Chinese Medicines Treatment for Sleep Disturbance in Breast Cancer Survivors: A Network Meta-Analysis

Abstract

Background: Sleep disturbance and insomnia are common adverse events in patients with breast cancer (BC). Traditional Chinese Medicine (TCM) treatment for sleep disturbance includes acupuncture, acupressure, auricular acupressure/auricular acupuncture, and Qigong. However, the specific efficacy of these TCM treatment remains unclear.

Materials and methods: This systematic review and network meta-analysis (NMA) investigated the effects of various TCM treatment on improving sleep quality in BC survivors.

Methods: Only randomized controlled trials (RCTs) reporting the results of TCM treatments were included. The main NMA included 12 RCTs involving 1011 participants. The risk of bias was assessed using the RoB 2 tool for randomized controlled trials. The certainty of evidence of the NMA was assessed in accordance with GRADE (the Grading of Recommendations, Assessment, Development, and Evaluations).

Results: Acupressure, acupuncture, auricular acupuncture/auricular acupressure, and qigong were identified as optimal TCM treatment (P < .05) for enhancing sleep quality in BC survivors.

Conclusion: Our results provide some evidence that TCM treatment, particularly acupressure, can be beneficial in improving sleep quality in BC survivors. However, larger-scale clinical trials with robust methodological designs are required to validate and extend our findings.

Keywords: breast cancer; insomnia; sleep disturbance; traditional Chinese medicine.

Figure 1.

Primary network graph for all types of sleep quality outcomes. Each node indicates treatment class and represents the size of the population involved in each treatment. A solid line between nodes means a direct comparison, and line thickness corresponds to the number of comparisons Abbreviations: AA/AT, auricular acupressure and auricular acupuncture; CBT, cognitive-behavioral therapy; MBSR, mindfulness-based stress reduction; WLC, wait-list control.