Trial Outcomes & Findings for Yoga, Survivorship Health Education, and Cognitive Behavioral Therapy in Reducing Insomnia in Cancer Survivors (NCT NCT02613364)

NCT ID: NCT02613364

Last Updated: 2024-05-01

Results Overview

The Insomnia Severity Index is a validated measure of insomnia. A 5-point Likert scale of 7 questions is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28 with higher scores indicating higher severity of insomnia. Means and 95% confidence intervals for YOCAS and CBT-I will be calculated and plotted and examined in comparison with the a priori specified non-inferiority margin of 1.15.

Recruitment status

COMPLETED

Study phase

NA

Target enrollment

746 participants

Primary outcome timeframe

Baseline up to post intervention (approximately 4 to 8 weeks)

Results posted on

2024-05-01

Participant Flow

6 participants were registered but not eligible.

Participant milestones

Participant milestones
Measure
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: 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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: 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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Overall Study
STARTED
251
238
251
Overall Study
COMPLETED
185
148
175
Overall Study
NOT COMPLETED
66
90
76

Reasons for withdrawal

Reasons for withdrawal
Measure
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: 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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: 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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Overall Study
Other
19
29
17
Overall Study
Too time consuming
21
26
26
Overall Study
Withdrawal by Subject
13
18
17
Overall Study
Medical
12
13
9
Overall Study
Disliked Study Procedure
1
1
4
Overall Study
Disliked Intervention
0
3
3

Baseline Characteristics

The difference between the number of participants analyzed and the overall number of baseline participants is due to participant withdrawal.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
Arm I (Behavioral Intervention-yoga)
n=251 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=238 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=251 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Total
n=740 Participants
Total of all reporting groups
Age, Continuous
55 years
n=251 Participants
56 years
n=238 Participants
57 years
n=251 Participants
56 years
n=740 Participants
Sex: Female, Male
Female
234 Participants
n=251 Participants
216 Participants
n=238 Participants
236 Participants
n=251 Participants
686 Participants
n=740 Participants
Sex: Female, Male
Male
17 Participants
n=251 Participants
22 Participants
n=238 Participants
15 Participants
n=251 Participants
54 Participants
n=740 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=251 Participants
2 Participants
n=238 Participants
2 Participants
n=251 Participants
4 Participants
n=740 Participants
Race (NIH/OMB)
Asian
5 Participants
n=251 Participants
3 Participants
n=238 Participants
3 Participants
n=251 Participants
11 Participants
n=740 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
2 Participants
n=251 Participants
0 Participants
n=238 Participants
0 Participants
n=251 Participants
2 Participants
n=740 Participants
Race (NIH/OMB)
Black or African American
29 Participants
n=251 Participants
26 Participants
n=238 Participants
28 Participants
n=251 Participants
83 Participants
n=740 Participants
Race (NIH/OMB)
White
213 Participants
n=251 Participants
207 Participants
n=238 Participants
214 Participants
n=251 Participants
634 Participants
n=740 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=251 Participants
0 Participants
n=238 Participants
0 Participants
n=251 Participants
0 Participants
n=740 Participants
Race (NIH/OMB)
Unknown or Not Reported
2 Participants
n=251 Participants
0 Participants
n=238 Participants
4 Participants
n=251 Participants
6 Participants
n=740 Participants
Region of Enrollment
United States
251 participants
n=251 Participants
238 participants
n=238 Participants
251 participants
n=251 Participants
740 participants
n=740 Participants
ISI at Baseline
15.41 units on a scale
STANDARD_DEVIATION 4.34 • n=216 Participants • The difference between the number of participants analyzed and the overall number of baseline participants is due to participant withdrawal.
15.57 units on a scale
STANDARD_DEVIATION 4.35 • n=198 Participants • The difference between the number of participants analyzed and the overall number of baseline participants is due to participant withdrawal.
15.39 units on a scale
STANDARD_DEVIATION 4.39 • n=205 Participants • The difference between the number of participants analyzed and the overall number of baseline participants is due to participant withdrawal.
15.45 units on a scale
STANDARD_DEVIATION 4.35 • n=619 Participants • The difference between the number of participants analyzed and the overall number of baseline participants is due to participant withdrawal.

PRIMARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is higher than the number of participants who completed the study because the timeframe for this outcome measure was from baseline up to post-intervention. Some participants withdrew after the post-intervention assessment.

The Insomnia Severity Index is a validated measure of insomnia. A 5-point Likert scale of 7 questions is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28 with higher scores indicating higher severity of insomnia. Means and 95% confidence intervals for YOCAS and CBT-I will be calculated and plotted and examined in comparison with the a priori specified non-inferiority margin of 1.15.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=202 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=163 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=185 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in the ISI Comparing YOCAS vs. CBT-I
-3.61 units on a scale
Interval -4.19 to -3.03
-7.22 units on a scale
Interval -7.95 to -6.49
-2.19 units on a scale
Interval -2.84 to -1.55

PRIMARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is higher than the number of participants who completed the study because the timeframe for this outcome measure was from baseline up to post-intervention. Some participants withdrew after the post-intervention assessment.

The Insomnia Severity Index is a validated measure of insomnia. A 5-point Likert scale of 7 questions is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28 with higher scores indicating higher severity of insomnia. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=202 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=163 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=185 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in the ISI Comparing YOCAS vs. Health Education
-3.61 units on a scale
Interval -4.19 to -3.03
-7.22 units on a scale
Interval -7.95 to -6.49
-2.19 units on a scale
Interval -2.84 to -1.55

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is higher than the number of participants who completed the study because the timeframe for this outcome measure was from baseline up to post-intervention. Some participants withdrew after the post-intervention assessment.

The PSQI measures sleep quality with a total score ranging from 0-21 with higher scores indicating worse sleep quality. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=202 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=163 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=186 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Global Sleep Quality Impairment as Measured by the Pittsburgh Sleep Quality Inventory (PSQI) Total Score Comparing YOCAS vs. Health Education
-1.59 units on a scale
Interval -1.99 to -1.18
-3.82 units on a scale
Interval -4.3 to -3.33
-1.11 units on a scale
Interval -1.55 to -0.68

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is higher than the number of participants who completed the study because the timeframe for this outcome measure was from baseline up to post-intervention. Some participants withdrew after the post-intervention assessment.

The PSQI measures sleep quality with a total score ranging from 0-21 with higher scores indicating worse sleep quality. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and CBT-I.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=202 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=163 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=186 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Global Sleep Quality Impairment as Measured by the Pittsburgh Sleep Quality Inventory (PSQI) Total Score Comparing YOCAS vs. CBT-I.
-1.59 units on a scale
Interval -1.99 to -1.18
-3.82 units on a scale
Interval -4.3 to -3.33
-1.11 units on a scale
Interval -1.55 to -0.68

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure the number of minutes of actual sleep. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Sleep Duration Via Actigraphy Comparing YOCAS vs. Health Education
395.99 minutes
Interval 383.49 to 408.5
380.06 minutes
Interval 366.93 to 393.18
376.27 minutes
Interval 363.06 to 389.48

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure the number of minutes of actual sleep. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and CBT-I.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Sleep Duration Via Actigraphy Comparing YOCAS vs. CBT-I
395.99 minutes
Interval 383.49 to 408.5
380.06 minutes
Interval 366.93 to 393.18
376.27 minutes
Interval 363.06 to 389.48

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure total minutes of wake time after sleep onset. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education. The transformation of the log base 10 of the original measurement was used for the analysis.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Wake After Sleep Onset Via Actigraphy Comparing YOCAS vs. Health Education
1.85 minutes
Interval 1.81 to 1.89
1.81 minutes
Interval 1.76 to 1.85
1.86 minutes
Interval 1.81 to 1.9

