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Poised Poses for more Z’s

November 17th, 2014

by Rachel Bull, PharmD student

Poor sleep quality is one of the most common health complaints in older adults today.  It is approximated that more than 80% of older adults experience sleep disturbance to some degree, while 50% note the common recurrence of sleep disturbance.1 Insomnia can be defined as, “having trouble falling or staying asleep, waking up too early and cannot return to sleep, or not feeling refreshed after sleeping”.2 The identification of the presence of insomnia is often quite obvious while the cause of the insomnia can be more difficult to identify.  The cause of insomnia can range greatly and is often not the primary disorder rather a response to an underlying issue.  The most common causes of insomnia are stress and anxiety.  Other causes can include a medical illness, poor sleep habits, or other sleep disorders such as sleep apnea and narcolepsy. The standard of care for insomnia is the practice of reestablishing a normal sleep cycle which can be accomplished with sleep hygiene practices such as exercise, a nonprescription sleep aid, or a prescription sleep aid.2 These treatments still pose barriers such as not being completely effective for all patients, therefore alternative treatments for insomnia are still being pursued.  Also, many over the counter sleep aids come with barriers of their own including the body building tolerance against antihistamines which are commonly found in these sleep aids, feeling groggy or unwell the next day, potential medication interactions, and a list of side effects associated with each sleep aid such as dizziness, dry mouth, and daytime sleepiness being the most common among all sleep aids.3 Recently an up and coming trend for treating insomnia has been focused on using the practice of yoga.  Yoga has been found to naturally strengthen the body by improving physical strength and flexibility, reducing stress, improving breathing patterns, and enhancing mental focus.4

A recent publication in Alternative Therapies by Health & Medicine explored the effects of yoga as a treatment for insomnia.1 Alternative therapies, such as yoga, have been proposed to be a safe alternative from the standard of care such as sleep aids and provide a treatment with little adverse events.  This waiting-list controlled trial study was conducted at Shaare Zedek Medical Center in Jerusalem, Israel and looked at how participating in yoga classes twice weekly as well as recommended home-based practices would affect older adults with complaints about insomnia.  The study included 67 participants who were 60 years and older. Sixteen of the participants were assigned to the waiting list control group while the other 43 participants were assigned to the yoga intervention group and 7 participants dropped out for various reasons.  The results concluded that overall the practice of yoga by older adults was shown to be a safe treatment and led to improved sleep quality and duration.  The study found that just 25 minutes of yoga per day for 12 weeks led to improved sleep status. A limitation presented by the authors was that there was not a single method of measuring the outcomes instead a wide range of measuring methods were used.  Another limitation would be the compliance of the participants throughout the study. This was evident with only 10% of participants maintaining the practice compliance level.1

There has been previous research done on this topic over the years. Another study showed yoga can positively affect insomnia by improving sleep efficiency and sleep duration.4 The study provided the participants with yoga training and instructed all participants to maintain daily yoga practice for eight weeks.  The participants kept sleep diaries for two weeks before the yoga practices began and for the entire eight week study to record the amount time spent asleep, number of times they woke up during the night, and the time spent sleeping between waking periods.  The study also noted that the cause of insomnia has commonly been linked to anxiety and depression.4 Another study published in the Indian Journal of Psychiatry found that 60 minutes of yoga daily for 6 months led to improved sleep quality among the elderly aged 60 years and older.5 This study supports the conclusion that the practice of yoga improves sleep quality while noting that further research should be conducted on this alternative therapy because of its great potential to treat insomnia.5

Yoga still offers barriers such as potential injury and the fact that the elderly population should not first attempt yoga on their own without seeking advice from their primary care provider. On the other hand, yoga can be more financially friendly than some medications offered to treat insomnia.  The benefits of yoga naturally target the most common causes of insomnia, which prove to be another reason why the practice of yoga should be utilized as a treatment for insomnia. Yoga can easily be incorporated into a basic lifestyle change by finding a yoga class at a local gym or fitness center or in the peace of your own home by using instructed yoga videos for just 30 minutes a day.

