The prevalence of sleep disturbances in cancer survivors, even 5 years after treatment, is nearly twice that of the general population. Nonpharmacological treatments, such as massage and relaxation therapy, may alleviate a variety of physical and psychosocial issues, including sleep outcomes in cancer survivors. However, there is a need for a systematic review of the available randomized controlled trials (RCTs).

The study

This paper is a systematic review of the effects of massage therapy (4 RCTs, 187 participants) and relaxation therapy (3 RCTs, 33 participants) on self-reported or objectively measured sleep outcomes in cancer survivors.

Out of the 7 trials, 6 involved adults (aged 18–78) and 1 involved children (aged 4–8).

Out of the 7 trials, 4 included participants with mixed cancer types, 3 included participants with metastatic cancer, and 2 included participants with leukemia.

The results

Relative to control, massage therapy improved self-reported sleep quality in one trial and objective sleep quality (in terms of the number of nighttime-long sleep episodes) in another trial.

None of the 3 trials on relaxation therapy reported improvements, relative to control, although there were trends for improved self-reported sleep quality.

Most of the massage therapy trials were assessed as having an unclear risk of bias, while most of the relaxation-therapy trials were assessed as having a high risk of bias.


Several of the few, small trials included in this review measured many outcomes but detected improvements only in a small subset of these outcomes — which suggests that some of the statistically significant improvements were false positives.

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This Study Summary was published on January 5, 2021.