Tailored individual Yoga practice improves sleep quality, fatigue, anxiety, and depression in chronic insomnia disorder

Denis Turmel, Sarah Carlier, Anne Violette Bruyneel, Marie Bruyneel, Denis Turmel, Sarah Carlier, Anne Violette Bruyneel, Marie Bruyneel

Abstract

Background: Chronic insomnia disorder (CI) is a prevalent sleep disorder that can lead to disturbed daytime functioning and is closely associated with anxiety and depression. First-choice treatment is cognitive behavioral therapy (CBT-I). Other mind-body interventions, such as Tai-chi and Yoga, have demonstrated subjective improvements in sleep quality. The purpose of this study was to assess the efficacy of Yoga for improvement of subjective and objective sleep quality as well as measures of anxiety, depression, sleepiness, and fatigue in patients with CI.

Methods: Adults with CI were prospectively included in this single group pre-post study. Baseline assessments included home polysomnography (PSG), 7-day actigraphy, and questionnaires (Pittsburgh Sleep Quality Index questionnaire (PSQI), Hospital Anxiety Depression scale (HADS), Epworth Sleepiness Scale (ESS), Pichot fatigue scale (PS)). Patients practiced Viniyoga, an individualised Yoga practice with daily self-administered exercises, for 14 weeks. Assessments were repeated at the end of Yoga practice.

Results: Twenty-one patients completed the study. Objective sleep measurements revealed no change in PSG parameters after Yoga practice, but a decrease in arousals on actigraphy (p < 0.001). Subjective symptoms improved for all questionnaires (PSQI, p < 0.001; HAD-A, p = 0.020, HAD-D, p = 0.001, ESS, p = 0.041, PS, p = 0.010). In univariate correlations, decrease in PSQI was associated with increase in sleep stage N3 (p < 0.001) on PSG.

Conclusions: We have demonstrated a positive impact of individualized Yoga practice on subjective parameters related to sleep and daytime symptoms in CI, resulting in fewer arousals on actigraphy. Yoga could be proposed as a potentially useful alternative to CBT-I in CI, as it is easy to practice autonomously over the long-term. However, given the design of the present study, future prospective controlled studies should first confirm our results.

Trial registration: ClinicalTrials.gov identifier: NCT03314441 , date of registration: 19/10/2017.

Keywords: Anxiety; Chronic insomnia; Sleep; Viniyoga; Yoga; Yoga Cikitsā.

Conflict of interest statement

The authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Pre and post-Yoga program comparison of questionnaire scores. All the pre-post values comparisons are significant, with a p < 0.005. PSQI: Pittsburgh Sleep Quality Index, PS: Pichot fatigue scale, ESS: Epworth Sleepiness Scale, HADS: Hospital Anxiety Depression scale, (A): anxiety, (D): depression

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