The Feasibility And Effectiveness Of Virtual Yocas©® Yoga For Insomnia Among Cancer Survivors

Up to 90% of cancer patients and survivors report experiencing insomnia, which increases morbidity, during and after treatment. In-person yoga therapy has previously been shown to alleviate insomnia. However, in-person therapy sessions are challenging to attend for patients and survivors, specifically for those residing in rural and underserved communities, because of little to no access to community-based yoga classes. PURPOSE: To conduct a multicenter, phase II randomized controlled trial (RCT) to evaluate the feasibility and effectiveness of a virtual yoga intervention for treating insomnia among cancer survivors. METHODS: Eligible participants were cancer survivors with insomnia, 2-120 months post-treatment. Participants were randomized into Yoga for Cancer Survivors (YOCAS©®) or standard care (Control). YOCAS©® sessions were delivered virtually (via Zoom) by a certified yoga instructor in a small-group setting (75 minutes/session, 2x/week for 4 weeks). Insomnia was assessed via the Insomnia Severity Index at baseline and post-intervention. ANCOVA was used to assess intervention effects. RESULTS: 42 survivors (93% female, 95% white, 57% breast cancer, 58.8 ± 11.8 years average age, 17% residing in small town/rural areas) were randomized and completed the study. YOCAS©® participants attended on average 6.2 of 8 prescribed sessions. 45% of YOCAS©® participants reported an additional 60.9 minutes of self-guided yoga therapy at home. From baseline to post-intervention, YOCAS©® participants reported significant improvements in the severity of insomnia (0.80 ± .20), were significantly more satisfied with their sleep pattern (-0.65 ± 0.21), less worried about their sleep problems (-0.75 ± 0.19), and their quality of life was significantly less impacted by sleep problems (-0.25 ± .22) while controls did not report such differences (all p < 0.05). The mean improvements in the severity of insomnia (-2.14 ± 0.11,p < 0.11), satisfaction of sleep patterns (-0.54 ± 0.25, p = 0.04), and worry about sleep problems (-0.58 ± 0.24, p = 0.02) were significantly greater in the YOCAS©® than the Control groups. CONCLUSIONS: Our data suggest that YOCAS©® delivered virtually in small groups is feasible and may improve insomnia among cancer survivors. Future phase III RCTs are needed to confirm these promising findings. NCI UG1CA189961