The Impact of Moderate to High Intensity Physical Activity on Sleep Health in Cancer Survivors.

Markey GE, Ruterbusch JJ, Baird TE, Martin JL, Schwartz AG, Finlay DG, Timban T, Trendowski MR, Badr MS, Winters-Stone K, Beebe-Dimmer JL. The Impact of Moderate to High Intensity Physical Activity on Sleep Health in Cancer Survivors. Cancer medicine. 2026 Feb 1; 15(2):e71546, DOI: 10.1002/cam4.71546.

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Abstract:

BACKGROUND: Sleep disturbances are common among cancer survivors and negatively impact quality of life. Regular moderate- to high-intensity physical activity may provide a cost-effective, low-risk alternative strategy to improve sleep. METHODS: Data collected as part of two distinct studies, the Detroit Research On Cancer Survivors (ROCS) cohort and the CrossFit And Physical Activity: A Better Life Experience (CAPABLE) High-Intensity Interval Training (HIIT) trial, were analyzed to evaluate the association between participation in moderate- to high-intensity physical activity and sleep health. Sleep health was assessed using the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS). RESULTS: Among Detroit ROCS cohort members who completed the supplemental sleep survey at baseline and/or follow-up (n = 3022), those meeting 2012 American Cancer Society (ACS) physical activity guidelines reported sleep outcomes compared with inactive participants, including lower ISI scores (4.5 vs. 5.9, p < 0.001), lower ESS scores (5.6 vs. 6.6, p < 0.001), and lower PSQI (6.3 vs. 7.9, p < 0.001). In the CAPABLE trial (n = 73), ISI scores improved from 4.5 at baseline to 3.4 at exit (p < 0.001), while PSQI scores showed more modest improvement (6.1 to 5.4, p = 0.063). ESS scores remained unchanged (5.4 to 5.2, p = 0.708). CONCLUSIONS: These findings support the role of moderate- to high-intensity physical activity in improving sleep health in a diverse cancer survivor population. Future research should further refine current methodologies to maximize benefit to survivors and implementation science to increase uptake and promote adherence to evidence-based guidelines.