Abstract
The improvement of sleep quality in patients with cancer has a positive therapeutic effect on them. However, there are no specific treatment guidelines for treating sleep disturbance in cancer patients. We investigated the effect of forest therapy on the quality of sleep in patients with cancer. This study was conducted on nine patients (one male, eight female; mean age, 53.6 ± 5.8 years) with gastrointestinal tract cancer. All patients participated in forest therapy for six days. They underwent polysomnography (PSG) and answered questionnaires on sleep apnea (STOP BANG), subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI), sleepiness (Stanford and Epworth Sleepiness Scales), and anxiety and depression (Hospital Anxiety and Depression Scale) to evaluate the quality of sleep before and after forest therapy. Sleep efficiency from the PSG results was shown to have increased from 79.6 ± 6.8% before forest therapy to 88.8 ± 4.9% after forest therapy (p = 0.027) in those patients, and total sleep time was also increased, from 367.2 ± 33.4 min to 398 ± 33.8 min (p = 0.020). There was no significant difference in the STOP BANG score, PSQI scores, daytime sleepiness based on the results of the Stanford and Epworth Sleepiness Scales, and depression and anxiety scores. Based on the results of this study, we suggest that forest therapy may be helpful in improving sleep quality in patients with gastrointestinal cancers.
Highlights
The natural environment is increasingly recognized as an alternative therapeutic resource for the emotional relaxation and stress management of urban people
ResultsEleven cancer patients were enrolled in this study
This study reported that forest therapy improved the quality of sleep of cancer patients using polysomnography, that is, a gold standard of sleep recording
Summary
The natural environment is increasingly recognized as an alternative therapeutic resource for the emotional relaxation and stress management of urban people. From forest bathing, the therapeutic effects of forest were studied, such as enhancing health and wellness and reducing negative emotions [1]. Recent studies have proposed that “forest therapy” offers benefits like improvement of depression/anxiety symptoms and the reduction of blood pressure due to autonomic nervous system stability [2,3,4]. Forest therapy has shown health benefits such as lower blood pressure, decreased sympathetic nervous system activity, and increased parasympathetic nervous system activity [2,5]. Forest therapy significantly influences the reduction of stress and emotional relaxation [6,7]
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