Yoga and Sleep

Compiled by: Trisha Lamb Last Revised: April 27, 2006

2005 by International Association of Yoga Therapists (IAYT)

International Association of Yoga Therapists

P.O. Box 2513 Prescott AZ 86302 Phone: 928-541-0004 E-mail: mail@iayt.org URL: www.iayt.org
The contents of this bibliography do not provide medical advice and should not be so interpreted. Before beginning any exercise program, see your physician for clearance.

Effects of Lack of Sleep (according to the August 2004 issue of the Harvard Heart Letter): Short-term effects include increases in blood pressure and levels of stress hormones. When the body is sleep-deprived, it has more difficulty processing blood sugar and has reduced levels of leptin, an appetite -suppressing hormone. These changes can increase the risk of weight gain and diabetes. Lack of sleep also increases inflammation in the body, which is thought to be an important factor in the development of heart disease. [David Wilson is] a Vietnam vet who wears clunky metal rings on nearly every finger and builds computers for fun, but lately the only place [he] wants to be is on his yoga mat. The 50-year-old is homeless, struggles with post-traumatic stress disorder and has chronic pain in his neck and back. And until recently, a good nights sleep meant just two hours of solid snooze time. But since enrolling in a stress reduction class at the Middletown Community Health Center, Wilson says he's finally sleeping through the night. Through yoga and meditation sessions, he is controlling his pain and has learned to focus his breathing. From an article by Laura Walsh, Low-Income Patients Beating Stress with Yoga, Meditation Class, Worcester Telegram & Gazette, 3 December 2004
Note: See also the Dreams bibliography.

Abrams, Allan I., and Larry M. Siegel. Transcendental Meditation program and rehabilitation at Folsom State Prison: A cross-validation study. Criminal Justice and Behavior, Mar 1978, 5:320. Indicates reduction in anxiety, neuroticism, hostility, and insomnia as effects of the TM program. Ajnananda, Swami. Tratak. Available online: http://www.yogalinks.net/Articles/Tratak.htm. On using tratak to assist someone suffering from insomnia due to night terrors linked to earlier sexual abuse.

Albert, I. B., and B. McNeece. The reported sleep characteristics of meditators and nonmeditators. Bulletin of the Psychonomic Society, 1974, 3(1B):73-74.
Alexander, C. N., and W. E. Larimore. Distinguishing between Transcendental Meditation and sleep according to electrophysiological criteria. In R. A. Chalmers, G. Glements, H. Schenklun, eds., Scientific Research on Maharishis Transcendental Meditation and TM -Sidhi Program: Collected Papers, Vol. 3. Vlodrop, The Netherlands: MVU Press, 1989, pp. 1712-1719. Ambikananda Saraswati, Swami. Insomnia . In Swami Ambikananda, Healing Yoga: A Guide to Integrating the Chakras with Your Yoga Practice. New York: Marlowe & Co., 2001, pp. 134135. Angus, Carrie. Bedtime blues: What to do when you cant sleep. Article available online: http://www.yogasite.com/sleep.htm.

