Yoga, Survivorship Health Education, and Cognitive Behavioral Therapy in Reducing Insomnia in Cancer Survivors

NCT ID: NCT02613364

Last Updated: 2024-05-01

Study Results

Results available

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Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

746 participants

Study Classification

INTERVENTIONAL

Study Start Date

2016-08-31

Study Completion Date

2020-02-04

Brief Summary

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This randomized phase III trial compares yoga, survivorship health education program, and cognitive behavioral therapy in reducing sleep disturbance (insomnia) in cancer survivors. Insomnia can be described as excessive daytime napping, difficulty falling asleep, difficulty staying asleep, or waking up earlier than desired. Insomnia can increase fatigue, impair physical function, impair immune function, cause circadian rhythms (known as the biological clock) to be disrupted and decrease quality of life. Yoga may improve circadian rhythms, physical and immune function, and improve insomnia and sleep quality in cancer survivors. It is not yet known whether yoga is more effective at treating insomnia than a health education program or cognitive behavioral therapy program.

Detailed Description

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PRIMARY OBJECTIVES:

I. To determine if Yoga for Cancer Survivors (YOCAS) is effective for improving patient-reported insomnia (Insomnia Severity Index) compared to Cognitive Behavioral Therapy for Insomnia (CBT-I) and a health education control immediately post intervention.

SECONDARY OBJECTIVES:

I. To examine if YOCAS is effective for improving objective symptoms of insomnia (sleep latency, sleep efficiency, wake after sleep onset, sleep duration, and daytime napping via actigraphy) and global sleep quality impairment (Pittsburgh Sleep Quality Index) compared to CBT-I and a health education control.

II. To examine if YOCAS and CBT-I are effective for maintaining improvements in insomnia (Insomnia Severity Index) 3 and 6 months post intervention compared to a health education control.

OUTLINE: Patients are randomized to 1 of 3 arms.

ARM I: Patients undergo the YOCAS intervention comprising 18 specific physical postures and mindfulness exercises focused on breathing and meditation and meet with the yoga instructor over 75 minutes 2 times a week for 4 weeks.

ARM II: Patients undergo CBT-I intervention comprising sleep education, sleep hygiene, sleep restriction, stimulus control, cognitive therapy, and relapse prevention delivered by a health professional over 90 minutes once a week for 8 weeks.

ARM III: Patients attend survivorship health education sessions over 75 minutes 2 times a week for 4 weeks based on the American Society of Clinical Oncology cancer survivorship educational recommendations delivered by a community health educator. Patients also receive a booklet entitled, "Cancer Survivorship Next Steps for Patients and Their Families."

After completion of intervention, patients are followed up at 3 and 6 months.

Conditions

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Cancer Survivor Insomnia Malignant Neoplasm

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

SUPPORTIVE_CARE

Blinding Strategy

DOUBLE

Participants Investigators

Study Groups

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Arm I (behavioral intervention-yoga)

Patients undergo the YOCAS intervention comprising 18 specific physical postures and mindfulness exercises focused on breathing and meditation and meet with the yoga instructor over 75 minutes 2 times a week for 4 weeks.

Group Type EXPERIMENTAL

Behavioral Intervention

Intervention Type BEHAVIORAL

Undergo yoga intervention

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Monitoring Device

Intervention Type DEVICE

Correlative studies

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Arm II (cognitive intervention-CBT-I)

Patients undergo CBT-I intervention comprising sleep education, sleep hygiene, sleep restriction, stimulus control, cognitive therapy, and relapse prevention delivered by a health professional over 90 minutes once a week for 8 weeks.

Group Type EXPERIMENTAL

Cognitive Intervention

Intervention Type OTHER

Undergo CBT-I intervention

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Monitoring Device

Intervention Type DEVICE

Correlative studies

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Arm III (educational intervention)

Patients attend survivorship health education sessions over 75 minutes 2 times a week for 4 weeks based on the American Society of Clinical Oncology cancer survivorship educational recommendations delivered by a community health educator. Patients also receive a booklet entitled, "Cancer Survivorship Next Steps for Patients and Their Families."

