Effect of mindfulness based interventions for sleep quality and stress reduction in breast cancer patients: A systematic review
Mindfulness for Better Sleep and Stress Relief in Breast Cancer
Abstract
Introduction:Breast cancer is the most common invasive cancer among women worldwide. While advancements in early diagnosis and treatment have improved survival rates, many breast cancer patients experience persistent sleep disturbances, anxiety, and stress, which negatively impact their quality of life. Pharmacological treatments for sleep disorders pose risks such as dependency and side effects, making non-pharmacological interventions like mindfulness-based interventions (MBIs) increasingly relevant. This systematic review evaluates the effectiveness of MBIs, particularly Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT), in improving sleep quality and reducing psychological distress in breast cancer patients. Methods:Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a comprehensive search was conducted across databases including PubMed, Web of Science (WOS), Scopus, Cochrane Library, SID, Irandoc, and Noormags. Studies published up to November 5, 2024, were screened using Medical Subject Headings (MeSH) terms and Boolean operators. Eligible studies included randomized controlled trials (RCTs) and quasi-experimental studies investigating MBIs' effects on sleep and psychological health in breast cancer patients. Data extraction and quality assessment were performed using the Joanna Briggs Institute (JBI) checklist. Results:Out of 207 initially identified studies, eight met the inclusion criteria. MBIs significantly improved sleep quality by reducing insomnia severity, sleep latency, and nighttime awakenings while enhancing sleep efficiency. Additionally, MBIs led to substantial reductions in anxiety and depression scores. Some studies reported improvements in emotional resilience and psychological well-being. However, variations in intervention duration, follow-up periods, and study designs influenced result consistency. Discussion:The findings indicate that MBIs effectively enhance sleep quality and reduce psychological distress in breast cancer patients. Compared to pharmacological treatments, MBIs provide a safer, non-invasive alternative. The benefits are attributed to mindfulness-induced stress reduction and emotional regulation. Despite promising outcomes, variations in methodologies and limited long-term evaluations warrant further research. Conclusion:MBIs are a valuable complementary approach to conventional breast cancer care, addressing sleep and psychological challenges. Further large-scale, high-quality RCTs are needed to confirm long-term efficacy and establish standardized protocols.
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18. Kröz M, Quittel F, Reif M, Zerm R, Pranga D, Bartsch C, et al. Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue. Scientific Reports. 2023;13(1):2705.
19. W Kanen J, Nazir R, Sedky K, K Pradhan B. The effects of mindfulness-based interventions on sleep disturbance: a meta-analysis. Adolescent Psychiatry. 2015;5(2):105-15.
20. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. bmj. 2021;372.
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22. Farzan R, Firooz M, Ghorbani Vajargah P, Mollaei A, Takasi P, Tolouei M, et al. Effects of aromatherapy with Rosa damascene and lavender on pain and anxiety of burn patients: a systematic review and meta‐analysis. International Wound Journal. 2023.
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24. Kröz M, Quittel F, Reif M, Zerm R, Pranga D, Bartsch C, et al. Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue. Scientific Reports. 2023;13(1):2705.
25. Hofmann SG, Gómez AF. Mindfulness-based interventions for anxiety and depression. Psychiatric clinics. 2017;40(4):739-49.
26. Li SYH, Bressington D. The effects of mindfulness‐based stress reduction on depression, anxiety, and stress in older adults: A systematic review and meta‐analysis. International journal of mental health nursing. 2019;28(3):635-56.
27. Bhattacharya S, Hofmann SG. Mindfulness-based interventions for anxiety and depression. Clinics in Integrated Care. 2023;16:100138.
28. Zhang M-F, Wen Y-S, Liu W-Y, Peng L-F, Wu X-D, Liu Q-W. Effectiveness of mindfulness-based therapy for reducing anxiety and depression in patients with cancer: a meta-analysis. Medicine. 2015;94(45):e0897-0.
29. Chen T-L, Chang S-C, Hsieh H-F, Huang C-Y, Chuang J-H, Wang H-H. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: A meta-analysis. Journal of Psychosomatic Research. 2020;135:110144.