Aurobindo, Sri, and The Mother. The Yoga of Sleep and Dream: The Night School of Sadhana. Twin Lakes, Wis.: Lotus Press, 2004. From the publisher: The practice of yoga continues day and night. This book aids the seeker in becoming conscious and turning sleep and dreams into the opportunity for real and substantial progress on the path of yoga. Banquet, J. P., C. Haynes, H. Russel, and B. Reber. Analysis of sleep in altered states of consciousness by classical electro encephalogram and coherence spectra. Electroencephalography and Clinical Neurophysiology, Oct 1977, 43:503. For Transcendental Meditation practitioners, dramatic changes occurred in the duration of different sleep stages. ___________, and M. Sailham. Quantified EEG spectral analysis of sleep and TM. In David W. Orme-Johnson, and John T. Farrow, eds., Scientific Research on the Transcendental Meditation Program: Collected Papers, Volume I. Maharishi European Research University Press, 1976, p. 182-186. Bhajan, Yogi. Insomnia; Sleep. In Alice Clagett and Elandra Kirsten Meredith, eds., Yoga for Health and Healing: From the Teachings of Yogi Bhajan, Ph.D. Santa Monica, Calif.: Alice B. Clagett, pp. 76; 117-121. Bhat, Vasanthi. Insomnia. In Vasanthi Bhat, The Power of Conscious Breathing in Hatha Yoga. San Jose, Calif.: Vasanthi Bhat, 1997, p. 222. Bhumi. Insomnia. Australian Yoga Life, 2004, no. 8, pp. 62-65. Burkovec, T. D., and T. C. Weerts. Effects of progressive relaxation on sleep disturbance: An EEG evaluation. Psychosomatic Medicine, 1976, 38(3): 178-180. Candelent, Thomas, and Gillian Candelent. Teaching Transcendental Meditation in a psychiatric setting. Hospital and Community Psychiatry, Mar 1975, 26:156-159. TM lowered anxiety, decreased insomnia, and lessened over-active or impulsive behavior of psychiatric patients. Cannici, J., R. Malcolm, and L. A. Peek. Treatment of insomnia in cancer patients using muscle relaxation training. Journal Behav. Ther. Exp. Psychiatry, 1983, 14(3): 251-256. Carr-Kaffashan, Lucille, and Robert L. Woolfolk. Active and placebo effects in treatment of moderate and severe insomnia . Journal of Consulting and Clinical Psychology, Dec 1979, 47(6):1072-1080. Examines the efficacy of relaxation training and a highly credible placebo in the treatment of both severe and moderate sleep-onset insomnia. Carrington, Patricia. Counteracting insomnia. In Patricia Carrington, Freedom in Meditation. New York: Anchor Press/Doubleday, 1977, pp. 207-210.

Chakravarti, Sree. Jnana mudra (for improving brain power and memory; insomnia). In Sree Chakravarti, A Heale rs Journey. Portland, Ore.: Rudra Press, 1993, pp. 206-207. Chang, Stephen T., with Richard Miller. Insomnia. In Dr. Stephen T. Chang with Richard Miller, The Book of Internal Exercises. San Francisco: Strawberry Hill Press, 1978, p. 134. Choliz, M. A breathing-retraining procedure in treatment of sleep-onset insomnia: theoretical basis and experimental findings. Perceptual Motor Skills, Apr 1995, 80(2):507-513. See also the negative commentary on this article by Kroeze S. van den Hout, An untenable rationale for treating insomnia, in the Aug 1995, 81(1):316-318 issue. Abstract: Increase in CO2 has a sedative effect upon the central nervous system, and the beginning of sleep coincides with modifications in breathing, decrease in ventilation, and in pCO2 increase. In this paper is described a technique of breathing that is useful in producing drowsiness in a very short time. 46 insomniacs were randomly allocated to either a treatment or control condition. In the former, patients were trained in the breathing process. The control group was taught no breathing process. Latencies to sleep for the insomniacs confirmed that the breathing process was useful in producing drowsiness. Theoretical bases are discussed. Abstract of van den Hout commentary: In 1995 Cholitz tested a breathing technique to treat insomniacs. The results were incomparably much better than typically reported. It is argued that Cholitz explanation of his findings is untenable and that independent replications are needed. Christensen, Alice. Insomnia. In Alice Christensen, The American Yoga Association Wellness Book. New York: Kensington Books, 1996, pp. 118-125. ___________. Relaxing breath; The complete relaxation procedure. In Alice Christensen, The American Yoga Associations Easy Does It Yoga. New York: Simon & Schuster, 1999, pp. 6061; 133-138. Corby, J. C., W. T. Roth, and B. S. Kopell. Psycho-physiological correlates of the practice of Tantric Yoga meditation. Archives of General Psychiatry, 1978, 35:571-580. (Includes a discussion of sleep.) Crisp, Tony. Yoga and dreams. Article available online: http://www.dreamhawk.com/d-yoga.htm. Dalphonse, Sherri. Find your balance: Headaches? Back pain? Insomnia? Try yoga. The Washingtonian, Dec 1997, 33(3):80. Dash, P., and C. N. Alexande r. Electrophysiological characteristics during Transcendental Meditation and napping. Was tentatively scheduled for inclusion in Scientific Research on the Transcendental Meditation Program: Collected Papers, Vol. 2. Rheinweiler, West Germany: Maharishi European Research University Press. EEG characteristics showed that sleep is distinguishable from TM. Delmonte, M. M. Electrocortical activity and related phenomena associated with meditation practice: A literature review. Int. Journal of Neuroscience, 1984, 24: 217-231. (Includes the effects of meditation on sleep.)

