This is an in-depth assessment of the current evidence for yoga for cancer-related fatigue. Follow the links for other information regarding yoga for cancer:
Across the three systematic reviews included, yoga demonstrates small, short-term improvements in subjective sleep outcomes in cancer populations, primarily when compared with inactive controls. However, no consistent benefits over active comparators, including cognitive behavioural therapy (CBT) were observed. Effects are The certainty of evidence is low to very low. The full description of the included SRs can be found in the yoga evidence tables.
General characteristics of included studies
Number of studies: 3 systematic reviews (Liu 2026; Han 2023a NMA; Han 2023b).
Number of RCTs per SR: From 32 to 68 RCTs per SR. Participants per SR: From 2,423 to 6,339 participants.
Participants: Cancer patients including breast cancer survivors (Liu 2026), adults with early-stage cancer (Han 2023a NMA), patients with mixed cancer types across stages (Han 2024b).
Interventions: Yoga (Hatha, Iyengar, mindfulness yoga, Viniyoga, general yoga); broader mind–body therapies (MBTs): mindfulness, qigong/tai chi, relaxation, hypnosis.
Comparators: Usual care (UC), wait-list control (WL), health education, active controls (e.g. CBT, exercise).
Outcomes: Subjective sleep disturbance / sleep quality measured with PSQI, ISI, PROMIS, EORTC QLQ-C30.
Objective sleep outcomes (wake after sleep onset, total sleep time, sleep efficiency, actigraphy, polysomnography).
Effects on sleep outcomes
Subjective sleep disturbance / sleep quality
Small but statistically significant improvements of sleep disturbances were reported for yoga and other mind-body therapies compared with usual care or wait-list.
Yoga (breast cancer survivors): SMD −0.29 (CrI −0.43 to −0.15) (Liu 2026).
Yoga (mixed cancers): SMD −0.21 (−0.35 to −0.08), p = 0.001 vs UC/WL (Han 2023b).
The certainty of evidence is low to very low.
No significant effects were reported when yoga was compared with active controls (e.g., CBT, exercise across time points). Among mindfulness-based therapies, mindfulness tends to show larger effects than yoga.
Objective sleep outcomes
The available evidence is limited and inconsistent. Improvements were reported for wake after sleep onset: SMD −4.87 (−8.57 to −1.17) (immediate effect). For other objective seep outcome measures total sleep time, sleep efficiency, sleep onset latency no consistent significant effects were reported. The certainty of the evidence is very low.
Dose–response / intervention characteristics
Some evidence suggests dose-dependent effects of yoga on sleep outcomes with an optimal dose of >160 METs*-min/week: SMD −0.39 (−0.78 to −0.01). *metabolic-equivalent of tasks The certainty of evidence is low. With increasing age, yoga may become less effective for CRF and poor sleep quality.
Methodological quality and limitations of the evidence
Quality of systematic reviews: Moderate–high quality (Liu 2026, Han 2023a), low–moderate quality (Han 2023b). SRs of critically low quality were excluded from this summary.
Quality of the networks meta-analysis: Han 2023a showed moderate to high methodological quality, appropriate NMA methods, and no major inconsistency. However, certainty of evidence remained limited (low–moderate) due to sparse comparisons, indirect evidence, and heterogeneity.
Common limitations across included studies: Substantial proportion of studies included in two SRs were rated as “some concerns” or “high risk” leading to downgrading of evidence to low certainty (GRADE). Likely systematic underestimation of bias in one SRs: use of self-reported outcomes (e.g., PSQI) in non-blinded trials should often be high risk but were rated as low.
High heterogeneity in populations, interventions, and outcome measures; strong reliance on self-reported sleep outcomes; many small or pilot studies; risk of publication bias.
