meditation session focusing on either sound or the breath. The sound meditation occurred to music played on a Didgeridoo. They were measured before and after the session for mood and perceived stress.

 

They found that after the meditation both groups had significant increases in relaxation and energy and decreases in negative arousal, tiredness, and perceived stress. But the sound meditation group had significantly greater increases in relaxation and decreases in perceived stress than the breath meditation group. The students reported enjoying the meditation but the sound meditation group reported significantly greater enjoyment than the breath meditation group.

 

The results of the study suggest that a single brief meditation session can improve mood and reduce perceived stress but that meditating to music played on a Didgeridoo produced greater relaxation and greater reductions in perceived stress that a more traditional meditation focused on the breath. It appears that the Didgeridoo music made for a more enjoyable meditation. It is possible that the effects observed were due to making meditation more enjoyable rather than a superiority of sound meditation. Future research needs to explore whether these effects occur to different sounds varying in enjoyability and are maintained with a greater number of meditation sessions.

 

So, enhance relaxation and reduce stress with a brief sound meditation.

 

Sound enhances our self-awareness, it facilitates connecting with the higher self, it promotes self-observation and self-worth, and it increases the state of personal resonance. It brings awareness to the inner processes of the mind: the habitual patterns, the good and bad discursive thinking, the judgment, the filters through which we experience the inner and the outer worlds and realities.” – SoundMeditation.com

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Philips, K. H., Brintz, C. E., Moss, K., & Gaylord, S. A. (2019). Didgeridoo Sound Meditation for Stress Reduction and Mood Enhancement in Undergraduates: A Randomized Controlled Trial. Global advances in health and medicine, 8, 2164956119879367. doi:10.1177/2164956119879367

 

Short abstract

Background

College students report feeling frequently stressed, which adversely impacts health. Meditation is one effective method for reducing stress, but program length and required effort are potential obstacles. Research on sound meditation, involving focused listening to sounds, is nascent but may appeal to undergraduates. The effects of listening to didgeridoo, an Australian wind instrument producing a low, resonant, droning sound, have not been studied.

Objective

This study compared the effect of a 30-minute didgeridoo sound meditation versus silent meditation with focus on one’s breath on acute self-perceived stress and mood in undergraduates without prior meditation experience.

Methods

Seventy-four undergraduates were randomized to 2 interventions: (1) didgeridoo meditation (n = 40) performed live by a musician or (2) silent meditation (n = 34) taught by a meditation instructor. Immediate pre–post effects of the session were examined using the 4-Dimension Mood Scale and an item assessing acute self-perceived stress. Intervention acceptability was assessed postintervention.

Results

Two-way mixed analyses of variance were performed. Both groups reported significantly increased relaxation after meditation (Group D, P = .0001 and Group S, P = .0005). Both groups reported decreased negative arousal (Group D, P = .02 and Group S, P = .02), energy (Group D, P = .0001 and Group S, P = .003), tiredness (Group D, P = .0001 and Group S, P = .005), and acute stress (Group D, P = .0001 and Group S, P = .0007). Group Didgeridoo experienced significantly more relaxation (P = .01) and less acute stress (P = .03) than Group Silent. Fifty-three percent of silent participants and 80% of didgeridoo participants agreed that they would attend that type of meditation again. Forty-seven percent of silent participants and 80% of didgeridoo participants enjoyed the meditation.

Conclusion

Didgeridoo sound meditation is as effective as silent meditation for decreasing self-perceived negative arousal, tiredness, and energy and more effective than silent meditation for relaxation and acute stress in undergraduates. Didgeridoo meditation participants reported higher levels of enjoyment and higher likelihood of attending another session. Further investigation into didgeridoo and sound meditation is warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6769210/

 

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

Improve the Physical and Psychological Health of Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

It turns out that some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. These feeling can result from changes in body image, changes to family and work roles, feelings of grief at these losses, and physical symptoms such as pain, nausea, or fatigue. People might also fear death, suffering, pain, or all the unknown things that lie ahead. So, coping with the emotions and stress of a cancer diagnosis is a challenge and there are no simple treatments for these psychological sequelae of cancer diagnosis.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatiguestress,  sleep disturbance, fear, and anxiety and depression. The evidence is accumulating. So, it is timely to review and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/), Cillessen and colleagues review, summarize, and perform a meta-analysis of the published randomized controlled trials (RCTs) on the effectiveness of mindfulness training in treating the symptoms of cancer and its treatment. They found 29 RCTs that included a total of 3224 participants.

