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Physical Activity and Sleep Quality in Breast Cancer Survivors: A Randomized Trial


Medicine & Science in Sports & Exercise: October 2017 - Volume 49 - Issue 10 - p 2009–2015
doi: 10.1249/MSS.0000000000001327
Clinical Sciences

Purpose Data from large randomized controlled trials confirming sleep quality improvements with aerobic physical activity have heretofore been lacking for post–primary treatment breast cancer survivors. Our primary purpose for this report was to determine the effects of a physical activity behavior change intervention, previously reported to significantly increase physical activity behavior, on sleep quality in post–primary treatment breast cancer survivors.

Methods Post–primary treatment breast cancer survivors (n = 222) were randomized to a 3-month physical activity behavior change intervention (Better Exercise Adherence after Treatment for Cancer [BEAT Cancer]) or usual care. Self-report (Pittsburgh Sleep Quality Index [PSQI]) and actigraphy (latency and efficiency) sleep outcomes were measured at baseline, 3 months (M3), and 6 months (M6).

Results After adjusting for covariates, BEAT Cancer significantly improved PSQI global sleep quality when compared with usual care at M3 (mean between-group difference [M] = −1.4, 95% confidence interval [CI] = −2.1 to −0.7, P < 0.001) and M6 (M = −1.0, 95% CI = −1.7 to −0.2, P = 0.01). BEAT Cancer improved several PSQI subscales at M3 (sleep quality M = −0.3, 95% CI = −0.4 to −0.1, P = 0.002; sleep disturbances M = −0.2, 95% CI = −0.3 to −0.03, P = 0.016; daytime dysfunction M = −0.2, 95% CI = −0.4 to −0.02, P = 0.027) but not M6. A nonsignificant increase in percent of participants classified as good sleepers occurred. No significant between-group difference was noted for accelerometer latency or efficiency.

Conclusion A physical activity intervention significantly reduced perceived global sleep dysfunction at 3 and 6 months, primarily because of improvements in sleep quality aspects not detected with accelerometer.

1Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL; 2Faculty of Physical Education and Recreation, University of Alberta, Edmonton, Alberta, CANADA; 3Department of Medicine, University of Alabama at Birmingham, Birmingham, AL; 4Department of Kinesiology, Southern Illinois University Carbondale, Carbondale, IL; 5Statistics and Research Informatics Core, Center for Clinical Research, Southern Illinois University School of Medicine, Springfield, IL; and 6Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL

Address for correspondence: Laura Q. Rogers, M.D., M.P.H., University of Alabama at Birmingham, Webb 222, 1720 2nd Avenue, South Birmingham, AL 35294-3360; E-mail:

Submitted for publication January 2017.

Accepted for publication May 2017.

© 2017 American College of Sports Medicine