Background: Sleep problems are common after an upper gastrointestinal (GI) cancer diagnosis. However, the efficacy of nonpharmacological interventions in addressing sleep problems is not well-documented. Identifying and summarizing evidence-based interventions to improve sleep is essential to support clinical practice and enhance quality of life in this population.
Aim: This review aimed to summarise evidence on the efficacy of nonpharmacological interventions for sleep in individuals with upper GI cancer and to meta-analyse randomised controlled trials (RCTs).
Methods: Databases (MEDLINE, EMBASE, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL, and Web of Science) were searched from inception until March 2024. Randomised controlled trials (RCT) and quasi‐experimental trials were included. All studies had to be published as full articles in either English or Chinese.
Conclusion: Of 2059 records identified, 21 studies were included involving 2039 participants with upper GI cancer. Nonpharmacological interventions were divided into four types. The effect size of (1) physical activity and rehabilitation interventions (SMD = -0.29, 95 % CI [-0.92, 0.33], p = 0.35), as well as (2) nutritional support interventions (SMD = -0.35, 95 % CI [-0.71, 0.02], p = 0.06) did not show statistical significance in relieving sleep problems in people with upper GI cancer. However, statistically significant results were observed for other two intervention categories: (3) psychological and pain interventions (SMD = -1.70, 95 % CI [-2.16, -1.24], p < 0.001), and (4) sensory-based interventions (SMD = -1.81, 95 % CI [-3.02, 0.60], p = 0.003). However, because of heterogeneity and limited number of trials, it is not possible to make definitive recommendations for the optimal intervention for improving sleep in people with upper GI cancer. Future research should include larger sample sizes, be randomised and blinded and include standardised procedures.