 

The summary of the published research reflected that mindfulness training produced significant reductions in psychological distress in the cancer patients including reductions in anxiety, depression, fatigue, and fear of cancer reoccurrence with small to moderate effects sizes. These improvements were found both immediately after treatment and also at follow-up from 3 to 24 months later. Further they found that mindfulness trainings that adhered to the protocols for Mindfulness-Based Stress Reduction (MBSR) or Mindfulness-Based Cognitive Therapy (MBCT) had the greatest effect sizes.

 

It has been repeatedly demonstrated that mindfulness training is effective in reducing psychological distress including reductions in anxiety, depression, fatigue, and fear in a wide variety of individuals with and without disease states. The present meta-analysis demonstrates the effectiveness of mindfulness training for the relief of psychological and physical suffering of cancer patients. It does not affect the disease process. Rather, it reduces the patients psychological suffering and does so for a prolonged period of time.

 

So, improve the physical and psychological health of cancer patients with mindfulness.

 

patients who practice mindfulness begin to feel better despite their medical problems. Physical symptoms don’t necessarily go away, but that’s not the aim of mindfulness. Rather, the goal is to help you find a different perspective and a new way of coping with your illness.” – Eric Tidline

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Cillessen, L., Johannsen, M., Speckens, A., & Zachariae, R. (2019). Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psycho-oncology, 28(12), 2257–2269. doi:10.1002/pon.5214

 

Abstract

Objective

Mindfulness‐based interventions (MBIs) are increasingly used within psycho‐oncology. Since the publication of the most recent comprehensive meta‐analysis on MBIs in cancer in 2012, the number of published trials has more than doubled. We therefore conducted a systematic review and meta‐analysis of randomized controlled trials (RCTs), testing the efficacy of MBIs on measures of psychological distress (primary outcome) and other health outcomes in cancer patients and survivors.

Methods

Two authors conducted independent literature searches in electronic databases from first available date to 10 October 2018, selected eligible studies, extracted data for meta‐analysis, and evaluated risk of bias.

Results

Twenty‐nine independent RCTs (reported in 38 papers) with 3274 participants were included. Small and statistically significant pooled effects of MBIs on combined measures of psychological distress were found at post‐intervention (Hedges’s g = 0.32; 95%CI: 0.22‐0.41; P < .001) and follow‐up (g = 0.19; 95%CI: 0.07‐0.30; P < .002). Statistically significant effects were also found at either post‐intervention or follow‐up for a range of self‐reported secondary outcomes, including anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbances, and pain (g: 0.20 to 0.51; p: <.001 to.047). Larger effects of MBIs on psychological distress were found in studies (a) adhering to the original MBI manuals, (b) with younger patients, (c) with passive control conditions, and (d) shorter time to follow‐up. Improvements in mindfulness skills were associated with greater reductions in psychological distress at post‐intervention.

Conclusions

MBIs appear efficacious in reducing psychological distress and other symptoms in cancer patients and survivors. However, many of the effects were of small magnitude, suggesting a need for intervention optimization research.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6916350/

 

Improve Chronic Fatigue Syndrome with Yoga Practice

Improve Chronic Fatigue Syndrome with Yoga Practice

 

By John M. de Castro, Ph.D.

 

“Turns out, in addition to improving sleep quality, relieving stress and anxiety and improving overall physical health, yoga can also be an excellent natural energy-booster.” – Carolyn Gregoire

 

Myalgic encephalomyelitis/Chronic Fatigue Syndrome (CFS) occurs in about 0.2% of the population. It produces a profound, prolonged, and debilitating tiredness that is not corrected by rest. When severe, it can produce a chronic and extreme tiredness, so severe that sufferers can become bed-bound or need to use a wheel-chair. It produces muscle pain, brain fog and dizziness, poor memory, disturbed sleep and trouble with digestion.

