Mind-body therapies for insomnia symptoms in people with cancer: A systematic review with network meta-analysis

Background: Insomnia symptoms are common in people with cancer and have detrimental effects on quality of life and survival rates. Mind-body therapies (MBTs) are promising forms of treatment for people with cancer and insomnia symptoms. The objective of this study is to assess the effectiveness of MBTs for insomnia symptoms in people living with cancer. Methods: EMBase, PubMed, Cinahl, PsychINFO, IndMED, CSI-NISCAIR, CNKI, Clinicaltrial.gov, ChiCTR, and CTRI were searched until February 2025 for randomized controlled studies in which MBT was tested in a cancer population. Network meta-analyses were used to rank the relative effectiveness of MBTs for insomnia symptoms compared with usual care. Results: We identified a total of 99 studies, which involved 9,562 participants. Compared with usual care, MBTs with a statistically significant large effect (standardized mean difference, SMD >0.8) for insomnia symptoms were relaxation training (SMD = −1.97, P < .001), music therapy (SMD = −1.99, P < .001), body-mind-spirit intervention (SMD = −1.56, P = .187), biofeedback (SMD = −1.28, P = .208), mindfulness-based interventions (MBIs) (SMD = −1.04, P < .001), Tai Chi/qigong (SMD = −0.80, P = .068), and yoga (SMD = −0.80, P = .012). Only Tai Chi/qigong (SMD = −0.51, P = .267) and (MBIs, SMD = −0.25, P = .444) were supported by the sensitivity analysis with studies from “advanced” economies, which had a lower risk of bias. Conclusions: Where MBT is recommended by clinicians for insomnia symptoms in people with cancer, priority should be given to Tai Chi/qigong and MBIs.