Are these poised poses worth a try? Do you think specifically yoga treats insomnia or simply exercise in general?  Is yoga the answer to your sleepless nights?

 References

  1. Baharav A, Cahan C, Cohen M, Halpern J, Kennedy G, Reece J. Yoga for improving sleep quality and quality of life for older adults. 2014; 20(3):37-38-46.
  2. Melton, C. K. Insomnia, Drowsiness, and Fatigue. In: R. R. Daniel L. Krinsky, Handbook of Nonprescription Drugs An Interactive Approach to Self-Care. Washington, DC: American Pharmacists Association; 2012: 867-876.
  3. Mayo Clinic Staff. Sleep aids: Understand over-the-counter options. Mayo Clinic Web site. http://www.mayoclinic.org/healthy-living/adult-health/in-depth/sleep-aids/art-20047860. Published 12/10/2011. Updated 2014. Accessed 11/15, 2014.
  4. Khalsa, SBS. Treatment of Chronic Insomnia with Yoga: A Preliminary Study with Sleep-Wake Diaries. 2004; 29(4):269-278.
  5. Basavaraddi IV, Gangadhar BN, Hariprasad VR, et al. Effects of yoga intervention on sleep and quality-of-life in elderly: A randomized controlled trial. 2013; 55:364-365-368.

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6 Responses to “Poised Poses for more Z’s”

  1. Kara Bobka Says:

    Rachel,

    Great, interesting article! I myself enjoy yoga, but I always took classes for the health benefits! Who knew it could also help with sleep insomnia, anxiety, and depression! Because I feel that such classes would be great for college students or younger adults, I was curious if you came across any studies that targeted the latter populations? If so, were the results similar or conflicting?

    Thanks,
    Kara

  2. Sarah Winey Says:

    Rachel, this was a great review of the literature on the topic of the benefits of yoga to sleep. Did you find any information on whether the time of day yoga was performed affected its impact on sleep?

  3. Matthew Johnson Says:

    I saw that exercise is one form of sleep assistance. Could it just be that since this is a form of exercise that this assists in sleep or do you think it would differ significantly from any other exercise routine in terms of sleep assistance?

  4. Neal Fox Says:

    Is Yoga usually considered a fairly easy practice for older adults? Do they need to be at a certain level of health in order to start?

  5. Colin Behm Says:

    Through your research did into insomnia, did you find any other ways of using either physical activity or some other means to combat the insomnia? If someone who were of older age or is unable to do some of the yoga what other alternatives could they use to get that sleep that they are craving?

  6. Rachel R Bull Says:

    Kara – Actually, during my research, I did not come across any studies that looked at college aged students and the affects of yoga on insomnia which was rather surprising to me. I was hoping to find some studies that took this age range into account considering the sleep schedules of college aged students is greatly diverse. I, as well, am curious whether or not the results would be similar or conflicting.
    Sarah – That’s a great question. I actually never took this into consideration as I was completing the research and would be very curious to see if the time of the yoga activity did have an effect on sleep. This would be a great topic to research some more!
    Matt – I think your question is the big debate and conflicting question about yoga’s true effect on sleep. I found several small articles in newspapers and magazines proposed the same question to its readers. I am not sure if an answer to this question has been found as of yet, but possibly it will be further addressed in future research.
    Neal – From what I found in the literature, yoga seemed to be a fairly easy level of exercise for the elderly. It all depends on the level of yoga exercises the person attempts. There are great variety of yoga exercises ranging from very difficult to very easy. However, all the literature did strongly suggest that any elderly person should consult their primary care provider before attempting to engage in yoga exercises.
    Colin – Majority of my research was about the effect of yoga on insomnia, however from what I found in the literature the standard of care for insomnia is the main treatment of choice for most people. None of the literature addressed the idea of a person being unable to perform yoga, so I am not sure of the answer to your question. The literature did mention whether or not yoga specifically helped insomnia or if any form of exercise would help insomnia.

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