Yoga Nidra: An innovative approach for management of chronic insomnia- A case report

Abstract

Background: Chronic insomnia is a common sleep problem and there is a need to complement the existing treatment options. Yoga nidra practice is documented to be used for sleep by sages. Recently, yoga nidra has been used in patients of menstrual abnormalities, post-traumatic stress disorder, diabetes, anxiety and depression but little is known about its effect on sleep or sleep disorders. Although we find description of yoga nidra in literature, there is no scientific report of its application in sleep disorders. The objective of the study was to develop yoga nidra model in management of chronic insomnia patients. The model was developed using inputs from yoga school trained instructors of yoga nidra. Case presentations: Patient 01: 60 years old widower with complaints of sleep maintenance insomnia since 20 years. He had worry at daytime regarding falling off to sleep which became even worse at bedtime. He had history of benign prostatic hypertrophy and had no history of any medications for sleep or any other disease. Patient 02: 78 years old male self-employed, company owner with complaints of sleep maintenance insomnia since 15 years. He felt quite energetic during the day due to the work requirement but in the evening started feeling anxious about sleep problem which worsened at bedtime. He was on tablet clonazepam 0.25 mg HS off and on since 1 year. After the baseline assessment, yoga nidra intervention was started followed by five supervised sessions after which the patients were instructed to practice yoga nidra daily on their own. Regular fortnightly follow ups were done till 4 weeks of start of yoga nidra intervention. Repeat PSG was offered in case patient volunteered. Sleep diary parameters were analysed using Friedman test and Wilcoxon Signed Ranks test. There was an improvement in sleep quality, insomnia severity, depression anxiety and stress scores after yoga nidra. The improvement remained even after 3 months of start of intervention. Repeat PSG in second patient showed an increase in N3 after 4 weeks of yoga nidra intervention.

The Thin Line Between Waking and Sleeping in Athletes: A Call for Yoga Nidra in the Sporting Context

“…As a long-term effect, the shift toward parasympathetic dominance and the subsequent high cardiac vagal control may increase slow-wave sleep and improve both subjective and objective sleep quality (Werner et al, 2015). The more the parasympathetic activity dominates during sleep, the more the sleep is restorative and rejuvenating, and body recovers balancing the daily stress responses (Datta et al, 2017). Thus, in more recent years, there has been a growing interest in YN effects on depression, perceived stress, posttraumatic stress disorder, well-being or quality of life, and insomnia/chronic sleep disorder, especially considering students, workers, and veterans; for a more detailed overview on these topics, see https://www.irest.us/ research.…”

“…More precisely, this practice, executed in supine position, naturally stimulates a hypnagogic state wherein an individual is physiologically asleep yet maintains an internal/external awareness (Sharpe et al, 2021); there is a withdraw from other senses, and only the auditory channel is open so that the participant stays aware of the directions coming from the instructor, but practices detachment from all other stimuli. YN interventions have been associated with significant improvements in sleep parameters such as sleep onset latency and sleep quality (Datta et al, 2017;Moszeik et al, 2020) because of a general parasympathetic dominance (Markil et al, 2012) and a subsequent high cardiac vagal control (Werner et al, 2015; see also YN Effects and Potential Benefits on Athletes); it first stimulates the parasympathetic nervous system increasing heart rate variability (HRV), or its high-frequency components (Markil et al, 2012), and alpha waves, to then demonstrate the symptoms of deep, non-REM sleep, including theta and delta brain waves (Parker et al, 2013).…”

Effectiveness of a short Yoga Nidra meditation on stress, sleep, and well-being in a large and diverse sample

“…Not only based on self-reports, but also by imaging techniques such as positron emission tomography (PET) and electroencephalography (EEG), sustained changes in the activation of the brain were recorded (e.g., Lou et al 1999;Mandlik et al 2002;). As examples for qualitative studies and case studies Datta et al (2017) show positive effects of Yoga Nidra on chronic sleep disorders and several others find positive effects on PTSD (posttraumatic stress disorder) for veterans (e.g. Stankovic 2011) and women with sexual assault experience (e.g.…”

Yoga and Quality of Life in Women with Primary Dysmenorrhea: A Systematic Review

“…Yoga Nidra is a restorative technique often performed at the end of a yoga session while supine. Typically, Yoga Nidra is guided and involves several steps in which attention is brought to the breath, emotions, and each part of the body to produce a deep, conscious relaxation of the entire body and mind …”

“…Typically, Yoga Nidra is guided and involves several steps in which attention is brought to the breath, emotions, and each part of the body to produce a deep, conscious relaxation of the entire body and mind. 16 Recommended as a generally safe intervention with few to no adverse side effects when practiced by healthy individuals under the guidance of a properly trained instructor, yoga may be specifically well suited to improving QOL in women with primary dysmenorrhea. 17 Menstrual pain is largely thought to result from a proinflammatory response and increase in prostaglandins, which mediate frequent and prolonged uterine contractions, causing myometrial ischemia.…”