Tai Chi and yoga may improve sleep more than other exercise in breast cancer survivors

Aerobic exercise showed possible benefit but with substantial uncertainty, while resistance training, dance, and stretching demonstrated no clear advantage over controls. Dose-response analyses suggested that sleep benefits clustered around moderate exercise intensities—approximately 4.5 METs (metabolic equivalent of task units), 281 MET-minutes per session, and 910 MET-minutes per week. People who started with worse baseline sleep scores (higher Pittsburgh Sleep Quality Index scores) experienced greater improvements. However, the authors emphasize that the certainty of evidence is very low, few trials compared exercise types head-to-head, and findings require confirmation by higher-quality future studies.

The effect sizes for the top exercise modalities (Tai Chi/Qigong and yoga at g ≈ −0.30 to −0.45) are clinically modest but meaningful in a population struggling with cancer-related fatigue and sleep disruption. Subgroup analyses showed that people with poorer baseline sleep benefited more—suggesting the approach may be particularly valuable for those most affected. The dose-response pattern is important: too little exercise showed minimal benefit, but very high doses did not offer proportionally greater returns, indicating a therapeutic window rather than a linear dose-response. The network meta-analysis design allowed comparison across many trials simultaneously, but the authors note head-to-head trial data is sparse, particularly for aerobic versus yoga or Tai Chi, so rank certainty remains low. These findings align with mechanistic work suggesting mind–body practices may modulate both the physiological arousal and the psychological stress-related sleep disruption common in cancer survivors.