Exercise interventions to improve sleep in cancer patients: a systematic review and meta-analysis
Abstract
Exercise leads to several positive outcomes in oncology. However, the question as to whether exercise is a valuable option for improving patients' sleep, which is frequently disturbed in cancer patients, remains unanswered. The aims of this study were to conduct a systematic review and meta-analysis of randomized and non-randomized clinical trials that have investigated the effect of exercise on sleep outcomes, assessed subjectively and objectively. Relevant studies, published before May 2016, were traced through a systematic search of PubMed, Embase, PsycINFO, SportDiscus and Cochrane library databases. The review looked at twenty one trials, including 17 randomized controlled trials. Most interventions were home-based aerobic walking programs and breast cancer patients were the subgroup most represented. Sleep variables were most commonly used as secondary outcomes in the reviewed studies. Studies were highly heterogeneous in terms of methodology. The qualitative review of available evidence suggested a beneficial effect of exercise interventions on sleep in several studies (48%). However, the meta-analysis conducted on RCTs revealed no significant effect either on subjective or on objective sleep measures. This lack of significant effect could be due, at least in part, to a floor effect. More rigorous studies are needed to assess the effect of exercise interventions in cancer patients, in particular randomized controlled trials conducted in patients with clinically significant sleep disturbances at baseline.
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Resistance plus impact training may not be safe for cancer survivors with bone fragility associated with osteoporosis or bony metastases in the hip or spine.
“In non-cancer populations, whether or not resistance plus impact training programs are safe for individuals with osteoporosis remains controversial(48), thus at this time this exercise prescription may not be safe for cancer survivors with bone fragility associated with osteoporosis or bony metastases in the hip or spine (see section 5).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [48]
In non-cancer populations, the safety of resistance plus impact training for individuals with osteoporosis is controversial.
“In non-cancer populations, whether or not resistance plus impact training programs are safe for individuals with osteoporosis remains controversial(48), thus at this time this exercise prescription may not be safe for cancer survivors with bone fragility associated with osteoporosis or bony metastases in the hip or spine (see section 5).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [48]
Meta-analyses that did not differentiate exercise type generally found similar effect size estimates, except in Mercier et al.
“Meta-analyses that did not differentiate exercise type [43,78,80e83] generally found similar effect size estimates, except in Mercier et al. [86].”
From The effects of exercise on sleep in unipolar depression: a systematic review and network meta-analysis (2021) · cites this paper as [86]
Mercier et al. only included patients with cancer, which might explain the discrepancy.
“However, they only included patients with cancer, which might explain the discrepancy.”
From The effects of exercise on sleep in unipolar depression: a systematic review and network meta-analysis (2021) · cites this paper as [86]
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The Impact of Moderate to High Intensity Physical Activity on Sleep Health in Cancer Survivors
Markey, G. E., Ruterbusch, J. J., Baird, T. E., Martin, J. L., Schwartz, A. G., Finlay, D. G., Timban, T., Trendowski, M. R., Badr, M. S., Winters‐Stone, K. M., et al. (2026) · Cancer Medicine · doi:10.1002/cam4.71546
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- Authors
- Mercier, J., Savard, J., & Bernard, P.
- Affiliations
- Université Laval (CA)
- Corresponding author
- Savard, Josée
- Venue
- Sleep Medicine Reviews
- Publisher
- Elsevier BV
- Published
- 2017-12
- Volume
- 36
- Pages
- 43-56
- ISSN
- 1087-0792 (ISSN-L)
- OpenAlex
- W2550997767
- Cited by
- 103
- References
- 103
- Citations by year
- 2026: 6 · 2025: 13 · 2024: 11 · 2023: 10 · 2022: 6 · 2021: 20 · 2020: 9 · 2019: 9 · 2018: 15 · 2017: 4
- FWCI
- 0.94
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Sleep Medicine Reviews (publishedVersion)
- PubMed (publishedVersion)
- HAL (submittedVersion)
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Keywords
- exercise intervention, cancer patients, sleep disorders, sleep quality, breast cancer, floor effect, cancer rehabilitation
- MeSH terms
- Clinical Trials as Topic, Exercise Therapy, Humans, Neoplasms, Quality of Life, Sleep Wake Disorders
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