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure total minutes of wake time after sleep onset. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and CBT-I. The transformation of log base 10 of the original measurement was used for the analysis.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Wake After Sleep Onset Via Actigraphy Comparing YOCAS vs. CBT-I
1.85 minutes
Interval 1.81 to 1.89
1.81 minutes
Interval 1.76 to 1.85
1.86 minutes
Interval 1.81 to 1.9

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure the percent of time actually slept compared to intended time sleeping. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Sleep Efficiency Via Actigraphy Comparing YOCAS vs. Health Education
81.65 percent of time
Interval 79.57 to 83.73
82.42 percent of time
Interval 80.24 to 84.6
79.38 percent of time
Interval 77.19 to 81.58

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure the percent of time actually slept compared to intended time sleeping. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and CBT-I.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Sleep Efficiency Via Actigraphy Comparing YOCAS vs. CBT-I
81.65 percent of time
Interval 79.57 to 83.73
82.42 percent of time
Interval 80.24 to 84.6
79.38 percent of time
Interval 77.19 to 81.58

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure the minutes it takes for the participant to fall asleep. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education. The transformation of log base 10 of the (measurement + 1) was used in the analysis.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Sleep Latency Via Actigraphy Comparing YOCAS vs. Health Education
0.76 minutes
Interval 0.69 to 0.83
0.74 minutes
Interval 0.67 to 0.82
0.80 minutes
Interval 0.73 to 0.87

SECONDARY outcome

Timeframe: Baseline up to post intervention (approximately 4 to 8 weeks)

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to the actigraphy device malfunction or battery issue and participant non-compliance.

Actigraphy will measure the minutes it takes for the participant to fall asleep. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and CBT-I. The transformation of the log base 10 of the (measure + 1) was used in the analysis.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=150 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=135 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=144 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in Objective Symptoms of Insomnia- Sleep Latency Via Actigraphy Comparing YOCAS vs. CBT-I
0.76 minutes
Interval 0.69 to 0.83
0.74 minutes
Interval 0.67 to 0.82
0.80 minutes
Interval 0.73 to 0.87

SECONDARY outcome

Timeframe: Baseline to 3 months

Population: The overall number of participants analyzed in arms I \& II is higher than the number of participants who completed the study. This difference is due to some participants withdrew after this outcome measure was collected. The overall number of participants analyzed in arm III is lower than the number of participants who completed the study. This difference is due to participant non-compliance.

The Insomnia Severity Index is a validated measure of insomnia. A 5-point Likert scale of 7 questions is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28 with higher scores indicating higher severity of insomnia. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=189 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=153 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=173 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in the ISI Comparing YOCAS and Health Education (3 Month)
-5.02 units on a scale
Interval -5.72 to -4.28
-7.59 units on a scale
Interval -8.37 to -6.81
-3.56 units on a scale
Interval -4.31 to -2.82

SECONDARY outcome

Timeframe: Baseline to 3 months

Population: The overall number of participants analyzed in arms I \& II is higher than the number of participants who completed the study. This difference is due to some participants withdrew after this outcome measure was collected. The overall number of participants analyzed in arm III is lower than the number of participants who completed the study. This difference is due to participant non-compliance.

The Insomnia Severity Index is a validated measure of insomnia. A 5-point Likert scale of 7 questions is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28 with higher scores indicating higher severity of insomnia. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and CBT-I.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=189 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=153 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=173 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in the ISI Comparing YOCAS and CBT-I (3 Month)
-5.02 units on a scale
Interval -5.72 to -4.28
-7.59 units on a scale
Interval -8.37 to -6.81
-3.56 units on a scale
Interval -4.31 to -2.82

SECONDARY outcome

Timeframe: Baseline to 6 months

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to participant non-compliance.