Devi, Nischala Joy. Prelude to sleep: Practice of techniques for a peaceful sleep. In Nischala Joy Devi, The Healing Path of Yoga. New York: Three Rivers Press, 2000. Devi Bhavanani, Meenaks hi. The nature of and need for sleep. Yoga Life, Jun 2005, 36(6):3-11. Dickman, Carol. Bed Top Yoga: Simple Stretches & Yoga Techniques You Can Do Lying Down for Home & Travel video. Available from Yoga Enterprises, 212-956-2327. Diskin, Eve. Sleep. In Eve Diskin, Yoga for Children. New York: Warner Books, 1976, p. 197. Easy yoga for restful sleep. Article available online: http://www.goldentemple.com/Clients/KIIT/GT/Yoga.nsf/AllKriyas. Editor of Yoga International. Answers the question: In which direction should we face when we sleep? Yoga International, Feb/Mar 2004, pp. 12-13. Elson, B. D., et al. Physiological changes in yoga meditation. Psychophysiology, 1977, 14(1): 5257. (Includes the effects of meditation on sleep.) Faber, P. A., G. S. Saayman, and S. W. Touyz. Meditation and archetypal content of nocturnal dreams. Journal of Analytical Psychology, Jan 1978, 23(1):1-22. PMID: 344296. Farhi, Donna. Insomnia. In Donna Farhi, The Breathing Book: Good Health and Vitality Through Essential Breath Work. New York: Henry Holt and Co., 1996, p. 221. Ferguson, R. E. The Transcendental Meditation program at MCI Walpole: An evaluation report. Was tentatively scheduled for inclusion in Scientific Research on the Transcendental Meditation Program: Collected Papers, Vol. 2. Rheinweiler, West Germany: Maharishi European Research University Press. Fincke, Alanna. Catch more zzzs. Body & Soul. Article available online: http://www.bodyandsoulmag.com/show_document.asp?iDocumentID=137&iBDC=1644&iPage Number=1. Discusses Sat Bir Singh Khalsas pilot study for his NIH-funded research on Yoga and insomnia. Folan, Lilias. Rest, Relax, and Sleep audiotape set. Portland, Ore.: Rudra Press. 1-800-876-7798. Fuson, J. W. The effect of the Transcendental Meditation program on sleeping and dreaming patterns. Was tentatively scheduled for inclusion in Scientific Research on the Transcendental Meditation Program: Collected Papers, Vol. 2. Rheinweiler, West Germany: Maharishi European Research University Press. Improved quality of sleeping and dreaming was reported by subjects practicing the TM technique. Gach, Michael Reed, with Carolyn Marco. Insomnia. In Michael Reed Gach with Carolyn Marco, Acu-Yoga: The Acupressure Stress Management Book . Tokyo: Japan Publications, 1981, pp. 190-192. Garde, R. K. Insomnia. In R. K. Garde, Principles and Practice of Yoga-Therapy. Bombay, India: D. B. Taraporevala Sons & Co., 1972, 1984, pp. 73.

