Frontiers in oncology · 2026
Effects of exercise interventions on sleep quality in breast cancer survivors: a systematic review and meta-analysis.
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Yu Haoran, Zhong Jianwei, Chen Siyu, Li Min, Guo Jirao
Аннотация
BACKGROUND: The probability of postoperative sleep disturbances in breast cancer survivors exceeds 60%. Poor sleep quality substantially undermines quality of life, exacerbates fatigue, and impairs postoperative recovery.
OBJECTIVE: To systematically review the effects of exercise interventions on sleep quality in breast cancer survivors and explore whether effect estimates vary according to exercise intervention characteristics.
METHODS: We searched PubMed, Web of Science, Embase, and the Cochrane Library from inception to August 2025. Methodological quality was assessed using the Cochrane Risk of Bias tool and the PEDro scale. Meta-analyses, subgroup analyses, assessments of publication bias, and sensitivity analyses were conducted in Stata 17.
RESULTS: A total of 31 randomized controlled trials were included. Meta-analysis revealed that exercise interventions may improve sleep quality in breast cancer survivors [g = -0.63, 95% CI (-0.80, -0.46), P = 0.00]. In subgroup analysis, the largest and statistically significant effect sizes were observed for yoga [g = -0.71, 95% CI (-0.97, -0.46), P< 0.001], 60 min/time [g = -1.02, 95% CI (-1.19, -0.84), P< 0.001], 3 times/week [g = -0.87, 95% CI (-1.07, -0.66), P< 0.001], intervention duration >12 weeks [g = -1.01, 95% CI (-1.32, -0.71), P< 0.001]. Effect sizes were comparable between group [g = -0.65, 95% CI (-0.91, -0.40), P< 0.001] and individual interventions [g = -0.60, 95% CI (-0.82, -0.38), P< 0.001].
CONCLUSION: Exercise interventions may improve sleep quality in breast cancer survivors. Exploratory subgroup analyses suggested larger pooled effect estimates for yoga performed three times per week for 60 minutes per session for more than 12 weeks, with similar estimates for group and individual delivery formats. However, these findings do not establish an optimal exercise prescription and require confirmation in adequately powered trials that directly compare exercise programs.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251125057.
OBJECTIVE: To systematically review the effects of exercise interventions on sleep quality in breast cancer survivors and explore whether effect estimates vary according to exercise intervention characteristics.
METHODS: We searched PubMed, Web of Science, Embase, and the Cochrane Library from inception to August 2025. Methodological quality was assessed using the Cochrane Risk of Bias tool and the PEDro scale. Meta-analyses, subgroup analyses, assessments of publication bias, and sensitivity analyses were conducted in Stata 17.
RESULTS: A total of 31 randomized controlled trials were included. Meta-analysis revealed that exercise interventions may improve sleep quality in breast cancer survivors [g = -0.63, 95% CI (-0.80, -0.46), P = 0.00]. In subgroup analysis, the largest and statistically significant effect sizes were observed for yoga [g = -0.71, 95% CI (-0.97, -0.46), P< 0.001], 60 min/time [g = -1.02, 95% CI (-1.19, -0.84), P< 0.001], 3 times/week [g = -0.87, 95% CI (-1.07, -0.66), P< 0.001], intervention duration >12 weeks [g = -1.01, 95% CI (-1.32, -0.71), P< 0.001]. Effect sizes were comparable between group [g = -0.65, 95% CI (-0.91, -0.40), P< 0.001] and individual interventions [g = -0.60, 95% CI (-0.82, -0.38), P< 0.001].
CONCLUSION: Exercise interventions may improve sleep quality in breast cancer survivors. Exploratory subgroup analyses suggested larger pooled effect estimates for yoga performed three times per week for 60 minutes per session for more than 12 weeks, with similar estimates for group and individual delivery formats. However, these findings do not establish an optimal exercise prescription and require confirmation in adequately powered trials that directly compare exercise programs.
SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/, identifier CRD420251125057.