The Insomnia Severity Index is a validated measure of insomnia. A 5-point Likert scale of 7 questions is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28 with higher scores indicating higher severity of insomnia. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and health education.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=182 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=144 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=171 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in the ISI Comparing YOCAS and Health Education (6 Month)
-5.29 units on a scale
Interval -6.0 to -4.57
-7.93 units on a scale
Interval -8.71 to -7.15
-3.91 units on a scale
Interval -4.75 to -3.07

SECONDARY outcome

Timeframe: Baseline to 6 months

Population: The overall number of participants analyzed is lower than the number of participants who completed the study. This difference is due to participant non-compliance.

The Insomnia Severity Index is a validated measure of insomnia. A 5-point Likert scale of 7 questions is used to rate each item (e.g., 0 = no problem; 4 = very severe problem), yielding a total score ranging from 0 to 28 with higher scores indicating higher severity of insomnia. A linear mixed effects ANCOVA will be used to assess the statistical significance of the differences in mean change between YOCAS and CBT-I.

Outcome measures

Outcome measures
Measure
Arm I (Behavioral Intervention-yoga)
n=182 Participants
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=144 Participants
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=171 Participants
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Mean Change in the ISI Comparing YOCAS and CBT-I (6 Month)
-5.29 units on a scale
Interval -6.0 to -4.57
-7.93 units on a scale
Interval -8.71 to -7.15
-3.91 units on a scale
Interval -4.75 to -3.07

Adverse Events

Arm I (Behavioral Intervention-yoga)

Serious events: 3 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm II (Cognitive Intervention-CBT-I)

Serious events: 1 serious events
Other events: 0 other events
Deaths: 0 deaths

Arm III (Educational Intervention)

Serious events: 1 serious events
Other events: 0 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
Arm I (Behavioral Intervention-yoga)
n=251 participants at risk
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. Behavioral Intervention: Undergo yoga intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm II (Cognitive Intervention-CBT-I)
n=238 participants at risk
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. Cognitive Intervention: Undergo CBT-I intervention Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Arm III (Educational Intervention)
n=251 participants at risk
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." Educational Intervention: Receive health education Laboratory Biomarker Analysis: Correlative studies Monitoring Device: Correlative studies Quality-of-Life Assessment: Ancillary studies
Nervous system disorders
Stroke
0.40%
1/251 • Number of events 1 • 1 year and 9 months
0.00%
0/238 • 1 year and 9 months
0.00%
0/251 • 1 year and 9 months
Respiratory, thoracic and mediastinal disorders
Acute respiratory distress
0.00%
0/251 • 1 year and 9 months
0.00%
0/238 • 1 year and 9 months
0.40%
1/251 • Number of events 2 • 1 year and 9 months
Psychiatric disorders
Confusion/brain met
0.40%
1/251 • Number of events 1 • 1 year and 9 months
0.00%
0/238 • 1 year and 9 months
0.00%
0/251 • 1 year and 9 months
Nervous system disorders
Intracranial hemorrhage/brain met
0.40%
1/251 • Number of events 2 • 1 year and 9 months
0.00%
0/238 • 1 year and 9 months
0.00%
0/251 • 1 year and 9 months
Psychiatric disorders
Depression
0.40%
1/251 • Number of events 1 • 1 year and 9 months
0.00%
0/238 • 1 year and 9 months
0.00%
0/251 • 1 year and 9 months
Nervous system disorders
Intraparenchymal hemorrhage
0.00%
0/251 • 1 year and 9 months
0.42%
1/238 • Number of events 1 • 1 year and 9 months
0.00%
0/251 • 1 year and 9 months
Hepatobiliary disorders
Hepatic Encephalopathy
0.00%
0/251 • 1 year and 9 months
0.42%
1/238 • Number of events 1 • 1 year and 9 months
0.00%
0/251 • 1 year and 9 months

Other adverse events

Adverse event data not reported

Additional Information

Dr. Karen Mustian, Study PI

University of Rochester Medical Center

Phone: 585-275-0557

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place