Gellhorn, E., and W. F. Kiely. Mystical states of consciousness: Neuro-physiological and clinical aspects. Journal of Nervous and Mental Disease, Jun 1972, 154(6):399-405. PMID: 5030966. Gendron, Kay. A good nights sleep. Yoga International, Sep/Oct 1991, pp. 62-64. Gitananda Giri, Dr. Swami. SleepSwapna: An important part of sadhana. Yoga Life, Oct 1999, 39(10):3-5. Harrison, Eric. How Meditation Heals. Piatkus Books, 2000. (Discusses insomnia.) Heffley, Lynne. Look and listen: A relaxing, positive way for kids to fall asleep. Los Angeles Times, 7 Feb 2002. Available for purchase online at www.latimes.com (search the Archives). A review of Patti Teels The Inside-Out Sleep Game CD, Buena Vista Records, ages 3-7. If nightmares, fear of the dark or just plain restlessness make bedtime a battle, help has arrived. Patti Teel, a special-education and music teacher, has come up with a soothing mix of yoga exercises, guided imagery, storytelling, and sweet, soft music and vocals to ease youngsters to sleep . . . Hewitt, James. Insomnia. In James Hewitt, The Complete Yoga Book. New York: Schocken Books, 1977, p. 367. His Holiness The Dalai Lama. Sleeping, Dreaming, and Dying. Somerville, Mass.: Wisdom Publications, 2001. This book is an account of an historic dialogue between leading Western scientists and the Dalai Lama of Tibet revolving around sleep, dreams, and deaththe three key moments of consciousness that internationally acclaimed neuroscientist Francisco Varela calls the egos shadow zones. With contributions from acclaimed voices such as philosopher Charles Taylor, psychoanalyst Joyce McDougall, psychologist Jayne Gackenbach, cultural ecologist Joan Halifax, and neuroscientist Jerome Engel, the book is both engrossing and highly readable. Whether the topic is lucid dreaming, near-death experiences, or the very structure of consciousness itself, the participants in this unique exchange continually surprise and delight us with their discoveries of convergences and divergences between their respective traditions. Insomnia. Yoga & Health, Dec 1999, p. 9. Iyengar, B. K. S. Insomnia. In B. K. S. Iyengar, Light on Yoga. Rev. ed. New York: Schocken Books, 1979, p. 500. ___________. Insomnia. In B. K. S. Iyengar, Yoga: The Path to Holistic Health. London/New York: Dorling Kindersley, 2001, pp. 340-342. Iyengar, Geeta. Asanas for insomnia. In Geeta Iyengar, Yoga: A Gem for Women. New Delhi, India: Allied Publishers, 1983, pp. 175-192. Jacobs, G. D., P. A. Rosenberg, R. Friedman, J. Matheson, G. M. Peavy, A. D. Domar, and H. Benson. Multifactor behavioral treatment of chronic sleep-onset insomnia using stimulus

