Effectiveness of App-Based Yoga of Immortals (YOI) Intervention for Insomnia in Asian Population during Pandemic Restrictions

Renuka Tunuguntla, Hari Siva Gurunadha Rao Tunuguntla, Himanshu Kathuria, Sadhna Verma, Renuka Tunuguntla, Hari Siva Gurunadha Rao Tunuguntla, Himanshu Kathuria, Sadhna Verma

Abstract

The coronavirus disease 2019 (COVID-19) pandemic created significant psychological challenges worldwide, including stress, emotional distress, and insomnia. In addition, social distancing, travel restrictions, and spread of disease have resulted in unique challenges, creating barriers to healthcare access. Compared to the rate prior to the COVID-19 pandemic, a significant increase in clinical insomnia rates have been reported. With well-known limitations of currently established treatments (e.g., cognitive behavioral therapy-insomnia (CBT-I), pharmacotherapy), there is a need to explore other effective and safe treatment modalities to treat insomnia, especially those that can be used remotely. The purpose of this study is to assess the effectiveness of app-based intervention to treat insomnia in the current era of the COVID-19 pandemic (using the Yoga of Immortals (YOI) app). This prospective cohort study was approved by the Institutional Review Board. All participants in this study were asked to complete an online survey including demographic data and validated Insomnia Severity Index (ISI) at baseline (15 May 2020), 4 weeks, and 8 weeks after starting the YOI intervention. Survey data was exported using Microsoft Excel. Statistical analysis was done using the GraphPad Prism 8. YOI intervention significantly improved the mean ISI scores in all categories of insomnia (severe, moderate, and subthreshold) at each follow-up (p ≤ 0.0001). The improvement was significant among all age groups and in both genders. In our study, YOI was a novel and effective intervention for improving insomnia symptoms and may be a new addition to the armamentarium of insomnia management. Being app-based, this has potential wider applicability, especially during the current COVID-19 pandemic.

Keywords: exercise; healthcare delivery; meditation; sleep disorders; yoga.

Conflict of interest statement

None of the authors have any past or present conflict of interest in regards to conducting this study or preparing the manuscript.

Figures

Figure 1
Figure 1
Outline of the study process, participants’ selection criteria, and selection of the final number of participants for data analysis.
Figure 2
Figure 2
Graphical distribution (%) of participants in YOI intervention across nations. n = 820.
Figure 3
Figure 3
Changes in the number of individuals based on different insomnia severity categories before intervention (Pre), during the intervention (Mid, 4 weeks), and post-intervention (post, 8 weeks). n = 820.
Figure 4
Figure 4
(A1–D1) Change in the number of individuals with YOI intervention among different age groups and different insomnia severity categories. Before YOI intervention (Pre), during YOI intervention (Mid, week 4), and post YOI intervention (Post, week 8). (A2–D2) Change in the mean ISI score with YOI intervention for different categories of insomnia. Before YOI intervention (Pre), during YOI intervention (Mid, week 4), and post YOI intervention (Post, week 8). Error bars are standard error of the mean (SEM). One-way repeated measures ANOVA with multiple comparisons using Tukey’s test was used for comparison with 95% confidence interval. ** p ≤ 0.01, **** p ≤ 0.0001.
Figure 5
Figure 5
Mean ISI score for all participants with different frequency of YOI practice. Error bars are standard error of the mean (SEM). One-way ANOVA with multiple comparisons using Tukey’s test was used for comparison with 95% confidence interval. * p ≤ 0.05, *** p ≤ 0.001, ***** p ≤ 0.0001.
Figure 6
Figure 6
Mean insomnia score of different insomnia categories with different frequency of YOI practice. Error bars are Standard Error of mean (SEM). One-way ANOVA with multiple comparisons using Tukey’s test was used for comparison with 95% Confidence interval. * p ≤ 0.05, ** p ≤ 0.01.

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