Effect of YOCAS yoga on circadian rhythm, anxiety, and mood: A URCC CCOP randomized, controlled clinical trial among 410 cancer survivors.

Abstract

9034 Background: Cancer treatments disrupt circadian rhythm exacerbating the anxiety and mood disorders experienced by survivors, ultimately, impairing recovery and quality of life. We conducted a nationwide, multi-site, phase III randomized, controlled, clinical trial examining the efficacy of yoga for improving circadian rhythm, anxiety and mood among cancer survivors through the University of Rochester (UR) Cancer Center Community Clinical Oncology Program (CCOP) Research Base. Methods: Cancer survivors with non-metastatic disease, between 2-24 months post adjuvant therapy who reported no participation in yoga during the prior 3 months were randomized into 2 arms: 1) standard care, and 2) standard care plus the 4-week (wk) yoga intervention (2 x’s/wk; 75 min./session). The yoga intervention utilized the UR Yoga for Cancer Survivors (YOCAS) program consisting of pranayama (breathing exercises), 18 gentle Hatha and Restorative yoga asanas (postures) and meditation. Circadian rhythm, anxiety and mood were assessed pre- and post-intervention. Results: 410 survivors were accrued (96% female, mean age = 54, 75% breast cancer). Multi-oscillator modeling revealed a 12-hour, ultradian rhythm model fit the circadian rhythm better than a single-oscillator, 24-hour model and demonstrated significant rhythm differences between groups post-intervention (p<0.05) with a more favorable rhythm in the yoga group. ANCOVAs showed a lower 24-hour amplitude and a delayed 12-hour acrophase in the yoga group (all p<0.05). ANCOVAs with baseline values as covariates revealed significant differences between groups on anxiety and mood (p<0.05) with yoga participants demonstrating greater improvements in anxiety (CS=-0.80, SE=0.21) and mood (CS=-6.7, SE=1.08) from pre- to post-intervention compared to controls (anxiety CS=-0.20, SE=0.24; mood CS=-1.6, SE=0.96). Conclusions: The brief community-based YOCAS intervention favorably alters circadian rhythm and improves anxiety and mood among survivors. Clinicians should consider prescribing the YOCAS program for survivors reporting anxiety and mood disorders. Funding: NCI U10CA37420 and K07CA120025.