control and the relaxation response: A preliminary study. Behavior Modification, Oct 1993, 17(4):498-509. PMID: 8216184. Abstract: Sleep latency changes following behavioral interventions for sleep-onset insomnia are only moderate because the majority of insomniacs do not achieve good sleeper status at posttreatment. This study evaluated the efficacy of a multifactor behavior intervention consisting of stimulus control and relaxation-response training (n = 10) compared to stimulus control alone (n = 10) for sleep-onset insomnia. Only the multifactor subjects mean posttest sleep latency fell within the good sleeper range. They also exhibited a 77% improvement on mean sleep-onset latency compared to the stimulus control group (63%). Thus a multifactor intervention may be more effective than stimulus control alone for treatment of sleep-onset insomnia. Jevning, R., A. F. Wilson, and W. R. Smith. Plasma amino acids during the Transcendental Meditation technique: Comparison to sleep. In David W. Orme-Johnson, and John T. Farrow, eds., Scientific Research on the Transcendental Meditation Program: Collected Papers, Volume I. 2d ed. Maharishi European Research University Press, 1977. ___________, W. R. Smith, A. F. Wilson, and M. E. Morton. Alterations in blood flow during Transcendental Meditation. Psychophysiology, Mar 1976, 13:168 (abstract). Was tentatively scheduled for inclusion in Scientific Research on the Transcendental Meditation Program: Collected Papers, Vol. 2. Rheinweiler, West Germany: Maharishi European Research University Press. Indicates that the physiology of TM is fundamentally different from simple relaxation or sleep. Joshi, K. S. Treatment of insomnia through yoga and nature care techniques: A scientific study. Proceedings 1 st National Conference on Yoga, Science and Society, Banaras Hindu University , 1979, pp. 89-90. ___________. Yogic treatment of insomnia: An experimental study. Yoga-Mimamsa, 1992, 30:24-26. Journey to the Soul: Ayurvedic Techniques for a Restful Sleep/Guided Meditation for a Restful Sleep CD and booklet. Contact: journeytothesoul@accesscomm.ca, tel.: 306-5694139. Combines the ancient Indian or Vedic sciences of astrology, yoga and Ayurveda . . . to create a program that will help to reduce stress and enhance the ability to sleep. Kasamatsu, Akira, and Tomio Hirai. An electroencephalographic study of the Zen meditation (Zazen). Journal of the American Institute of Hypnosis, May 1973, 14:107-114. Also in Deane H. Shapiro, Jr., and Roger N. Walsh, Meditation: Classic and Contemporary Perspectives. Hawthorne, N.Y.: Aldine Pub. Co., 1984. The EEG changes accompanying Zen meditation are described in detail; changes are also compared with that of hypnotic trance and sleep. Kelly, Alice Lesch. Sleep on it: Insomniacs who have grown tired of relying on over-the-counter sleep aids are waking up to the fact that yoga is a healthier alternative for getting a good nights rest. Yoga Journal, Mar/Apr 2002, pp. 96-103.

Khalsa, Sat Bir S. Treatment of chronic insomnia with yoga: A preliminary study with sleepwake diaries. Applied Psychophysiology and Biofeedback, Dec 2004, 29(4):269278. Author email: e-mail: khalsa@hms.harvard.edu. Abstract: There is good evidence for cognitive and physiological arousal in chronic insomnia. Accordingly, clinical trial studies of insomnia treatments aimed at reducing arousal, including relaxation and meditation, have reported positive results. Yoga is a multi-component practice that is also known to be effective in reducing arousal, although it has not been well evaluated as a treatment for insomnia. In this preliminary study, a simple daily yoga treatment was evaluated in a chronic insomnia population consisting of sleep-onset and/or sleep-maintenance insomnia and primary or secondary insomnia. Participants maintained sleepwake diaries during a pretreatment 2-week baseline and a subsequent 8-week intervention, in which they practiced the treatment on their own following a single in-person training session with subsequent brief in-person and telephone follow-ups. Sleep efficiency (SE), total sleep time (TST), total wake time (TWT), sleep onset latency (SOL), wake time after sleep onset (WASO), number of awakenings, and sleep quality measures were derived from sleepwake diary entries and were averaged in 2-week intervals. For 20 participants completing the protocol, statistically significant improvements were observed in SE, TST, TWT, SOL, and WASO at end-treatment as compared with pretreatment values. Kiran, Usha. Integrated approach of yoga therapy for diabetes, obesity, constipation, insomnia, paralysis, and depression. Vivekananda Kendra Yoga Research Foundation, 1991. Koch, U., S. Volk, T. Heidenreich, and B. Pflug. Yoga treatment in psycho-physiological insomnia. Journal of Sleep Research, 1998, 7(Suppl. 2) :137. Kozak, Sandra Summerfield. Relaxing your mind: A practice for reducing pitta. Yoga International, Jun/Jul 2001, pp. 90-97. Krahne, W., and G. Tenoli. EEG and Transcendental Meditation. Pflgers Archiv: European Journal of Physiology, 1975, 359:R95. Abstract of a report showing that EEG changes during TM were different from those seen in states of wakefulness, drowsiness and sleep, but showed some similarities to other forms of relaxation. Kraftsow, Gary. Hyper conditions of the nervous system. In Gary Kraftsow, Yoga for Wellness: Healing with the Timeless Teachings of Viniyoga. New York: Penguin/Arkana, 1999, pp. 274280. (Applicable to insomnia.) Krugman, Michael. Sleepless in Chicago. YOGAChicago, Sep-Oct 2002, pp. 14, 19. Article available online: http://www.yogachicago.com/sep02/sleepless.shtml. Lalitananda, Swami. Meditate upon the moments before sleep. In Swami Lalitananda, Practice of Yoga in Daily Life. Bombay: Taraporevala, 1973, pp. 50-53. Originally published under the title Yoga in Life. ___________. Vedantic insight into sleep. International Yoga Guide, July 1999, p. 251. Manjunath, N. K., and S. Telles. Influence of Yoga & Ayurveda on self-rated sleep in a geriatric population. Indian Journal of Medical Research, May 2005, 121(5):683-690.

