Effect of Conscious Connected Breathing Added to Sleep Hygiene Education on Sleep Quality and Anxiety in Mothers of Pediatric Oncology Patients: A Pilot Randomized Controlled Trial

Background: Mothers of pediatric oncology patients face high psychosocial burden, poor sleep, and anxiety. Evidence for simple breathing interventions is limited; this study evaluated their impact. Materials and Methods: In this single-center, prospective pilot randomized controlled trial, 38 mothers of children undergoing active cancer treatment were allocated 1:1 to the intervention group (conscious connected breathing [CCB] plus sleep hygiene, n = 19) or the control group (sleep hygiene alone, n = 19). The intervention group received weekly 45-minute face-to-face CCB sessions for 3 weeks, with home practice encouraged. CCB consisted of continuous, deep breathing through the mouth without an intentional pause between inhalation and exhalation. Controls received standardized sleep hygiene education at baseline. Assessments were performed at baseline (T0), week 4 (T1), and week 8 (T2). Sleep quality and anxiety were measured using the PSQI and STAI, with between-group comparisons based on change scores (Δ). Results: Baseline characteristics were comparable, except for higher STAI-II in the intervention group ( P = 0.015). Sleep quality improved in both groups, with greater reductions in the intervention group (ΔT0 to T1: Z = −4.371, P < 0.001, r = 0.71; ΔT0 to T2: Z = −4.612, P < 0.001, r = 0.75). State anxiety decreased over time, with greater reductions observed in the intervention group across all time points (pre-post: Z = −5.116; pre to T1: Z = −5.177; pre to T2: Z = −4.883; all P < 0.001; r = 0.79 to 0.84). Despite higher baseline levels, trait anxiety also decreased more in the intervention group (ΔT0 to T1: Z = −4.635; ΔT0 to T2: Z = −4.544; both P < 0.001). Conclusion: CCB added to sleep hygiene education appears to be a feasible and promising complementary approach associated with improved sleep quality and reduced anxiety among mothers of pediatric oncology patients. Given the pilot nature of the study and the small sample size, these findings should be considered preliminary and require confirmation in larger, adequately powered randomized controlled trials.