 

Unfortunately, there are no known cures for CFS. The usual treatments for fatigue are targeted at symptom relief and include exercise and drugs. As an alternative to these traditional treatments, mindfulness training has been shown to reduce fatigue. The mindfulness practice of Yoga also includes exercise and it has been shown to be an effective treatment for the symptoms of Chronic Fatigue Syndrome (CFS). But the mechanism is not known of how yoga may be affecting the symptoms of CFS.

 

In today’s Research News article “Changes in circulating microRNA after recumbent isometric yoga practice by patients with myalgic encephalomyelitis/chronic fatigue syndrome: an explorative pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886179/), Takakura and colleagues recruited female Chronic Fatigue Syndrome (CFS) who had not progressed over 6 months with standard treatment and were not able to work or carry on normal activities. They were provided 3 months of recumbent isometric yoga practice every 2 to 4 weeks and practiced at home daily. Before and after the yoga intervention the women had blood drawn and assayed for micro-ribonucleic acids (miRNAs) expressions. They also completed a measure of fatigue.

 

They found that although the patients had shown no improvement in fatigue levels over the 6-month pre-intervention period, after the recumbent isometric yoga practice there were significant reductions in fatigue. The blood assays revealed that after treatment 4 miRNAs levels were significantly higher and 42 were significantly lower.

 

Micro-ribonucleic acid (miRNAs) contribute to gene silencing. Circulating miRNAs have been proposed as biomarkers for some medical conditions. Because the blood levels of these miRNAs are changed by isometric yoga practice at the same time that fatigue levels decrease suggests that these miRNAs may be involved in or a marker for Chronic Fatigue Syndrome (CFS).

 

Chronic Fatigue Syndrome (CFS) has no known causes and no effective treatments have been discovered. It is encouraging that yoga practice can help with this debilitating condition. In addition, the study provides an interesting possibility of miRNA changes in the blood that may be biomarkers for the disease. Further investigating these leads may lead to a better understanding of the biological mechanisms underlying CFS.

 

So, improve chronic fatigue syndrome with yoga practice.

 

Many believe that yoga is a powerful treatment for fatigue as it combines the tools of yoga postures, breathing techniques, and meditation that helps clear the brain fog and body fatigue.” – Rishikul Yogshala

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Takakura, S., Oka, T., & Sudo, N. (2019). Changes in circulating microRNA after recumbent isometric yoga practice by patients with myalgic encephalomyelitis/chronic fatigue syndrome: an explorative pilot study. BioPsychoSocial medicine, 13, 29. doi:10.1186/s13030-019-0171-2

 

Abstract

Background

Yoga is a representative mind-body therapy. Our previous studies have demonstrated that isometric yoga (i.e. yoga programs that we developed so individuals can practice yoga poses with a self-adjustable isometric load) reduces the fatigue of patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS); however, the underlying mechanisms remain unclear. Several studies have suggested that the micro-ribonucleic acid (miRNA) expression of ME/CFS patients is different from that of healthy subjects. However, it has not to date been determined if the practice of isometric yoga can affect miRNA expression. Therefore, we sought to investigate if isometric yoga is associated with changes in the expression levels of serum miRNA of patients with ME/CFS.

Methods

The study included nine patients with ME/CFS who failed to show satisfactory improvement after at least 6 months of treatment administered at our hospital. Patients practiced recumbent isometric yoga for 3 months; they met with a yoga instructor every 2 to 4 weeks and participated in daily in-home sessions. The effect of recumbent isometric yoga on fatigue was assessed by comparing pre- and post-intervention scores on the Japanese version of the 11-item Chalder fatigue scale (CFQ 11). Patient blood samples were drawn pre- and post-intervention, just prior to practicing recumbent isometric yoga with an instructor. The serum was used for miRNA array analysis with known human miRNAs.