Abstract: Background & objective: Sleep in older persons is characterized by decreased ability to stay asleep, resulting in fragmented sleep and reduced daytime alertness. Pharmacological treatment of insomnia in older persons is associated with hazardous side effects. Hence, the present study was designed to compare the effects of Yoga and Ayurveda on the self-rated sleep in a geriatric population. Methods: Of the 120 residents from a home for the aged, 69 were stratified based on age (five-year intervals) and randomly allocated to three groups, i.e., Yoga (physical postures, relaxation techniques, voluntarily regulated breathing and lectures on yoga philosophy), Ayurveda (a herbal preparation), and Wait-list control (no intervention). The groups were evaluated for self-assessment of sleep over a one-week period at baseline, and after three and six months of the respective interventions. Results: The Yoga group showed a significant decrease in the time taken to fall asleep (approximate group average decrease: 10 min, P<0.05), an increase in the total number of hours slept (approximate group average increase: 60 min, P< 0.05) and in the feeling of being rested in the morning based on a rating scale (P<0.05) after six months. The other groups showed no significant change. Interpretation & Conclusion: Yoga practice improved different aspects of sleep in a geriatric population. Mason, L. I., C. N. Alexander, F. T. Travis, G. Marsh, D. W. Orme -Johnson, J. Gackenbach, D. C. Mason, M. Rainforth, and K. G. Walton. Electrophysiological correlates of higher states of consciousness during sleep in long-term practitioners of the Transcendental Meditation program. Sleep, Feb 1997, 20(2):102-110. PMID: 9143069. Abstract: Standard ambulatory night sleep electroencephalograph (EEG) of 11 long-term practitioners of the Transcendental Meditation (TM) program reporting higher states of consciousness during sleep (the experimental group) was compared to that of nine short-term practit ioners and 11 non-practitioners. EEG tracings during stages 3 and 4 sleep showed the experimental group to have: 1) theta-alpha activity simultaneously with delta activity and 2) decreased chin electro-myograph (EMG) during deep sleep (p = 0.002) compared to short-term practitioners. Spectral analysis fast Fourier transform (FFT) data of the first three cycles showed that: 3) the experimental subjects had significantly greater theta 2 (6-8 Hz)-alpha 1 (8-10 Hz) relative power during stages 3 and 4 than the combined control groups [t(30) = 5.5, p = 0.0000008] with no difference in time in delta; 4) there was a graded difference across groups during stages 3 and 4 in theta 2-alpha 1 power, with experimentals having greater power than short-term practitioners, who in turn had greater power than non-practitioners [t(30) = 5.08, p = 0.00002]; and 5) experimentals also had increased rapid eye movement (REM) density during REM periods compared to short-term practitioners (p = 0.04). Previous studies have found increased theta-alpha EEG activ ity during reported periods of transcendental consciousness during the TM technique. In the Vedic tradition, as described by Maharishi Mahesh Yogi, transcendental consciousness is the first of a sequence of higher states. The maintenance of transcendental consciousness along with deep sleep is said to be a distinctive criterion of further, stabilized higher states of consciousness. The findings of this study are interpreted as physiological support for this model. Meditation: Lets sleep on it. Science News, 24 Jan 1976, 109:54. Briefly surveys studies comparing TM and sleep. Mehta, Silva, Mira, and Shyam. Insomnia. In Silva, Mira, and Shyam Mehta, Yoga: The Iyengar Way. New York: Alfred A. Knopf, 1992, p. 186.

