Zhang YM, Sun LY, Chi HT. Hyperbaric oxygen with muscle relaxation for sleep quality anxiety and depression in post-gastric cancer sleep disorders. World J Psychiatry 2026; 16(9): 122884 [DOI: 10.5498/wjp.122884]
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Zhang YM, Sun LY, Chi HT. Hyperbaric oxygen with muscle relaxation for sleep quality anxiety and depression in post-gastric cancer sleep disorders. World J Psychiatry 2026; 16(9): 122884 [DOI: 10.5498/wjp.122884]
World J Psychiatry. Sep 19, 2026; 16(9): 122884 Published online Sep 19, 2026. doi: 10.5498/wjp.122884
Hyperbaric oxygen with muscle relaxation for sleep quality anxiety and depression in post-gastric cancer sleep disorders
Yi-Mei Zhang, Li-Yan Sun, Hai-Tao Chi
Yi-Mei Zhang, Sleep Monitoring Room, Dalian University Affiliated Xinhua Hospital, Dalian 116021, Liaoning Province, China
Li-Yan Sun, Third Ward, Department of Neurology, Dalian University Affiliated Xinhua Hospital, Dalian 116021, Liaoning Province, China
Hai-Tao Chi, First Ward, Department of Neurology, Dalian University Affiliated Xinhua Hospital, Dalian 116021, Liaoning Province, China
Author contributions: Sun LY and Chi HT contributed to data collection and paper writing; Zhang YM was responsible for funding application, reviewing and editing, communication coordination, ethical review, copyright and licensing, and follow-up. All authors contributed to research design and data analysis, and approved the final version to publish.
AI contribution statement: The translation software (DeepL) was used to improve the English.
Institutional review board statement: The research was reviewed and approved by the Dalian University Affiliated Xinhua Hospital, No. 2026-037-01.
Informed consent statement: All research participants or their legal guardians provided written informed consent prior to study registration.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
STROBE statement: The authors have read the STROBE Statement-checklist of items, and the manuscript was prepared and revised according to the STROBE Statement-checklist of items.
Received: May 19, 2026 Revised: June 18, 2026 Accepted: July 9, 2026 Published online: September 19, 2026 Processing time: 96 Days and 20.4 Hours
Abstract
BACKGROUND
Gastric cancer surgery frequently leads to postoperative sleep disorders, anxiety, and depression, which negatively impact recovery and quality of life. Conventional treatments offer limited benefits, and non-pharmacological approaches are gaining interest. While hyperbaric oxygen therapy improves tissue oxygenation and muscle relaxation reduces physiological arousal, their combined effect remains unexplored. Therefore, this study hypothesizes that hyperbaric oxygen therapy combined with muscle relaxation training can significantly improve sleep quality and reduce anxiety and depression in patients with postoperative sleep disorders.
AIM
To evaluate hyperbaric oxygen and muscle relaxation on sleep quality and anxiety/depression in postoperative sleep disorders after gastric cancer surgery.
METHODS
This retrospective cohort study included 96 patients with postoperative sleep disorders after gastric cancer surgery at Dalian University Affiliated Xinhua Hospital Outpatient Clinic (June 2023-June 2025). Based on actual treatment, 48 received hyperbaric oxygen therapy (2.0 atmospheres absolute, 60 minutes, 5 times/week for 4 weeks) plus progressive muscle relaxation (30 minutes daily, 5 times/week for 4 weeks) and 48 received conventional care alone. Outcomes: Pittsburgh Sleep Quality Index, Self-Rating Anxiety Scale, Self-Rating Depression Scale, serum cortisol, adverse events. Independent t tests and χ2 tests were used.
RESULTS
After therapy, both groups improved, but the combined intervention group showed significantly greater benefits: Pittsburgh Sleep Quality Index score [(4.25 ± 0.64):(7.35 ± 1.12), P < 0.001], Self-Rating Anxiety Scale [(31.50 ± 2.29):(41.72 ± 2.43), P < 0.001], Self-Rating Depression Scale [(32.48 ± 5.31):(43.34 ± 2.22), P < 0.001], and serum cortisol (271.20 ± 25.15 nmol/L:360.63 ± 20.52 nmol/L, P < 0.001). The observation group also had a higher proportion of shortened sleep latency (83.33%:58.33%, P = 0.007) and improved sleep efficiency (87.50%:62.50%, P = 0.005). Adverse event rate was lower in the observation group (8.33%:22.92%, P = 0.049). No serious adverse events occurred.
CONCLUSION
Hyperbaric oxygen combined with muscle relaxation training may improve sleep quality, reduce anxiety and depression, and lower serum cortisol more effectively than conventional treatment alone.
Core Tip: This retrospective cohort study of 96 patients with postoperative sleep disorders after gastric cancer surgery suggests that a four-week regimen of hyperbaric oxygen therapy combined with progressive muscle relaxation training may be associated with improved sleep quality (Pittsburgh Sleep Quality Index), reduced anxiety (Self-Rating Anxiety Scale) and depression (Self-Rating Depression Scale), and lower serum cortisol levels compared with conventional treatment alone. This mindbody integrative approach appears to be a potentially safe nonpharmacological rehabilitation strategy for gastric cancer survivors.
