Mindfulness-based stress reduction with acupressure for sleep quality in breast cancer patients with insomnia undergoing chemotherapy: A randomized controlled trial.
Study Goal
The researchers aimed to compare the effectiveness of mindfulness-based stress reduction (MBSR), acupressure, and their combination in improving sleep quality, fatigue, anxiety, and depression in breast cancer patients with sleep disorders.
Results Summary
MBSR, acupressure, and combined therapy significantly improved sleep quality, reduced fatigue, and decreased anxiety. Acupressure and combined therapy outperformed MBSR in improving sleep quality, with no significant difference between acupressure and combined therapy.
Population
Breast cancer patients with sleep disorders
Effective Dosage
Not specified
Duration
8 weeks
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
mindfulness-based stress reduction (MBSR) | increase | PSQI outcomes | breast cancer patients with sleep disorders | p < 0.001 | led to better PSQI outcomes | #1 |
mindfulness-based stress reduction (MBSR) | decrease | fatigue | breast cancer patients with sleep disorders | p < 0.001 | reduced fatigue | #2 |
mindfulness-based stress reduction (MBSR) | decrease | anxiety | breast cancer patients with sleep disorders | p < 0.05 | decreased anxiety | #3 |
mindfulness-based stress reduction (MBSR) | increase | sleep measured by all actigraphy indices | breast cancer patients with sleep disorders | - | improved sleep measured by all actigraphy indices | #4 |
mindfulness-based stress reduction (MBSR) | no change | Sleep Latency | breast cancer patients with sleep disorders | p = 0.235 | did not differ from control on Sleep Latency | #5 |
mindfulness-based stress reduction (MBSR) | no change | mean waking by time (MWBT) | breast cancer patients with sleep disorders | p = 0.058 | did not differ from control on mean waking by time (MWBT) | #6 |
acupressure | increase | PSQI outcomes | breast cancer patients with sleep disorders | p < 0.001 | led to better PSQI outcomes | #7 |
acupressure | decrease | fatigue | breast cancer patients with sleep disorders | p < 0.001 | reduced fatigue | #8 |
acupressure | decrease | anxiety | breast cancer patients with sleep disorders | p < 0.05 | decreased anxiety | #9 |
acupressure | increase | sleep measured by all actigraphy indices | breast cancer patients with sleep disorders | - | improved sleep measured by all actigraphy indices | #10 |
acupressure | increase | Sleep Efficiency (SE) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Sleep Efficiency (SE) | #11 |
acupressure | decrease | Sleep Latency (SL) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Sleep Latency (SL) | #12 |
acupressure | increase | Total Sleep Time (TST) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Total Sleep Time (TST) | #13 |
acupressure | decrease | Wake after sleep onset (WASO) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Wake after sleep onset (WASO) | #14 |
MBSR combined with acupressure | increase | PSQI outcomes | breast cancer patients with sleep disorders | p < 0.001 | led to better PSQI outcomes | #15 |
MBSR combined with acupressure | decrease | fatigue | breast cancer patients with sleep disorders | p < 0.001 | reduced fatigue | #16 |
MBSR combined with acupressure | decrease | anxiety | breast cancer patients with sleep disorders | p < 0.05 | decreased anxiety | #17 |
MBSR combined with acupressure | increase | sleep measured by all actigraphy indices | breast cancer patients with sleep disorders | - | improved sleep measured by all actigraphy indices | #18 |
MBSR combined with acupressure | increase | Sleep Efficiency (SE) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Sleep Efficiency (SE) | #19 |
MBSR combined with acupressure | decrease | Sleep Latency (SL) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Sleep Latency (SL) | #20 |
MBSR combined with acupressure | increase | Total Sleep Time (TST) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Total Sleep Time (TST) | #21 |
MBSR combined with acupressure | decrease | Wake after sleep onset (WASO) | breast cancer patients with sleep disorders | p < 0.05 | outperformed MBSR on Wake after sleep onset (WASO) | #22 |
MBSR combined with acupressure | increase | PSQI | breast cancer patients with sleep disorders | p = 0.03 | further outperformed MBSR on PSQI | #23 |
MBSR combined with acupressure | decrease | Number of awakings (NOA) | breast cancer patients with sleep disorders | p = 0.003 | further outperformed MBSR on Number of awakings (NOA) | #24 |
acupressure | no change | all outcomes | breast cancer patients with sleep disorders | p ≥ 0.05 | no significant difference across all outcomes between acupressure and combined intervention | #25 |
MBSR combined with acupressure | no change | all outcomes | breast cancer patients with sleep disorders | p ≥ 0.05 | no significant difference across all outcomes between acupressure and combined intervention | #26 |
PURPOSE: The objective of this randomized controlled trial was to evaluate and compare the effectiveness of mindfulness-based stress reduction (MBSR), acupressure, and MBSR combined with acupressure in improving sleep quality in breast cancer patients with sleep disorders, as well as the potential effects of these interventions on relieving fatigue, anxiety, and depression. METHODS: A four-arm parallel-group randomized controlled trial was conducted in a tertiary hospital in Fujian between July 2019 and January 2021. A total of 147 breast cancer patients were randomly assigned to a usual care group (n = 34), a MBSR group (n = 38), an acupressure group (n = 36), or a combined group (n = 39). We assessed patients' sleep quality (Pittsburgh Sleep Quality Index-PSQI and 6 actigraphy indices), fatigue, anxiety, and depression at baseline and at the mid-intervention (fourth week) and the end of intervention (eighth week). RESULTS: The ANOVA showed a significant difference (p < 0.05) in PSQI, and all sleep parameters measured by wrist actigraphy, and anxiety between groups. The three active treatments led to better PSQI outcomes (p < 0.001), reduced fatigue (p < 0.001), decreased anxiety (p < 0.05), and improved sleep measured by all actigraphy indices with two exceptions (MBSR did not differ from control on Sleep Latency (p = 0.235) and mean waking by time (MWBT) (p = 0.058)). Both acupressure and the combined intervention outperformed MBSR on four actigraphy indices: Sleep Efficiency (SE), Sleep Latency (SL), Totatl Sleep Time (TST), and Wake after sleep onset (WASO) (p < 0.05), and the combined intervention further outperformed MBSR on PSQI (p = 0.03) and Number of awakings (NOA) (p = 0.003). Moreover, there was no significant difference across all outcomes between acupressure and combined intervention (p ≥ 0.05). CONCLUSIONS: MBSR, acupressure, and combined therapy all show a remarkable advantages in allemiating sleep quality, fatigue, and anxiety. Acupressure and combined therapy outperformed MBSR in improving sleep quality.