Impact of breathing exercises on anxiety and depression in cancer patients: A systematic review and meta-analysis
Abstract
Background: Anxiety and depression are prevalent emotional disorders with significant socio-economic impacts. They are particularly common in cancer patients, affecting up to 20% and 10% of patients, respectively, compared to 3.15% and 4.8% in the general population. While medication is a common treatment, it can have side effects and may not address the psychosocial aspects of these conditions. Breathing exercises have emerged as a potential non-pharmacological approach to controlling anxiety and depression. Objective: This systematic review and meta-analysis aimed to assess the efficacy of breathing exercises, to determine if these exercises help reduce anxiety and depression, and to measure the impact compared to a control group. Methods: We conducted a comprehensive literature search across several databases from 1 January 2000 to 1 July 2024, following the PRISMA guidelines. Screening, data extraction, and quality assessment were undertaken independently by two researchers and adjudicated by another. Outcomes included anxiety and depression scores. In meta-analyses, the I2 statistic was used to explore heterogeneity. Random effects models were used in the presence of moderate heterogeneity. Sources of heterogeneity were investigated by subgroup analyses and meta-regression. Results: The search yielded 14 eligible studies involving 1067 participants with a mean age of 46.35 years and a female/male ratio of 1.19. Meta-analysis revealed a significant reduction in anxiety (−0.49; 95% CI, −0.68 to −0.30; p < 0.001) and depression (−0.38; 95% CI, −0.53 to −0.23; p < 0.001) following breathing exercises compared to control interventions. Subgroup analysis indicated that yoga breathing exercises had a more pronounced effect on anxiety reduction. Conclusion: Breathing exercises may help reduce anxiety and depression in individuals managing cancer. Further exploration is needed in the future to alleviate anxiety and depression through breathing exercises as the first step in promoting this potentially valuable adjunct therapy.
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