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

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.

Living through the psychological consequences of COVID-19 pandemic: a systematic review of effective mitigating interventions

“… 26 27 32 33 36–43 50 Out of the 29 studies, 14 (48.3%) were RCTs. 27–29 33 34 38–42 44 (2B,3) 48 50 The remaining 15 (51.7%) were non-RCT studies.…”

“…The Insomnia Severity Index was widely used to determine sleep quality in four studies. 27 33 35 45 There were several measures assessing outcomes beyond the focus of this study, one test for self-compassion and two tests for loneliness. 26 36 41 44 …”

“…On population, out of the total 29 studies, 8 (27.6%) targeted patients with COVID-19,28–30 45 48 49 51 52 6 (20.7%) among healthcare workers31 34 35 44 46 47 and more than half (51.7%) were general population 26 27 32 33 36–43 50. Out of the 29 studies, 14 (48.3%) were RCTs 27–29 33 34 38–42 4448 50 The remaining 15 (51.7%) were non-RCT studies.…”

“…The interventions reported by the studies can be classified into three types: 19 online-based interventions (65.5%),26 27 29–31 33 35 36 38 40–45 47 48 6 on-site-based interventions (20.7%)28 34 39 49–51 and 4 combined online and on-site interventions (13.8%) 32 37 46 52…”

“…One paper reported three studies, 26 totalling 29 studies, all of which were conducted in 2020. Of the 29 studies, one was conducted globally (3.5%) 27 and the rest were categorised according to WHO geographical area. Three studies (10.3%) were conducted in the Eastern Mediterranean region, 28-30 10 (34.5%) in the European region, [31][32][33][34][35][36][37][38][39][40] 4 (13.8%) in the Americas [41][42][43][44] and 11 (37.9%) in the Western Pacific.…”