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Systematic review
Exercise regimens for improved sleep quality in adult breast cancer survivors: systematic review and network meta-analysis
  1. Faizul Hasan1,2,
  2. Yu-Kang Tu3,4,
  3. Chia-Chin Lin1,5,6,
  4. Lia Taurussia Yuliana1,
  5. Debby Syahru Romadlon1,2 and
  6. Hsiao-Yean Chiu1,7,8,9
  1. 1 School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
  2. 2 Faculty of Nursing, Chulalongkorn University, Bangkok, Thailand
  3. 3 Department of Public Health, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
  4. 4 Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan
  5. 5 School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
  6. 6 Alice Ho Miu Ling Nethersole Charity Foundation Professor in Nursing, Hong Kong, Hong Kong
  7. 7 Research Center of Sleep Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
  8. 8 Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
  9. 9 Research Center of Sleep Medicine, Taipei Medical University Hospital, Taipei, Taiwan
  1. Correspondence to Professor Hsiao-Yean Chiu, School of Nursing, College of Nursing, Taipei Medical University, Taipei, 110, Taiwan; hychiu0315{at}tmu.edu.tw

Abstract

Objective The relative efficacy of exercise regimens for improving sleep quality in adult breast cancer survivors remains unknown. This network meta-analysis aimed to compare the efficacy of various exercise regimens for improving sleep quality in adult breast cancer survivors.

Methods This study searched four electronic databases for relevant literature from inception to 18 July 2023. Randomised controlled trials reporting the effects of exercise on sleep quality in adults with breast cancer were included. A random-effects network meta-analysis based on the frequentist framework was performed.

Results In total, 35 trials including 3374 breast cancer survivors were included. Compared with usual care, endurance training combined with resistance training significantly improved sleep quality (standardised mean differences (SMDs) = −0.97; 95% CI = −1.50 to −0.43; certainty of evidence=moderate) (p<0.05). Endurance training combined with resistance training (SMDs: −1.42; 95% CIs: −2.31 to −0.53; moderate) achieved superior sleep quality results compared with stretching exercises (p<0.05). The surface under the cumulative ranking curve analysis indicated that endurance training combined with resistance training was ranked as the top effective treatment among other exercise regimens for improving sleep quality in breast cancer survivors (71%).

Conclusions Endurance training combined with resistance training is effective in improving sleep quality in adult breast cancer survivors. Our results provide evidence that exercise can improve sleep quality in adult breast cancer survivors.

  • breast

Data availability statement

Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

https://doi.org/10.1136/spcare-2023-004363

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    Data availability statement

    Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

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    Footnotes

    • Contributors H-YC was the principal investigator and guarantor in the study. FH, Y-KT and H-YC designed the trial. FH, LTY and H-YC collected and extracted all trial data. H-YC, FH and DSR evaluated the risk of bias in the included studies. FH, Y-KT, C-CL and H-YC drafted the manuscript. FH, Y-KT and H-YC analysed the trial outcomes. All authors contributed to, read and have approved the final manuscript.

    • Funding This research was supported by grants from the National Science and Technology, Taiwan (NSTC 112-2628-B-038-003 and NSTC 111-2314-B-038-033-MY3).

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.