Yoga Exercises as a Therapeutic Approach for Adults with Insomnia to Promote better Sleep: A Randomized Control Trial

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Onaiza Mumtaz
Muddsar Hameed
Rand Saleem Kashif
Saja Abazeed
Alishba Ali
Aliyah Usman Qureshi
Aliza Akhtar
Fatima Saeed


Background: Insomnia is a prevalent sleep disorder that significantly impacts the quality of life and is associated with various health complications, including high blood pressure, heart disease, diabetes, anxiety, and depression. Traditional treatments for insomnia often involve pharmacological interventions, but there is growing interest in alternative therapies such as yoga. This study investigates the efficacy of yoga as a therapeutic approach to improving sleep quality in adults with insomnia.

Objective: The objective of this study was to evaluate the effects of a structured yoga program on sleep quality and sleep latency in adults diagnosed with insomnia.

Methods: The study employed a cross-sectional design conducted at multiple healthcare facilities, including the Physiotherapy Outpatient Department at Holy Family Hospital, Benazir Bhutto Hospital, and District Headquarters Hospital in Rawalpindi. The study duration was four months, involving 54 participants selected through random sampling techniques. Inclusion criteria included adults aged 18 to 65 years diagnosed with insomnia according to the International Classification of Sleep Disorders (ICSD) or the Diagnostic and Statistical Manual of Mental Disorders (DSM). Exclusion criteria included severe medical or psychiatric disorders, substance abuse, pregnancy, or recent changes in sleep medication. Participants in the intervention group engaged in a standardized yoga program consisting of gentle yoga postures, controlled breathing techniques, and mindfulness meditation, conducted twice weekly for eight weeks, with each session lasting 60 minutes. The control group received standard care for insomnia. Data collection involved subjective assessments of sleep quality using validated questionnaires and objective measures through polysomnography. Statistical analysis was performed using SPSS version 25.0, with independent sample t-tests comparing means between groups and repeated measures ANOVA for within-group analysis.

Results: The yoga group showed significant improvements in subjective sleep quality and sleep latency. The mean sleep quality score improved from 2.18 ± 0.66 pre-intervention to 0.92 ± 0.37 post-intervention (p=0.0001), while the control group showed a less marked improvement from 2.37 ± 0.48 to 2.03 ± 0.18 (p=0.0012). Sleep latency in the yoga group decreased from 3.00 ± 0.00 to 1.29 ± 0.40 (p=0.0002), whereas the control group showed a reduction from 2.44 ± 0.49 to 2.11 ± 0.31 (p=0.0013). ANOVA results confirmed the statistical significance of these findings, with an F-value of 69.897 for sleep quality (p=0.0001) and 361.947 for sleep latency (p=0.0002).

Conclusion: The findings indicate that a structured yoga program significantly improves sleep quality and reduces sleep latency in adults with insomnia. Yoga appears to be an effective non-pharmacological intervention for managing insomnia, offering a viable alternative to traditional treatments.

Article Details

How to Cite
Mumtaz, O., Hameed, M., Kashif, R. S., Abazeed, S., Ali, A., Qureshi , A. U., Akhtar, A., & Saeed, F. (2024). Yoga Exercises as a Therapeutic Approach for Adults with Insomnia to Promote better Sleep: A Randomized Control Trial. Journal of Health and Rehabilitation Research, 4(2), 585–592.
Author Biographies

Onaiza Mumtaz, Rawalpindi Medical University Rawalpindi Pakistan.

Rawalpindi Medical University, Rawalpindi, Pakistan.

Muddsar Hameed, Shifa Tameer e Millat University Islamabad Pakistan.

Shifa Tameer e Millat University, Islamabad, Pakistan.

Rand Saleem Kashif, Dubai Medical University Dubai United Arab Emirates.

Dubai Medical University, Dubai, United Arab Emirates.

Saja Abazeed, Aqaba University of Technology Jordan.

Department of Physiotherapy, Aqaba University of Technology, Jordan.

Alishba Ali, Children's Hospital Lahore Pakistan.

Children's Hospital, Lahore, Pakistan.

Aliyah Usman Qureshi , Rawalpindi Medical University Rawalpindi Pakistan.

Rawalpindi Medical University, Rawalpindi, Pakistan.

Aliza Akhtar, Hamdard University Karachi Pakistan.

Hamdard University, Karachi, Pakistan.

Fatima Saeed, Shifa Tameer e Millat University Islamabad Pakistan.

Shifa Tameer e Millat University, Islamabad, Pakistan.