Group Type ACTIVE_COMPARATOR

Educational Intervention

Intervention Type OTHER

Receive health education

Laboratory Biomarker Analysis

Intervention Type OTHER

Correlative studies

Monitoring Device

Intervention Type DEVICE

Correlative studies

Quality-of-Life Assessment

Intervention Type OTHER

Ancillary studies

Interventions

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Behavioral Intervention

Undergo yoga intervention

Intervention Type BEHAVIORAL

Cognitive Intervention

Undergo CBT-I intervention

Intervention Type OTHER

Educational Intervention

Receive health education

Intervention Type OTHER

Laboratory Biomarker Analysis

Correlative studies

Intervention Type OTHER

Monitoring Device

Correlative studies

Intervention Type DEVICE

Quality-of-Life Assessment

Ancillary studies

Intervention Type OTHER

Other Intervention Names

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Behavior Conditioning Therapy Behavior Modification Behavior or Life Style Modifications Behavior Therapy Behavioral Interventions Behavioral Modification BEHAVIORAL THERAPY Behavioral Treatment Behavioral Treatments Education for Intervention Intervention by Education Intervention through Education Intervention, Educational Monitor Quality of Life Assessment

Eligibility Criteria

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Inclusion Criteria

* Have a confirmed diagnosis of cancer
* Have received surgery, chemotherapy, and/or radiation therapy
* Have completed all surgery, chemotherapy and/or radiation therapy within the last 2-60 months
* Meet Diagnostic and Statistical Manual of Mental Disorders (DSM)-V criteria for insomnia and score \>= 10 on the Insomnia Severity Index
* Be able to read and understand English
* Be able to provide written informed consent

Exclusion Criteria

* Have contraindications to functional testing or yoga participation according to the treating physician
* Have practiced yoga \>= 1 day a week within the 3 months prior to enrolling in the study
* Be planning to start yoga on their own during the time they are enrolled in the study
* Have a confirmed diagnosis of sleep apnea or restless leg syndrome
* Be receiving any form of treatment for cancer with the exception of hormonal or biologic therapy
* Have distant metastases
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Cancer Institute (NCI)

NIH

Sponsor Role collaborator

University of Rochester NCORP Research Base

OTHER

Sponsor Role lead

Responsible Party

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Karen Mustian

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Karen Mustian

Role: PRINCIPAL_INVESTIGATOR

University of Rochester NCORP Research Base

Locations

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Hawaii MU NCORP

Honolulu, Hawaii, United States

Site Status

Heartland NCORP

Decatur, Illinois, United States

Site Status

Wichita NCORP

Wichita, Kansas, United States

Site Status

Gulf South MU-NCORP

New Orleans, Louisiana, United States

Site Status

Michigan Cancer Research Consortium NCORP

Ann Arbor, Michigan, United States

Site Status

Cancer Research Consortium of West Michigan

Grand Rapids, Michigan, United States

Site Status

Metro-Minnesota NCORP

Minneapolis, Minnesota, United States

Site Status

Nevada Cancer Research Foundation NCORP

Las Vegas, Nevada, United States

Site Status

University of Rochester NCORP Research Base

Rochester, New York, United States

Site Status

Southeast Clinical Oncology Research Consortium

Winston-Salem, North Carolina, United States

Site Status

Columbus NCORP

Columbus, Ohio, United States

Site Status

Dayton Clinical Oncology Program

Dayton, Ohio, United States

Site Status

Pacific Cancer Research Consortium Ncorp

Portland, Oregon, United States

Site Status

Greenville Health System NCORP

Greenville, South Carolina, United States

Site Status

Wisconsin NCORP

Marshfield, Wisconsin, United States

Site Status

Aurora NCORP

Milwaukee, Wisconsin, United States

Site Status

Countries

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United States

References

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Altman BJ, Lin PJ, Mattick LJ, Outland EH, Bautista J, Li CS, Gada U, Morris KM, Knudsen-Clark AM, Mwangi D, DeRollo RE, Kleckner AS, Kleckner IR, Gilmore NJ, Esparaz BT, Curtis A, Conlin A, Monaco G, Hughey JJ, Mustian KM. Blood Clock Correlation Distance (BloodCCD) as a novel marker to detect circadian rhythm disruption in cancer survivors with insomnia. BJC Rep. 2025 Sep 3;3(1):60. doi: 10.1038/s44276-025-00176-9.

Reference Type DERIVED
PMID: 40903493 (View on PubMed)

Provided Documents

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Document Type: Study Protocol and Statistical Analysis Plan

View Document

Other Identifiers

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NCI-2015-01144

Identifier Type: REGISTRY

Identifier Source: secondary_id

RSRB052271

Identifier Type: OTHER

Identifier Source: secondary_id

URCC14040

Identifier Type: OTHER

Identifier Source: secondary_id

URCC-14040

Identifier Type: OTHER

Identifier Source: secondary_id

URCC-14040

Identifier Type: OTHER

Identifier Source: secondary_id

R01CA181064

Identifier Type: NIH

Identifier Source: secondary_id

View Link

UG1CA189961

Identifier Type: NIH

Identifier Source: secondary_id

View Link

URCC14040

Identifier Type: -

Identifier Source: org_study_id

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