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Impact of a patient-tailored complementary/integrative medicine programme on disturbed sleep quality among patients undergoing chemotherapy
  1. Hilit Kerner1,2,
  2. Noah Samuels3,
  3. Shlomi Ben Moshe4,
  4. Ilanit Shalom Sharabi1,5 and
  5. Eran Ben-Arye1,2
  1. 1 Integrative Oncology Program, The Oncology Service and Lin Medical Center, Clalit Health Services, Haifa, Israel
  2. 2 Family Medicine Department, Technion-Israel Institute of Technology, Haifa, Israel
  3. 3 Tal Center for Integrative Oncology, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel
  4. 4 Sleep Laboratory and Clinics, Clalit Health Services, Haifa and Western Galilee and Carmel Medical Center, Kiryat Bialik, Israel
  5. 5 Graduate Studies Authority, Haifa University, Haifa, Israel
  1. Correspondence to Proffesor Eran Ben-Arye, Integrative Oncology Program, Oncology Service, Lin Medical Center, 35 Rothschild St., Haifa; eranben{at}


Objectives The present study examined the impact of a patient-tailored complementary/integrative medicine (CIM) programme on sleep quality in patients undergoing chemotherapy for breast and gynaecological cancer.

Methods Study participants received standard supportive care, with or without weekly CIM treatments. Disturbed sleep quality was defined as a score of ≥4 on the Edmonton Symptom Assessment Scale (ESAS) or a score of ≥3 on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). Adherence to integrative care was defined as attending ≥4 CIM treatments, with ≤30 days between each session.

Results Of 388 eligible patients, 264 (68%) reported disturbed sleep quality. Baseline-to-follow up assessment (at 6 weeks) was optimal for 104 patients in the treatment group and for 76 controls, with 75 of treated patients found to be adherent to the CIM intervention. Sleep-related ESAS scores improved more significantly in treated patients (p=0.008), as did sleep-related concerns on EORTC (treatment group, p=0.026).

Conclusions A patient-tailored CIM programme may improve sleep quality and related concerns among patients with breast and gynaecological cancer undergoing chemotherapy. Further research is needed to better understand the impact of CIM on sleep quality in this patient population.

Trial registration number NCT01860365.

  • complementary/integrative medicine (CIM)
  • breast cancer
  • gynecological cancer
  • sleep disorders
  • insomnia
  • integrative oncology.

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  • Contributors HK, NS, SBM, ISS and EB-A contributed to the planning, conduct and reporting of the work described in this article. EB-A, HK and NS are responsible for conception and design, acquisition of data, analysis and interpretation of data.

  • Competing interests The authors state that there are neither actual nor potential conflicts of interest, including any financial, personal or other relationships with other people or organisations whatsoever.

  • Ethics approval Carmel Medical Center, Haifa, Israel.

  • Provenance and peer review Not commissioned; externally peer reviewed.