Park CL, Finkelstein-Fox L, Groessl EJ, Elwy AR, Lee SY. Exploring How Different Types of Yoga Change Psychological Resources and Emotional Well-Being Across a Single Session. Complement Ther Med. 2020;49:102354.

Turmel D, Carlier S, Bruyneel AV, Bruyneel M. Tailored Individual Yoga Practice Improves Sleep Quality, Fatigue, Anxiety, and Depression in Chronic Insomnia Disorder. BMC Psychiatry. 2022;22(1):267.

McGovern CE, Cheung C. Yoga and Quality of Life in Women With Primary Dysmenorrhea: A Systematic Review. J Midwifery Womens Health. 2018;63(4):470-82.

American Academy of Sleep Medicine. International Classification of Sleep Disorders: Diagnostic and Coding Manual. 2005:148-52.

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed. American Psychiatric Association; 2000.

Sateia MJ. International Classification of Sleep Disorders. Chest. 2014;146(5):1387-94.

Taylor DJ, Mallory LJ, Lichstein KL, Durrence HH, Riedel BW, Bush AJ. Comorbidity of Chronic Insomnia With Medical Problems. Sleep. 2007;30(2):213-8.

Bhaskar S, Hemavathy D, Prasad S. Prevalence of Chronic Insomnia in Adult Patients and Its Correlation With Medical Comorbidities. J Family Med Prim Care. 2016;5(4):780.

Meng L, Zheng Y, Hui R. The Relationship of Sleep Duration and Insomnia to Risk of Hypertension Incidence: A Meta-Analysis of Prospective Cohort Studies. Hypertens Res. 2013;36(11):985-95.

Morin CM, Belleville G, Bélanger L, Ivers H. The Insomnia Severity Index: Psychometric Indicators to Detect Insomnia Cases and Evaluate Treatment Response. Sleep. 2011;34(5):601-8.

Bathgate CJ, Edinger JD, Wyatt JK, Krystal AD. Objective But Not Subjective Short Sleep Duration Associated With Increased Risk for Hypertension in Individuals With Insomnia. Sleep. 2016;39(5):1037-45.

Zheng B, Yu C, Lv J, Guo Y, Bian Z, Zhou M, et al. Insomnia Symptoms and Risk of Cardiovascular Diseases Among 0.5 Million Adults: A 10-Year Cohort. Neurology. 2019;93(23):e2110-e20.

Floam S, Simpson N, Nemeth E, Scott-Sutherland J, Gautam S, Haack M. Sleep Characteristics as Predictor Variables of Stress Systems Markers in Insomnia Disorder. J Sleep Res. 2015;24(3):296-304.

Meier-Ewert HK, Ridker PM, Rifai N, Regan MM, Price NJ, Dinges DF, et al. Effect of Sleep Loss on C-Reactive Protein, an Inflammatory Marker of Cardiovascular Risk. J Am Coll Cardiol. 2004;43(4):678-83.

Yamamoto-Morimoto K, Horibe S, Takao R, Anami K. Positive Effects of Yoga on Physical and Respiratory Functions in Healthy Inactive Middle-Aged People. Int J Yoga. 2019;12(1):62-67.

Liu D, Kahathuduwa C, Vazsonyi AT. The Pittsburgh Sleep Quality Index (PSQI): Psychometric and Clinical Risk Score Applications Among College Students. Psychol Assess. 2021;33(9):816-26.

Chalise S. The Joint Effect of Insomnia With Short Sleep Duration and Leisure-Time Physical Activity On the Risk of Cardiovascular and All-Cause Mortality: The HUNT Study. 2022.

Franzen PL, Buysse DJ. Sleep Disturbances and Depression: Risk Relationships for Subsequent Depression and Therapeutic Implications. Dialogues Clin Neurosci. 2008;10(4):473-81.

Jiang W, Alexander J, Christopher E, Kuchibhatla M, Gaulden LH, Cuffe MS, et al. Relationship of Depression to Increased Risk of Mortality and Rehospitalization in Patients With Congestive Heart Failure. Arch Intern Med. 2001;161(15):1849-56.

Yang CM, Lin SC, Cheng CP. Transient Insomnia Versus Chronic Insomnia: A Comparison Study of Sleep‐Related Psychological/Behavioral Characteristics. J Clin Psychol. 2013;69(10):1094-107.

Drake C, Richardson G, Roehrs T, Scofield H, Roth T. Vulnerability to Stress-Related Sleep Disturbance and Hyperarousal. Sleep. 2004;27(2):285-91.