30. Suh H-W, Jeong HY, Hong S, Kim JW, Yoon SW, Lee JY, et al. The mindfulness-based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta-analysis. Complementary Therapies in Medicine. 2021;57:102667.
31. Kim SM, Park JM, Seo H-J, Kim J, Noh J-W, Kim HL. Effects of mindfulness-based stress reduction on adults with sleep disturbance: an updated systematic review and meta-analysis. BMJ open. 2022;12(11):e058032.
32. Winbush NY, Gross CR, Kreitzer MJ. The Effects of Mindfulness-Based Stress Reduction on Sleep Disturbance: A Systematic Review. EXPLORE. 2007;3(6):585-91.
2. Chinh K, Mosher CE, Brown LF, Beck-Coon KA, Kroenke K, Johns SA. Psychological Processes and Symptom Outcomes in Mindfulness-Based Stress Reduction for Cancer Survivors: A Pilot Study. Mindfulness. 2020;11:905-16.
3. Girschik J, Heyworth J, Fritschi L. Self-reported sleep duration, sleep quality, and breast cancer risk in a population-based case-control study. American journal of epidemiology. 2013;177(4):316-27.
4. Kang C, Sun S, Yang Z, Fan X, Yuan J, Xu L, et al. The psychological effect of internet-based mindfulness-based stress reduction on the survivors of breast cancer during the COVID-19. Frontiers in Psychiatry. 2021;12:738579.
5. Wang L, Zhang Y. The factors influencing psychological resilience in breast cancer patients undergoing mastectomy and the effects of mindfulness-based stress reduction on the patients’ psychological resilience and anxiety. International Journal Of Clinical And Experimental Medicine. 2020;13:8924-32.
6. Bray F LM, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024; 74(3): 229-263 doi:103322/caac21834. 2024.
7. Yegane ZA, Nasiri A, Sahranavard S, Sebzari AR. Effect of Online Mindfulness-based Stress Reduction Intervention on Sleep Quality of Breast Cancer Patients. Modern Care Journal. 2024;21(1).
8. Zimmaro LA, Carson JW, Olsen MK, Sanders LL, Keefe FJ, Porter LS. Greater mindfulness associated with lower pain, fatigue, and psychological distress in women with metastatic breast cancer. Psycho‐Oncology. 2020;29(2):263-70.
9. Fekih-Romdhane F, Achouri L, Hakiri A, Jaidane O, Rahal K, Cheour M. Hopelessness is associated with poor sleep quality after breast cancer surgery among Tunisian women. Current Problems in Cancer. 2020;44(1):100504.
10. Jing S, Zhang A, Chen Y, Shen C, Currin-McCulloch J, Zhu C. Mindfulness-based interventions for breast cancer patients in China across outcome domains: a systematic review and meta-analysis of the Chinese literature. Supportive Care in Cancer. 2021;29:5611-21.
11. Chang Y-C, Lin G-M, Yeh T-L, Chang Y-M, Yang C-H, Lo C, et al. Impact of mindfulness-based stress reduction on female sexual function and mental health in patients with breast cancer. Supportive Care in Cancer. 2022;30(5):4315-25.
12. Cho OH, Hwang KH. Association between sleep quality, anxiety and depression among Korean breast cancer survivors. Nursing Open. 2021;8(3):1030-7.
13. Zhao Y, Liu J-E, Lewis FM, Nie Z-H, Qiu H, Han J, et al. Effects of mindfulness‐based cognitive therapy on breast cancer survivors with insomnia: A randomised controlled trial. European Journal of Cancer Care. 2020;29(5):e13259.
14. Liu Q, Wang C, Wang Y, Xu W, Zhan C, Wu J, et al. Mindfulness-based stress reduction with acupressure for sleep quality in breast cancer patients with insomnia undergoing chemotherapy: A randomized controlled trial. European Journal of Oncology Nursing. 2022;61:102219.
15. Lengacher CA, Gruss LF, Kip KE, Reich RR, Chauca KG, Moscoso MS, et al. Mindfulness-based stress reduction for breast cancer survivors (MBSR (BC)): evaluating mediators of psychological and physical outcomes in a large randomized controlled trial. Journal of behavioral medicine. 2021;44(5):591-604.
