Effect of a Single Light-intensity Walking Session on Sleep Quality of Patients with Bladder Cancer: A Randomized Cross-Over Study

Sleep is vital for human health and well-being,1 but patients with cancer often have sleep disturbances.2,3 It is estimated that 60.7% of patients with cancer experience disturbed sleep,4 which is higher than the general public (33.2%)5 and those with other chronic conditions such as cardiovascular disease (36.5%),6 cystic fibrosis (43%),7 or diabetes (47.2%).8 The negative effects on patients with cancer who have disturbed sleep have been established, including decreased psychological and physical health, impaired health-related quality of life, 9 and high mortality rates.10,11 There is a growing interest in improving sleep quality in this clinical population, especially through nonpharmacologic lifestyle changes.

Bladder cancer is the 10th most common cancer worldwide, with 573,278 new cases a year. It is the sixth most common cancer diagnosis among men.12 Due to disease characteristics or corresponding treatments, patients with bladder cancer may develop symptoms such as bladder pain, urinary urgency, or nocturia that can easily lead to poor sleep.13 One study assessed sleep via the Pittsburgh Sleep Quality Inventory (PSQI) post-treatment, 52.2% had scores indicating poor sleep quality.13

Regular exercise is beneficial for cancer survivors, such as improving survival for several cancers (eg, breast, colorectal, and prostate),14 diminishing cancer-related fatigue,15 and improving physical function16 and quality of life.17 In addition, multiple reviews have suggested that exercise effectively improves sleep quality and reduces sleep complaints for cancer survivors.18, 19, 20 However, most of the research is based on samples of patients with breast, lung, prostate, and colorectal cancers,17,19, 20, 21, 22 and there is a lack of evidence for exercise interventions for sleep in patients with bladder cancer.23

The intensity of physical activity may be a crucial factor in its impact on sleep quality.24 Previous studies predominantly examined the effects of moderate- to high-intensity exercise on sleep in patients with cancer,19,20,25 with limited research on the benefits of light-intensity physical activity in this population, despite its accessibility and preference among patients with bladder cancer.26 Notably, the duration of exercise interventions in these studies varied from 1 week to 1 year.20,25,27 Additionally, a single session of light-intensity walking has been found to enhance sleep quality in another vulnerable group, specifically older adults with sleep disorders.28 This study aimed to investigate the effects of a single session of light-intensity walking on patients with bladder cancer with sleep disorders.

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