Effectiveness of non-pharmacological interventions on quality of sleep of breast cancer patients undergoing chemotherapy: a systematic review and meta-analysis

Non-pharmacological interventions on quality of sleep of breast cancer’s patients

Abstract

Insomnia is a frequent sleep problem experienced by patients undergoing chemotherapy. Various non-pharmacological approaches are applied to manage this condition; however, their influence on sleep quality in patients with breast cancer remains unclear. This study examines the effectiveness of these approaches in reducing insomnia through a systematic review and meta-analysis of randomized controlled trials. Relevant studies are retrieved from CINAHL, Web of Science, PubMed, and Scopus, covering publications from inception to February 2024. The Joanna Briggs Institute (JBI) assesses the methodological quality of the included trials. Data analysis is conducted using STATA 17.0, applying a random-effects model to estimate pooled effect sizes. Thirteen trials (n=13) involving 942 patients with breast cancer receiving chemotherapy are included. Most participants are in stage II, with a mean age of 55.8 years, and the majority are married. The interventions consist of acupuncture, acupressure, electroacupuncture, tai chi, aromatherapy, and massage. The overall analysis shows that non-pharmacological interventions significantly improve sleep quality, with a standardized mean difference (SMD) of −0.91 (95% CI: −1.51 to −0.30, p = 0.00, I² = 94.82%; τ² = 1.15; Q = 58.18; df = 12). Outcomes are measured using the Pittsburgh Sleep Quality Index (PSQI) and the Insomnia Severity Index (ISI). The findings indicate that these interventions effectively reduce insomnia and enhance sleep quality in patients with breast cancer undergoing chemotherapy. Despite these positive results, broader generalization of the findings still requires further confirmation due to the variability of the non-pharmacological methods applied.