Effects of Yoga Practices on Insomnia

A number of contributory factors have been implicated in chronic insomnia, including psychological conditioning, constitutional predisposing factors, dysfunctional beliefs and attitudes, and cognitive and physiological arousal (Morin et al., 1999). The observed elevated physiological arousal may be related to activation of the stress system in these patients (Vgontzas et al., 1998) and is the basis for a hyper arousal hypothesis of insomnia (Bonnet & Arand, 1997). It has been suggested that “insomnia is a disorder of inappropriate arousal,” rather than a disorder of sleep, and that “treatment strategies should be directed toward normalizing the level of arousal” (Bonnet & Arand, 1995). In support of this hypothesis, cognitive and somatic relaxation techniques have been reported to be effective Yoga is a comprehensive system whose aim is the achievement of physical, psychological, and spiritual health and well-being, and incorporates a wide variety of postural/exercise, breathing, and meditation techniques (Goyeche, 1979). Yoga has also been used as a therapeutic treatment (“yoga therapy”; Khalsa, 2004; Sharma&Singh, 1989) as it is believed that different techniques can produce unique psycho physiological effects and that this specificity can be used to target specific disorders. Basic research on yoga has suggested that it is effective in influencing psycho physiological, neuro endocrine, and autonomic parameters, and therefore, has mostly been used to treat disorders that have a strong psychosomatic or psychological component (Arpita, 1990; Funderburk, 1977; Goyeche, 1979; Khalsa, 2004; Murphy & Donovan, 1999; Sharma & Singh, 1989). Research on the efficacy of yoga has been reported on its component techniques independently, as well as on its practice as a comprehensive multi component discipline (Funderburk, 1977; Goyeche, 1979; Khalsa, 2004; Patel, 1993; Raub, 2002; Sharma & Singh, 1989).

Insomnia is defined as repeated difficulty with the initiation, duration, maintenance, or quality of sleep and resulting in some form of daytime impairment. Chronic insomnia is associated with impaired occupational and social performance. It is associated with higher healthcare use, with a 2-fold increase in hospitalizations and office visits. Insomniacs have an elevated absenteeism rate that is 10-fold greater than controls. Chronic insomnia is also a risk factor for depression and a symptom of a number of medical, psychiatric, and sleep disorders. Pharmacological agents used in the treatment of insomnia are often associated with hazardous side effects. Yoga practice may help produce a significant improvement in sleep quality and related daytime impairments in these patients (23, 24).

The yoga exercises used were from the Kundalini Yoga style (as taught by Yogi Bhajan) that practiced widely. The exercises chosen were selected because they were specifically recommended for improving sleep and were easy to learn and perform with minimal instruction. The same set of exercises was performed every day during the intervention. All exercises were done in the seated posture, with instructions to maintain the spine erect but relaxed, with all breathing through the nose, and with eyes closed unless otherwise specified. Special attention in the initial training session was devoted to specific instructions on the practice of long, slow abdominal breathing to insure that participants understood this breathing pattern. Participants were instructed to breathe as slowly as was comfortable. The basic cognitive process of meditation was also described in detail. Participants were instructed to maintain a relaxed mental focus either on their breathing or a mantra, returning their attention to this focus in a relaxed manner when they found their thoughts wandering. The full set of exercises included the following: (1) Long, slow, abdominal breathing with meditation on long, slow abdominal breathing for 1–3 min; (2) Arms extended upwards at a 60◦ degree angle with the palms flat and facing upwards with meditation on the breath for 1–3 min; (3) Arms extended horizontally to the sides with the wrists bent upwards and the palms facing away with meditation on the breath for 1–3 min; (4) Hands clasped together at the sternum with the arms pushing the palms together with meditation on the breath for 1–3 min; (5) a breathing meditation called “Shabad Kriya.” Palms are resting in the lap facing upward with right over left and the thumbs touching. Eyes are 1/10 open and gaze is downwards past the tip of the nose.

Yoga for the Treatment of Insomnia and Sleep Quality Impairment The study suggests that yoga is helpful in treating depression, anxiety, fatigue and other conditions associated with sleep disorders among healthy individuals and those with cancer. Herein, we review the extant literature on yoga and its use in the treatment of sleep problems among cancer patients

Yoga is a more and more popular mind-body put into practice and is also characterized as a mindfulness from India (e.g. Classical, Advaita Vedanta, Tantra), Tibet (e.g. Tibetan), and China (e.g. Chi Kung, Tai Chi). The word yoga is derived from its Sanskrit root „yuj‟ which factually means „to yoke‟ or join together. In this case, yoga refers to joining the mind and the body. The earliest forms of yoga were firmly rooted in physical and mindful (breathing and meditative) practices and led to what is known today as traditional yoga which forms the basis for most of the yoga currently taught today. Hatha yoga, the foundation of all yoga styles and the most accepted form, includes both Gentle Hatha and Restorative yoga, and is growing in acceptance for healing use in traditional Western medicine. Gentle Hatha yoga focuses on physical aspects and is fraction of many styles of yoga, including Iyengar, Anusara, and others. Restorative yoga focuses on full recreation and is part of the Iyengar style. The mixture of Gentle Hatha and Restorative yoga may provide an effective approach for improving sleep because it utilizes a holistic series of meditative, breathing, and physical position exercises, requiring both the active and passive engagement of skeletal muscles. Existing scientific evidence suggests that yoga is effective for improving insomnia and sleep quality injury in cancer patients and survivors.

Yoga is practiced by most people to improve their physical health and fitness, relieve stress, and enhance the quality of life. However, yoga is increasingly being recognized as an important complementary therapeutic modality in disease states. Physicians are increasingly integrating postures, breathing exercises and meditation in the treatment of patients' health disorders. Yoga is readily available, is easy to perform, incurs no cost and has a low attrition rate. Although generally safe, it is advisable for people with uncontrolled blood pressure, a good treatment insomnia, glaucoma, or sciatica. Years of human experience has established that the regular practice of yoga is an excellent way to maintain overall health and to prevent illness.

Morin, C. M., Hauri, P. J., Espie, C. A., Spielman, A. J., Buysse, D. J.,&Bootzin, R. R. (1999). Nonpharmacologic treatment of chronic insomnia. An American Academy of Sleep Medicine review. Sleep, 22, pp. 1134–1156. Vgontzas, A. N., Tsigos, C., Bixler, E. O., Stratakis, C. A., Zachman, K., Kales, A., et al. (1998). Chronic insomnia and activity of the stress system: A preliminary study. Journal of Psychosomatic Research, 45, pp. 21–31.

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Research Scholar, Sai Nath University, Ranchi, Jharkhand