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An exercise oncology program improves sleep quality in head and neck cancer patients undergoing chemo-radiation therapy

A randomized controlled trial of 70 head and neck cancer patients found that a 7-week exercise oncology program (15-20 minutes of brisk walking and resistance training) significantly improved Pittsburgh Sleep Quality Index scores from 13.97 to 7.09, while the control group's scores worsened from 13.06 to 14.14 (both p < 0.001). Urinary melatonin levels increased in the exercise group but the between-group difference was not significant after adjusting for baseline values (p = 0.372).

Last updated: Jul 8, 2026•1 RCTs•📖 Read as article →

Evidence Score

Evidence Score42/100
Human RCT★★☆☆☆
Meta-analysis☆☆☆☆☆
Mechanism★★★★★
Safety★★★★☆
Confidencelow

Study Evidence

Study 1. Efficacy of an exercise oncology program on sleep quality and circadian rhythm in head and neck cancer patients undergoing chemo-radiation therapy: a randomized controlled trial.

observational

Dsilva C, Shetty VJ, Fernandes D, Baeyens JP, Kumari N S, Srivastava S, Samuel SR · PeerJ (2026)

Participants: N/A
Duration: 7 weeks
Intervention: Exercise oncology program: 15-20 minute sessions of aerobic (brisk walking) and resistance training (upper and lower limb exercises), five days per week for seven weeks
Outcome: Sleep quality measured by Pittsburgh Sleep Quality Index (PSQI) and circadian rhythm measured by urinary melatonin excretion (ELISA)
Effect Size: N/A
Population: Head and neck cancer patients (stage III, IVa, or IVb) undergoing chemo-radiation therapy, aged 18 years or above, any gender, with ECOG score < 2

Result:

PubMed: 42371549DOI: 10.7717/peerj.21409

Mechanism Graph

Exercise may enhance melatonin secretion
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Improved circadian rhythm regulation
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Reduced inflammation and stress
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Result: Improved sleep quality

Limitations

  • ⚠Between-group difference in urinary melatonin was not statistically significant (p = 0.372), limiting support for circadian rhythm mechanism
  • ⚠Small sample size (n=70) and single-center design may limit generalizability

Frequently Asked Questions

What type of exercise was used in the program?▼

The program included 15-20 minutes of brisk walking (aerobic) and upper/lower limb resistance training.

How was sleep quality measured?▼

Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), a validated self-report questionnaire.

Did the exercise program affect melatonin levels?▼

Urinary melatonin increased in the exercise group but the change was not statistically significant compared to the control group after adjusting for baseline values.

Who was eligible for this study?▼

Patients with stage III, IVa, or IVb head and neck cancer undergoing chemo-radiation, aged 18+, with ECOG score less than 2, and without severe orthopedic or neurological conditions.

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References

  1. 1.Dsilva C, Shetty VJ, Fernandes D, Baeyens JP, Kumari N S, Srivastava S, Samuel SR. "Efficacy of an exercise oncology program on sleep quality and circadian rhythm in head and neck cancer patients undergoing chemo-radiation therapy: a randomized controlled trial.." PeerJ, 2026. PMID: 42371549 DOI: 10.7717/peerj.21409
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