16. Chang W-P, Chang Y-P. Meta-analysis of changes in sleep quality of women with breast cancer before and after therapy. Breast Care. 2020;15(3):227-35.
17. Yang H, Yang Z, Pan H, Zhou Q. Effects of physical activity on sleep problems in breast cancer survivors: a meta-analysis. Supportive Care in Cancer. 2021;29:4023-32.
18. Kröz M, Quittel F, Reif M, Zerm R, Pranga D, Bartsch C, et al. Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue. Scientific Reports. 2023;13(1):2705.
19. W Kanen J, Nazir R, Sedky K, K Pradhan B. The effects of mindfulness-based interventions on sleep disturbance: a meta-analysis. Adolescent Psychiatry. 2015;5(2):105-15.
20. Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. bmj. 2021;372.
21. John JR, Jani H, Peters K, Agho K, Tannous WK. The effectiveness of patient-centred medical home-based models of care versus standard primary care in chronic disease management: A systematic review and meta-analysis of randomised and non-randomised controlled trials. International journal of environmental research and public health. 2020;17(18):6886.
22. Farzan R, Firooz M, Ghorbani Vajargah P, Mollaei A, Takasi P, Tolouei M, et al. Effects of aromatherapy with Rosa damascene and lavender on pain and anxiety of burn patients: a systematic review and meta‐analysis. International Wound Journal. 2023.
23. Higgins JPT TJ, Chandler J, Cumpston M, Li T, Page MJ, Welch VA. Cochrane Handbook for Systematic Reviews of Interventions version 6.5 (updated August 2024). 2024.
24. Kröz M, Quittel F, Reif M, Zerm R, Pranga D, Bartsch C, et al. Four-year follow-up on fatigue and sleep quality of a three-armed partly randomized controlled study in breast cancer survivors with cancer-related fatigue. Scientific Reports. 2023;13(1):2705.
25. Hofmann SG, Gómez AF. Mindfulness-based interventions for anxiety and depression. Psychiatric clinics. 2017;40(4):739-49.
26. Li SYH, Bressington D. The effects of mindfulness‐based stress reduction on depression, anxiety, and stress in older adults: A systematic review and meta‐analysis. International journal of mental health nursing. 2019;28(3):635-56.
27. Bhattacharya S, Hofmann SG. Mindfulness-based interventions for anxiety and depression. Clinics in Integrated Care. 2023;16:100138.
28. Zhang M-F, Wen Y-S, Liu W-Y, Peng L-F, Wu X-D, Liu Q-W. Effectiveness of mindfulness-based therapy for reducing anxiety and depression in patients with cancer: a meta-analysis. Medicine. 2015;94(45):e0897-0.
29. Chen T-L, Chang S-C, Hsieh H-F, Huang C-Y, Chuang J-H, Wang H-H. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: A meta-analysis. Journal of Psychosomatic Research. 2020;135:110144.
30. Suh H-W, Jeong HY, Hong S, Kim JW, Yoon SW, Lee JY, et al. The mindfulness-based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta-analysis. Complementary Therapies in Medicine. 2021;57:102667.
31. Kim SM, Park JM, Seo H-J, Kim J, Noh J-W, Kim HL. Effects of mindfulness-based stress reduction on adults with sleep disturbance: an updated systematic review and meta-analysis. BMJ open. 2022;12(11):e058032.
32. Winbush NY, Gross CR, Kreitzer MJ. The Effects of Mindfulness-Based Stress Reduction on Sleep Disturbance: A Systematic Review. EXPLORE. 2007;3(6):585-91.
| Files | ||
| Issue | Vol 17 No 2 (2025) | |
| Section | Reviews | |
| Keywords | ||
| Mindfulness mindfulness-based stress reduction sleep quality breast cancer insomnia stress management psychological well-being | ||
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How to Cite
1.
Ryahin A, Ebadi K, Azadmehr F. Effect of mindfulness based interventions for sleep quality and stress reduction in breast cancer patients: A systematic review. Basic Clin Cancer Res. 2026;17(2):241-251.