Yang CM, Chou CP, Hsiao FC. The Association of Dysfunctional Beliefs About Sleep With Vulnerability to Stress-Related Sleep Disturbance in Young Adults. Behav Sleep Med. 2011;9(2):86-91.

Schutte-Rodin S, Broch L, Buysse D, Dorsey C, Sateia M. Clinical Guideline for the Evaluation and Management of Chronic Insomnia in Adults. J Clin Sleep Med. 2008;4(5):487-504.

Irwin MR, Cole JC, Nicassio PM. Comparative Meta-Analysis of Behavioral Interventions for Insomnia and Their Efficacy in Middle-Aged Adults and in Older Adults 55+ Years of Age. Health Psychol. 2006;25(1):3.

Stepanski EJ, Wyatt JK. Use of Sleep Hygiene in the Treatment of Insomnia. Sleep Med Rev. 2003;7(3):215-25.

Morin CM. Cognitive-Behavioral Approaches to the Treatment of Insomnia. J Clin Psychiatry. 2004;65(Suppl 16):33-40.

Sharma MP, Andrade C. Behavioral Interventions for Insomnia: Theory and Practice. Indian J Psychiatry. 2012;54(4):359.

Okajima I, Komada Y, Inoue Y. A Meta-Analysis on the Treatment Effectiveness of Cognitive Behavioral Therapy for Primary Insomnia. Sleep Biol Rhythms. 2011;9:24-34.

Ozminkowski RJ, Wang S, Walsh JK. The Direct and Indirect Costs of Untreated Insomnia in Adults in the United States. Sleep. 2007;30(3):263-73.

Daley M. The Impact and Economic Costs of Insomnia: Health-Care Utilisation, Work Function and Accidents (Doctoral Dissertation, Université Laval).

Halpern J, Cohen M, Kennedy G, Reece J, Cahan C, Baharav A. Yoga for Improving Sleep Quality and Quality of Life for Older Adults. Altern Ther Health Med. 2014;20(3):37-46.

Wang WL, Chen KH, Pan YC, Yang SN, Chan YY. The Effect of Yoga on Sleep Quality and Insomnia in Women With Sleep Problems: A Systematic Review and Meta-Analysis. BMC Psychiatry. 2020;20:1-9.

Khalsa SB. Treatment of Chronic Insomnia With Yoga: A Preliminary Study With Sleep–Wake Diaries. Appl Psychophysiol Biofeedback. 2004;29:269-78.

Penders K. Implementation of Yoga to Treat Insomnia in an Adult Population (Doctoral Dissertation, Seton Hall University). 2021.

Xie Y, Liu S, Chen XJ, Yu HH, Yang Y, Wang W. Effects of Exercise on Sleep Quality and Insomnia in Adults: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Front Psychiatry. 2021;12:664499.

Basavegowda M, Umeshchandra SM, Duraisamy P, Thimmulappa RK, Manivasagan MS, Mallaiah C, et al. The Effect of Yoga on Insomnia and Quality of Life Among Nursing Professionals During COVID-19: A Pre–Post-Test Interventional Study. Indian J Psychiatry. 2023;65(11):1143-50.

Datta K, Tripathi M, Verma M, Masiwal D, Mallick HN. Yoga Nidra Practice Shows Improvement in Sleep in Patients With Chronic Insomnia: A Randomized Controlled Trial. Natl Med J India. 2021;34(3).

Riemann D, Baglioni C, Bassetti C, Bjorvatn B, Dolenc Groselj L, Ellis JG, et al. European Guideline for the Diagnosis and Treatment of Insomnia. J Sleep Res. 2017;26(6):675-700.

Sharpe E, Lacombe A, Butler MP, Hanes D, Bradley R. A Closer Look at Yoga Nidra: Sleep Lab Protocol. Int J Yoga Ther. 2021;31(1):Article_20.

Appleton SL, Reynolds AC, Gill TK, Melaku YA, Adams RJ. Insomnia Prevalence Varies With Symptom Criteria Used With Implications for Epidemiological Studies: Role of Anthropometrics, Sleep Habit, and Comorbidities. Nat Sci Sleep. 2022;14:775-90.

Porwal A, Yadav YC, Pathak K, Yadav R. An Update on Assessment, Therapeutic Management, and Patents on Insomnia. Biomed Res Int. 2021;2021:1-9.

Pigeon WR, Bishop TM, Marcus JA. Advances in the Management of Insomnia. F1000Prime Rep. 2014;6.