@article{ac509a298ff24b808b09d9b0f969d4d3,
title = "Effects and moderators of exercise on sleep in adults with cancer: Individual patient data and aggregated meta-analyses",
abstract = "OBJECTIVES: To evaluate the effects of exercise interventions on sleep disturbances and sleep quality in patients with mixed cancer diagnoses, and identify demographic, clinical, and intervention-related moderators of these effects.METHODS: Individual patient data (IPD) and aggregated meta-analyses of randomized controlled trials (RCTs). Using data from the Predicting OptimaL cAncer RehabIlitation and Supportive care project, IPD of 2173 adults (mean age = 54.8) with cancer from 17 RCTs were analyzed. A complementary systematic search was conducted (until November 2018) to study the overall effects and test the representativeness of analyzed IPD. Effect sizes of exercise effects on self-reported sleep outcomes were calculated for all included RCTs. Linear mixed-effect models were used to evaluate the effects of exercise on post-intervention outcome values, adjusting for baseline values. Moderator effects were studied by testing interactions for demographic, clinical and intervention-related characteristics.RESULTS: For all 27 eligible RCTs from the updated search, exercise interventions significantly decreased sleep disturbances in adults with cancer (g = -0.09, 95\% CI [-0.16; -0.02]). No significant effect was obtained for sleep quality. RCTs included in IPD analyses constituted a representative sample of the published literature. The intervention effects on sleep disturbances were not significantly moderated by any demographic, clinical, or intervention-related factor, nor by sleep disturbances.CONCLUSIONS: This meta-analysis provides some evidence that, compared to control conditions, exercise interventions may improve sleep disturbances, but not sleep quality, in cancer patients, although this effect is of a small magnitude. Among the investigated variables, none was found to significantly moderate the effect of exercise interventions on sleep disturbances.",
keywords = "Cancer, Physical activity, Treatment, sleep",
author = "P Bernard and J Savard and K Steindorf and Sweegers, \{M G\} and Courneya, \{K S\} and Newton, \{R U\} and Aaronson, \{N K\} and Jacobsen, \{P B\} and May, \{A M\} and Galvao, \{D A\} and Chinapaw, \{M J\} and Stuiver, \{M M\} and Griffith, \{K A\} and I Mesters and H Knoop and Goedendorp, \{M M\} and M Bohus and L Thorsen and Schmidt, \{M E\} and Ulrich, \{C M\} and Sonke, \{G S\} and \{van Harten\}, W and Winters-Stone, \{K M\} and Velthuis, \{M J\} and Taaffe, \{D R\} and \{van Mechelen\}, W and Kersten, \{M J\} and F Nollet and J Wenzel and J Wiskemann and \{Verdonck-de Leeuw\}, \{I M\} and J Brug and Buffart, \{L M\}",
note = "Funding Information: The POLARIS study was supported by the “ Bas Mulder Award ” granted to L.M. Buffart by the Alpe d'HuZes foundation , part of the Dutch Cancer Society ( VU 2011-5045 ). Funding Information: PB is supported by Universit{\'e} du Qu{\'e}bec {\`a} Montr{\'e}al , Institut Universitaire de Sant{\'e} Mentale de Montr{\'e}al and by a salary award from the Fonds de recherche du Qu{\'e}bec – Sant{\'e}. The views expressed are those of the authors and do not necessarily represent those of the (U.S.) National Cancer Institute. Dr. Steindorf reports personal fees from Lilly Deutschland (Award), outside the submitted work; Dr. Bohus reports grants from Josse Carreras Foundation , during the conduct of the study; Dr. van Mechelen reports to be shareholder-director of VU University Medical Center Amsterdam spin-off company Evalua Neder-land B.V. ( www.evalua.nl ) and non-executive board member of Arbo Unie B.V. ( www.arbounie.nl ). Both companies are active in the Dutch occupational health care sector. Dr. Nollet reports grants from Dutch Cancer Society , during the conduct of the study. Dr. Brug reports grants from Dutch Cancer Society , during the conduct of the study. Funding Information: PB is supported by Universit? du Qu?bec ? Montr?al, Institut Universitaire de Sant? Mentale de Montr?al and by a salary award from the Fonds de recherche du Qu?bec ? Sant?. The views expressed are those of the authors and do not necessarily represent those of the (U.S.) National Cancer Institute. Dr. Steindorf reports personal fees from Lilly Deutschland (Award), outside the submitted work; Dr. Bohus reports grants from Josse Carreras Foundation, during the conduct of the study; Dr. van Mechelen reports to be shareholder-director of VU University Medical Center Amsterdam spin-off company Evalua Neder-land B.V. (www.evalua.nl) and non-executive board member of Arbo Unie B.V. (www.arbounie.nl). Both companies are active in the Dutch occupational health care sector. Dr. Nollet reports grants from Dutch Cancer Society, during the conduct of the study. Dr. Brug reports grants from Dutch Cancer Society, during the conduct of the study.The POLARIS study was supported by the ?Bas Mulder Award? granted to L.M. Buffart by the Alpe d'HuZes foundation, part of the Dutch Cancer Society (VU 2011-5045). Publisher Copyright: {\textcopyright} 2019 Elsevier Inc.",
year = "2019",
month = sep,
day = "1",
doi = "10.1016/j.jpsychores.2019.109746",
language = "English",
volume = "124",
pages = "1--9",
journal = "Journal of Psychosomatic Research",
issn = "0022-3999",
publisher = "Elsevier",
}