Results

The average CFQ 11 score decreased significantly (from 25.3 ± 5.5 to 17.0 ± 5.8, p <  0.0001) after practicing recumbent isometric yoga for 3 months. The miRNA microarray analysis revealed that four miRNAs were significantly upregulated, and 42 were downregulated after the intervention period.

Conclusions

This explorative pilot study is the first to demonstrate changes in the serum levels of several miRNAs after regular practice of recumbent isometric yoga. These miRNAs might represent biomarkers for the fatigue-relieving effects of isometric yoga of patients with ME/CFS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6886179/

 

Improve Chronic Fatigue Syndrome with Seated Yoga

Improve Chronic Fatigue Syndrome with Seated Yoga

 

By John M. de Castro, Ph.D.

 

The benefits of yoga, in general, include loosening up muscles, joints, and connective tissues, and improving strength and balance. But is it right for ME/CFS, with post-exertional malaise plus other problematic symptoms such as dizziness and muscle pain? We don’t have a lot of research on yoga for ME/CFS, but what we do have suggests that it just might be.” – Adrienne Dellwo

 

Chronic Fatigue Syndrome (CFS) occurs in about 0.2% of the population. It produces a profound, prolonged, and debilitating tiredness. When severe, it can produce a chronic and extreme tiredness, so severe that sufferers can become bed-bound or need to use a wheel-chair. It produces muscle pain, brain fog and dizziness, poor memory, disturbed sleep and trouble with digestion. Unfortunately, there are no known cures for CFS. The usual treatments for fatigue are targeted at symptom relief and include exercise and drugs. As an alternative to these traditional treatments, mindfulness training has been shown to reduce fatigue. The mindfulness practice of Yoga also includes exercise and it has been shown to be an effective treatment for the symptoms of Chronic Fatigue Syndrome (CFS). But the mechanism is not known of how yoga may be affecting the symptoms of CFS.

 

In today’s Research News article “The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836361/), Oka and colleagues recruited adults with Chronic Fatigue Syndrome (CFS) and randomly assigned them to receive either 20 minute, twice a week, for 2 months seated yoga practice with daily home practice or to no further treatment. Both groups continued to receive pharmacotherapy. They were measured before and after treatment for fatigue, anxiety, depression, and alexithymia. In addition, blood was drawn and assayed for DHEA-S, PRL, and TNF-α. Heart rate variability was also measured with and electrocardiogram (EKG).

 

They found that in comparison to baseline and the control group, the seated yoga group had a large and significant decrease in fatigue and depression. Further they found that the greater the decrease in fatigue for the seated yoga group, the greater the decrease in TNF-α, in the high frequency component of heartrate variability, and in alexithymia.

 

These results suggest that seated yoga is effective in reducing fatigue and depression in patients with Chronic Fatigue Syndrome (CFS). The correlation analysis suggests that the reduction in fatigue is associated with decreases in inflammation (TNF-α) and an increase in the ability to sense emotions (decreased alexithymia). The correlations do not indicate causation. So, it is not clear if the changes in fatigue produced the reductions in inflammation and alexithymia, or the reverse, or a third factor is responsible. But it is clear that seated yoga practice improves fatigue and depression in patients with CFS.

 

This is important as Chronic Fatigue Syndrome (CFS) is relatively common and debilitating and pharmacological treatments are most often ineffective. The fact that yoga practice can improve the symptoms of CFS is encouraging. In addition, the fact that the yoga practice was performed in a seated position makes it better suited to patients with fatigue who lack the energy for more intense yoga practice. The results of this small pilot study further provide justification for performing a large randomized controlled trial. Seated yoga practice may be able to at least in part reduce the physical and psychological problems produced by CFS.

 

So, improve chronic fatigue syndrome with seated yoga.

