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A structured program combining gentle yoga poses, breathing exercises, and mindfulness significantly reduced insomnia, fatigue, and mood symptoms among cancer survivors in a large randomized trial.

Up to 95% of cancer survivors experience sleep disturbances or insomnia during or after treatment, while more than half report mood disturbances, anxiety, or fatigue. In the new trial, just 4 weeks of simple yoga practices helped address all of those issues, according to findings presented at a press briefing ahead of the American Society of Clinical Oncology (ASCO) 2026.

“Clinicians should consider recommending gentle hatha and restorative yoga for survivors experiencing these side effects,” said lead investigator Yuri Choi, PhD, RN, of the Wilmot Cancer Institute, University of Rochester Medical Center, in Rochester, New York.

Fumiko Chino, MD, an ASCO expert in survivorship, agreed. In a statement, she noted that many cancer survivors are already managing multiple medications — and yoga offers a nondrug option for “reducing four different side effects at once.”

Yoga’s Role in Survivorship Care

The trial evaluated a program known as YOCAS (YOga for CAncer Survivors) — a 4-week intervention that incorporates 18 gentle hatha and restorative yoga poses, breathing exercises, and mindfulness practices. Hatha yoga generally involves slow movement, with standing and seated postures that are held, and an emphasis on breathing and alignment. Restorative yoga poses are typically done lying down with cushions and other support.

Prior data has shown that YOCAS is effective for relieving insomnia, prompting the current trial to evaluate its effects on mood disturbance, anxiety, and fatigue.

Participants included 410 survivors of nonmetastatic cancer who were 2-24 months past treatment, had at least moderate sleep disruption, and had not participated in yoga in the prior 3 months. Their mean age was 54 years, and the vast majority were white individuals and women, with 75% being breast cancer survivors.

Participants were randomly assigned to standard survivorship care alone or standard survivorship care plus YOCAS. Those in the YOGAS program attended two 75-minute instructor-led sessions per week and were encouraged to practice at home for at least 30 minutes a week.

Mood disturbance was assessed using the Profile of Mood States (POMS) questionnaire, and insomnia was evaluated using the Insomnia Severity Index.

Better Mood, Less Fatigue

Overall, yoga participants showed greater symptom improvements during the intervention. Compared with standard care alone, they reported significantly less overall mood disturbance, indicated by a 5.08-point lower POMS total score (representing a moderate-to-large effect).

Similarly, they had less anxiety, indicated by a 0.72-point lower score on the POMS anxiety subscale (small-to-medium effect), and less fatigue, with a 1.49-point lower score on the fatigue subscale (medium-to-large effect).

The benefits for mood and fatigue seemed to translate into better sleep, as well. Choi said that improvements in those measures each accounted for roughly 25% of the improvement seen in participants’ insomnia ratings.

The findings come as the number of cancer survivors continues to grow — to an expected 22 million in the US alone by 2035, according to the American Cancer Society.

ASCO guidelines, including those on managing fatigue, already support gentle yoga as an option for cancer survivors. And this trial bolsters the case for it, said briefing moderator Julie Gralow, MD, a breast medical oncologist at the University of Washington, Seattle.

“Gentle, evidence-based practices, such as the restorative or therapeutic yoga studied here, are safe and highly effective tools for managing symptoms like fatigue, anxiety, and sleep disturbances during and after treatment,” Gralow said.

Going forward, one goal is to make yoga more accessible. Choi said future work on the YOCAS program will focus on adapting it for young cancer survivors and developing digital delivery platforms, including an online version and mobile app.

The study was funded by the National Cancer Institute. Choi, Chino, and Gralow reported having no relevant disclosures.