Table 2.
Summary of relaxation therapy studies
| Reference | Sample | Intervention details | Results | |||||
|---|---|---|---|---|---|---|---|---|
| Cancer type and stage | Age, sex and sample size | Cancer treatment and sleep disorder status | Description | Duration and frequency | Pre | Mid | Post | |
| Ducloux et al. 2012[29], Geneva, Switzerland | Mixed (stage 4) with metastatic cancer and estimated prognosis < 6 months |
61 ± 15 yr (3 M, 6 F) |
Cancer treatment: not stated; Sleep disorder: diagnosed using ICSD criteria. |
Immediate intervention: Deep breathing exercises, somatic tension release was taught by a specialized nurse with certification in relaxation. An audio recording of the program on CD was provided to the participants to use prior to nighttime sleep. | 1 h/day for 3 days |
NRSSS day 1: 6.1 + 2.4 |
NRSSS day 2: 3.6 ± 2.3 |
NRSSS day 5: 4.0 ± 2.3 |
|
66 ± 12 yr (3 M, 6 F) |
Delayed intervention: as above, but started 3 days after the immediate intervention group. | 6.5 + 2.2 | 4.0 ± 2.1 | 3.8 ± 2.3 | ||||
| Nooner et al. 2016 [30], OK, USA | Hematologic malignancies or solid tumors, undergoing chemotherapy or prior to HSCT |
45 ± 18 yr (6 M, 5 F) |
Cancer treatment: chemotherapy and pre-HSCT therapy; Sleep disorder: not stated. |
Guided imagery: 19-min audio program-morning exercise, which guides the listener through waking in the morning. | 19 to 39 min/day for 60 days |
PROMIS sleep baseline: Pt.5: 23/40 Pt.7: 19/40 Pt.9: 25/40 |
PROMIS sleep day 30: 21/40 17/40 29/40 |
PROMIS sleep day 60: - 20/40 - |
| Relaxation: 39-min audio program guide to serenity which guided the listener through a 10-point system of progressive relaxation. |
Pt.2: 25/40 Pt.3: 35/40 Pt.10: 27/40 |
20/40 - - |
26/40 - - |
|||||
| Relaxation + guided imagery - received both. |
Pt.1: 28/40 Pt.8: 25/40 Pt.12: 17/40 |
- 22/40 21/40 |
- 20/40 19/40 |
|||||
| Usual care: received usual medical care but were given relaxation video resources used in the intervention after study was completed. |
Pt.4: 22/40 Pt.6: - Pt.11: 20/40 |
21/40 - - |
- - - |
|||||
| Zupanec et al. 2017 [31], Toronto, Canada | Children with ALL undergoing maintenance chemotherapy |
6.3 ± 1.8 yr (10 M, 1 F) |
Cancer treatment: Maintenance- chemotherapy; Sleep disorder: excluded from study if they had a physician- diagnosed sleep disorder such as insomnia or restless leg syndrome. |
Education and children’s books to promote relaxation using deep breathing and progressive muscle relaxation; facilitated by 2 registered nurses who had completed an 8-h training course on sleep hygiene and relaxation techniques | 4 weeks |
NS: 456 ± 105 LSNS: 120 ± 32 DS: 42 ± 27 LSDS: 28 ± 19 WTASO: 117 ± 44 NNA: 16 ± 4 CSHQ: 50 ± 8 |
- |
NS: 498 ± 65 LSNS: 129 ± 44 DS: 32 ± 51 LSDS: 17 ± 28 WTASO: should 99 ± 47 NNA: 17 ± 5 CSHQ: 48 ± 8 |
|
6.2 ± 2.0 yr (8 M, 1 F) |
Usual care - advised to continue usual clinical activities. |
NS: 488 ± 36 LSNS: 135 ± 28 DS: 21 ± 17 LSDS: 16 ± 12 WTASO:75 ± 39 NNA: 16 ± 3 CSHQ: 49 ± 6 |
- |
NS: 495 ± 59 LSNS: 134 ± 89 DS: 11 ± 14 LSDS: 5 ± 7 WTASO:106 ± 43 NNA: 18 ± 6 CSHQ: 48 ± 6 |
||||
ALL acute lymphoblastic leukemia, CSHQ Children sleep habits questionnaire, DS Daytime sleep, F females, ICSD International Classification of Sleep Disorders, LSDS longest stretch of daytime sleep, LSNS longest stretch of nighttime sleep, M males, NNA number of nighttime awakenings, NRSSS Numerical Rating Scale of Satisfaction of Sleep, NS Nighttime sleep, PROMIS Patient-Reported Outcomes Measurement Information System, Pt participant, WTASO wake time after sleep onset, yr years
□No face-to-face therapist guidance appeared to be provided to the intervention participants