Progressive Muscle Relaxation

Efficacy

The available evidence suggests PMR to be effective for sleep/insomnia. Three RCTs (n=30, n=60, n=148) found sleep improved. Furthermore, three CCTs (n=30, n=49, n=229) found improvement in sleep quality and insomnia but one study did not have a non-treatment control group, and the other one had a small sample size. 

Safety

Generally considered safe when administered by a qualified practitioner. Some concerns have been raised about the use of relaxation therapy interventions among individuals who have a history of psychiatric disorders.

Read the full version of the Progressive Muscle Relaxation summary.

Yoga 

Efficacy

The evidence suggests yoga to be effective on sleep/insomnia for patients diagnosed with cancers other than breast cancer.  Three RTCs (ranging from 54-410 participants) found beneficial effects on sleep quality. 

Safety

Generally considered safe when administered by a qualified practitioner. Few adverse events are reported in clinical trials, and serious adverse effects appear to be rare. Overall, injury rates are comparable to other exercise types.

Read the full version of the Yoga summary.

Autogenic therapy

Efficacy

Few trial data are available for the effect of autogenic therapy on sleep. One RCT (n=229) showed that sleep parameters were enhanced, and the need for sleep medication was reduced. 

Safety

The safety of Autogenic therapy has not been systematically assessed. No adverse events were reported in the studies analysed for this summary. Concerns exist for children under the age of five, individuals with schizophrenia, or who are actively psychotic.

Read the full version of the Autogenic therapy summary.

Aromatherapy

Efficacy

The available evidence on the effect of aromatherapy on sleep is of low methodological quality. The results are based on a SR (n=4 RCTs) and an additional RCT (n=57). The SR reported positive findings on sleep quality; however, there was no blinding among two of the RCTs. The RCT reported a positive difference in sleep quality among those receiving aromatherapy, but the results were not consistent at different time points. 

Safety

Generally safe and only associated with minimal adverse effects when used in appropriate dilutions. Allergic reactions can occur with all oils. Should not be used undiluted.

Read the full version of the Aromatherapy summary. 

Ginseng

Efficacy

The available evidence on the effect of Asian ginseng on sleep/insomnia has methodological limitations. Two RCTs found positive effects on sleep: the first one (n=30) is of moderate methodological quality and found sleep improved after 12 weeks of treatment; the second one (n=113) found fewer sleep disorders after a 30-day treatment but is of low methodological quality. 

Safety

Generally considered safe, with only minor adverse drug reactions reported. Mainly gastrointestinal intolerances, headaches, and sleep disorders have been reported. These are dose-dependent, infrequent, and transient. 

Read the full version of the Ginseng summary.

Mindfulness

Efficacy

Mindfulness-based stress reduction (MBSR): The available evidence is contradictory on the effect of MBSR on sleep/insomnia. One SR (n=10 RCTs) found positive short-term effects. A second SR (n=14 mixed study designs) found no effect on sleep/insomnia. 

 Mindfulness-based cognitive therapy (MBCT): Few trial data are available for the effect of MBCT on sleep/insomnia. One RCT (n=70) found improved subjective and objective sleep quality. 

Safety

Mindfulness-based approaches are generally considered safe in supportive cancer care. However, no rigorous assessment of their safety in cancer patients is available.

Read the full version of the Mindfulness summary.

Qigong

Efficacy

The available evidence is contradictory on the effect of qigong on sleep. Five SRs (including 2- 17 mixed study designs) evaluated the effect of qigong on sleep. Three SRs found improvement in sleep quality but one did not differentiate between qigong and Taichi. The remaining SRs found no significant differences.

Safety

Generally considered safe when administered by a qualified practitioner. As it is a moderate form of aerobic exercise, it may be beneficial for people to check with their health practitioner if they have a known heart condition, severe osteoporosis, or musculoskeletal difficulties.

Read the full version of the Qigong summary.

Reflexology 

Efficacy

Few data on the effect of reflexology on sleep/insomnia are available. One RCT (n=72) found that reflexology improved sleep quality.   

Safety

Generally considered safe when administered by a qualified practitioner. 

Read the full version of the Reflexology summary.

Tai chi

Efficacy

The available evidence on the effect of tai chi on sleep/insomnia is contradictory based on two SRs. The first one (n=16 RCTs) reported no difference between tai chi and controls in improving sleeping quality while the second one SR (n=26 mixed study designs) found improved sleep quality. Both SRs were limited by the significant clinical and methodological heterogeneity.

Safety

Generally considered safe when administered by a qualified practitioner. As it is a moderate form of aerobic exercise, it may be beneficial for people to check with their health practitioner if they have a known heart condition, severe osteoporosis, or musculoskeletal difficulties.

Read the full version of the Tai chi summary.

Yoga 

Efficacy

Breast cancer: The available evidence is contradictory on the effect of yoga on sleep/insomnia. Five SRs (ranging from 7- 26 RCTs) evaluated the effect of yoga on sleep. One found short-term improvement for sleep disturbances. The remaining four SRs did not find any significant differences.

Safety

Generally considered safe when administered by a qualified practitioner. Few adverse events are reported in clinical trials, and serious adverse effects appear to be rare. Overall, injury rates are comparable to other exercise types.

Read the full version of the Yoga summary.

At the time of assessment, the available evidence did not suggest no effects for any of the treatments evaluated by CAM Cancer for this symptom.