Meirsman, Jan M . R. Neuro-physiological order in the REM sleep of participants of the Transcendental Meditation and TM-Sidhi program. Lucidity Letter, 9(2). Abstract available online: http://www.sawka.com/spiritwatch/neurophy.htm. Miskiman, Donald E. The effect of the Transcendental Meditation program on compensatory paradoxical sleep. In David W. Orme-Johnson, and John T. Farrow, eds., Scientific Research on the Transcendental Meditation Program: Collected Papers, Volume I. Maharishi European Research University Press, 1976, pp. 292-295. ___________. Long-term effects of the Transcendental Meditation program in the treatment of insomnia. In David W. Orme-Johnson, and John T. Farrow, eds., Scientific Research on the Transcendental Meditation Program: Collected Papers, Volume I. Maharishi European Research University Press, 1976, p. 299. ___________. The treatment of insomnia by the Transcendental Meditation program. In David W. Orme-Johnson, and John T. Farrow, eds., Scientific Research on the Transcendental Meditation Program: Collected Papers, Volume I. Maharishi European Research University Press, 1976, pp. 296-298. Monro, R., R. Nagarathna, and H. R. Nagendra. Insomnia. In R. Monro, R. Nagarathna, and H. R. Nagendra, Yoga for Common Ailments. New York/London: Simon & Schuster, 1990, p. 56. Murthy, H. S. Keshava. Insomnia. In H. R. Nagendra, R. Ragarathna, and S. Telles, Yoga Research & Applications: Proceedings of the 5 th International Conference on Frontiers in Yoga Research and Applications. Bangalore, Vivekananda Kendra Yoga Research Foundation, 2000, pp. 225-226 Muzumdar, S. Insomnia. In S. Muzumdar, Healthy Middle -Age Through Yoga. Bombay, India: Jaico Publishing, 1960, 1993, p. 159. Naveen, K. V., and S. Telles. Sensory perception during sleep and meditation: common features and differences. Perceptual Motor Skills, Jun 2003, 96(3 Pt 1):810-811. PMID: 12831256. Abstract: Sleep and meditation are both physiological conditions in which peripheral sensory input is voluntarily reduced, but sensory perception of internally generated information continues. . . . the two conditions differ in the level of awareness retained. NIH Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia. Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. Journal of the American Medical Association, 1996, 276:313-318.

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Oki, Masahiro. Sleep problems: Snoring and grinding of the teeth; Insomnia. In Masahiro Oki, Healing Yourself Through Okido Yoga. Tokyo: Japan Publications, 1977, pp. 71-74; 81-84. ___________. Insomnia. In Masahiro Oki, Zen Yoga Therapy. Tokyo: Japan Publications,
1979, pp. 58-72. Osborne, Sally Eauclaire. Yoga for a good nights sleep. Yoga Journal, Mar/Apr 2000. Article available online: http://www.yogajournal.com/health/122_1.cfm. If insomnia is keeping you up at night, try a few relaxing poses before bedtime. Osho . Insomnia: Unwinding the mind. YOGAChicago, Sep-Oct 2002, pp. 12-14.

Excerpted from From Medication to Meditation (C. W. Daniel). Available from www.osho.com. Pagano, Robert R., Richard M. Rose, Robert M. Stivers, and Stephen Warrenburg. Sleep during Transcendental Meditation. Science, 1976, 191: 308-310. Also in D. H. Shapiro, and R. N. Walsh, eds., Meditation: Classic and Contemporary Perspectives. New York: Aldine Publishing, 1984, pp. 527-531.
The range of states observed during sleep and meditation did not support the view that meditation produces a single unique state of consciousness. Paty, J., P. Brenot, C. Bensch, J. M. A. Faure, and J. D. Vincent. Electrophysiology of Transcendental Meditation: Contingent negative variation and evoked response studies. Was tentatively scheduled for inclusion in Scientific Research on the Transcendental Meditation Program: Collected Papers, Vol. 2. Rheinweiler, West Germany: Maharishi European Research University Press. The states induced by TM were shown to be different from that of sleep. Phelan, Nancy, and Michael Volin. Sleep. In Nancy Phelan and Michael Volin, Yoga for Women. New York: Harper & Row, 1963, pp. 71-73.