 

“isometric yoga together with conventional therapy was more effective in relieving fatigue than was conventional therapy alone in patients with CFS who did not respond adequately to conventional therapy.” – Takakazu Oka

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Oka, T., Tanahashi, T., Lkhagvasuren, B., & Yamada, Y. (2019). The longitudinal effects of seated isometric yoga on blood biomarkers, autonomic functions, and psychological parameters of patients with chronic fatigue syndrome: a pilot study. BioPsychoSocial medicine, 13, 28. doi:10.1186/s13030-019-0168-x

 

Abstract

Background

In a previous randomized controlled trial, we found that practicing seated isometric yoga regularly for 2 months improved the fatigue of patients with chronic fatigue syndrome (CFS) who are resistant to conventional therapy. The aim of this pilot study was to investigate the possible mechanisms behind this finding by comparing blood biomarkers, autonomic nervous function, and psychological indices before versus after an intervention period of seated isometric yoga practice.

Methods

Fifteen patients with CFS who did not show satisfactory improvements after at least 6 months of conventional therapy practiced seated isometric yoga (biweekly 20-min sessions with a yoga instructor and daily practice at home) for 2 months. The longitudinal effects of seated isometric yoga on fatigue, blood biomarkers, autonomic function, and psychological state were investigated by comparing the following parameters before and after the intervention period: Fatigue severity was assessed by the Chalder fatigue scale (FS) score. Levels of the blood biomarkers cortisol, DHEA-S, TNF-α, IL-6, prolactin, carnitine, TGF-β1, BDNF, MHPG, HVA, and α-MSH were measured. The autonomic nervous functions assessed were heart rate (HR) and HR variability. Psychological indices included the 20-item Toronto Alexithymia Scale (TAS-20) and the Hospital Anxiety and Depression Scale (HADS).

Results

Practicing seated isometric yoga for 2 months resulted in significant reductions in the Chalder FS (P = 0.002) and HADS-depression (P = 0.02) scores. No significant changes were observed in any other parameter evaluated. The change in Chalder FS score was not correlated with the change in HADS-depression score. However, this change was positively correlated with changes in the serum TNF-α levels (P = 0.048), the high frequency component of HR variability (P = 0.042), and TAS-20 scores (P = 0.001).

Conclusions

Regular practice of seated isometric yoga for 2 months reduced the fatigue and depressive symptom scores of patients with CFS without affecting any other parameters we investigated. This study failed to identify the markers responsible for the longitudinal fatigue-relieving effect of seated isometric yoga. However, considering that the reduced fatigue was associated with decreased serum TNF-α level and TAS-20 scores, fatigue improvement might be related to reduced inflammation and improved alexithymia in these patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6836361/

 

Improve Sleep and Relieve Fatigue in Cancer Survivors with Yoga

Improve Sleep and Relieve Fatigue in Cancer Survivors with Yoga

 

By John M. de Castro, Ph.D.

 

We recommend that doctors prescribe this low-risk, low-cost treatment to all cancer patients with cancer-related fatigue. We would like them to prescribe gentle hatha yoga but they need to refer to appropriate yoga instructors who have experience of working with cancer patients.” – Po-Ju Lin

 

Because of great advances in treatment, many patients today are surviving cancer. But cancer survivors frequently suffer from anxiety, depression, mood disturbance, post-traumatic stress disorder (PTSD), sleep disturbance, fatigue, sexual dysfunction, loss of personal control, impaired quality of life, and psychiatric symptoms which have been found to persist even ten years after remission. Also, cancer survivors can have to deal with a heightened fear of reoccurrence. This is particularly true with metastatic cancer. So, safe and effective treatments for the symptoms in cancer and the physical and psychological effects of the treatments are needed.

 

Mindfulness training has been shown to help with general cancer recovery . Yoga is both an exercise and a mindfulness practice that has also been shown to be helpful with the residual symptoms in cancer survivors, the psychological and physical ability to deal with cancer treatment and improves sleep. So, it’s reasonable to further explore the potential benefits of yoga practice to improve sleep and relieve fatigue in patients who have survived cancer.

 

In today’s Research News article “Influence of Yoga on Cancer-Related Fatigue and on Mediational Relationships Between Changes in Sleep and Cancer-Related Fatigue: A Nationwide, Multicenter Randomized Controlled Trial of Yoga in Cancer Survivors.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552348/), Lin and colleagues recruited patients who had survived a variety of different cancers, and who had completed primary care and who had sleep disturbance, from centers all over the U.S. They were randomly assigned them to receive standard care plus yoga training or standard care alone. Yoga training occurred for 75 minutes, twice a week, for 4 weeks and consisted of breathing exercises, physical alignment postures, and mindfulness exercises. They were measured before and after treatment for cancer related fatigue, including general, physical, emotional, mental, and vigor domains, and sleep, including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, sleep medication use, and daytime dysfunction.

 

They found that in comparison to baseline and the treatment-as-usual group, the participants who received yoga training had significant improvements in all domains of fatigue with moderate effect sizes. The yoga group also had significant improvements in sleep, including increases in overall sleep quality and subjective sleep quality and decreases in daytime dysfunction. Finally, they found, employing path analysis, that yoga training improved fatigue directly and indirectly by improving sleep that in turn improved sleep.

 

These are potentially important findings. Fatigue and sleep disturbance are difficult residual problems. There is a need to have long-term follow-up of these patients to determine whether yoga practice produces sustained relief of sleep disturbance and fatigue. Nevertheless, the findings show that at least on the short-term, yoga practice can address these symptoms and as a result improve the well-being and quality of life of cancer survivors. In addition, practicing yoga has been shown to produce widespread benefits for the physical and psychological health of practitioners. So, yoga practice would seem to be an excellent additional treatment for patients who have survived cancer.

 

So, improve sleep and relieve fatigue in cancer survivors with yoga.

 

“Two randomized controlled trials in breast cancer patients (one in patients undergoing radiation and one in breast cancer survivors) showed yoga practice significantly improved fatigue.” – Carrie Newsom

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Lin, P. J., Kleckner, I. R., Loh, K. P., Inglis, J. E., Peppone, L. J., Janelsins, M. C., … Mustian, K. M. (2019). Influence of Yoga on Cancer-Related Fatigue and on Mediational Relationships Between Changes in Sleep and Cancer-Related Fatigue: A Nationwide, Multicenter Randomized Controlled Trial of Yoga in Cancer Survivors. Integrative cancer therapies, 18, 1534735419855134. doi:10.1177/1534735419855134

 

Abstract

Background: Cancer-related fatigue (CRF) often co-occurs with sleep disturbance and is one of the most pervasive toxicities resulting from cancer and its treatment. We and other investigators have previously reported that yoga therapy can improve sleep quality in cancer patients and survivors. No nationwide multicenter phase III randomized controlled trial (RCT) has investigated whether yoga therapy improves CRF or whether improvements in sleep mediate the effect of yoga on CRF. We examined the effect of a standardized, 4-week, yoga therapy program (Yoga for Cancer Survivors [YOCAS]) on CRF and whether YOCAS-induced changes in sleep mediated changes in CRF among survivors. Study Design and Methods: Four hundred ten cancer survivors were recruited to a nationwide multicenter phase III RCT comparing the effect of YOCAS to standard survivorship care on CRF and examining the mediating effects of changes in sleep, stemming from yoga, on changes in CRF. CRF was assessed by the Multidimensional Fatigue Symptom Inventory. Sleep was assessed via the Pittsburgh Sleep Quality Index. Between- and within-group intervention effects on CRF were assessed by analysis of covariance and 2-tailed t test, respectively. Path analysis was used to evaluate mediation. Results: YOCAS participants demonstrated significantly greater improvements in CRF compared with participants in standard survivorship care at post-intervention (P < .01). Improvements in overall sleep quality and reductions in daytime dysfunction (eg, excessive napping) resulting from yoga significantly mediated the effect of yoga on CRF (22% and 37%, respectively, both P < .01). Conclusions: YOCAS is effective for treating CRF among cancer survivors; 22% to 37% of the improvements in CRF from yoga therapy result from improvements in sleep quality and daytime dysfunction. Oncologists should consider prescribing yoga to cancer survivors for treating CRF and sleep disturbance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6552348/