Polkinghorne, Thomas. Yoga and insomnia. The Llewellyn Journal, 22 Aug 2005.
Radha, Swami Sivananda. Realities of the Dreaming Mind. Seattle, Wash.: Timeless Books. From the publisher: Provides tools for developing a personally meaningful method of dream interpretation . . . thoroughly investigates prophetic dreams, dreams about past lives and dreams containing spiritual guidance. Using her own dream experiences, Swami Sivananda Radha provides practical tools to help you uncover the buried treasure of your subconscious mind. ___________. Dream Yoga. Ascent, Apr-Jun 1995, pp. 21-25.

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Ramalingam, K. K., and M. C. Smith. Simple treatment for snoring also a means of prediction of uvulopalatopharyngoplasty success? Journal of Laryngology and Otology, May 1990, 104(5):428-429. PMID: 2370474. Abstract: The old Indian literature describes a technique known as Sutra-Neti. That is, passing a catheter or similar material through the nose and out of the mouth as a means of clearing the airway. One of our patients adapted this method, tying the catheter end to end, in order to control his severe snoring and obstructive sleep apnea. This was effective for several months. He subsequently responded well to a uvulopalatopharyngoplasty. Raman, Dr. Krishna. The insomnia issue [for women]. In Dr. Krishna Raman, A Matter of Health: Integration of Yoga & Western Medicine for Prevention & Cure. Chennai (Madras), India: Eastwest Books, 1998, pp. 140-141. Ranade, Prof. Dr. Subhash, and Dr. Mrs. Sunanda Ranade. Insomnia. In Prof. Dr. Subhash Ranade and Dr. Mrs. Sunanda Ranade, Ayurveda and Yoga Therapy. Pune, India: Anmol Prakashan, 1995, pp. 87-88. Ravishankar, N. S. Insomnia . In N. S. Ravishankar, Yoga for Health: Curative Powers of Yogasanas. New Delhi: Pustak Mahal, 2001, pp. 158-159. Rawls, Eugene, and Eve Diskin. A yoga program for better sleep. In Eugene Rawls and Eve Diskin, Yoga for Beauty and Health . West Nyack, N.Y.: Parker Publishing, 1967, p. 228. Richmond, Sonya. Insomnia, neurasthenia and fatigue. In Sonya Richmond, How to be Healthy with Yoga. New York: Bell Publishing, 1962, pp. 34-43. Riddell, Hanna G. Falling blissfully asleep with Chin Mudra (or) lifting a finger to help oneself! Yoga Life, May 2002, 33(5):232. Rose, Tracy. No sweeter savasana than sleep. Article available online: http://www.practiceashtanga.com (click on Archived Articles). On insomnia. Saraswati, Paramahansa Satyananda. General psychological ailments (includes insomnia). In Paramahansa Satyananda Saraswati, Health Benefits of Inverted Asanas. Bihar, India: Bihar School of Yoga, 2d ed., 1992, p. 29. Satyananda Saraswati, Swami. [Yoga nidra for] insomnia. In Swami Satyananda, Yoga Nidra. 6th ed. Munger, Bihar, India: Yoga Publications Trust, 1998, p. 197. ___________. Sleep, dreams and yoga nidra. In Swami Satyananda, Yoga Nidra. 6th ed. Munger, Bihar, India: Yoga Publications Trust, 1998, pp. 169-178. ___________. The problem of sleep [and meditation]. In the article Antar Mounda, Yoga (Sivananda Math), Feb 2005, pp. 13-15.

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___________. Trataka and sleep. In The practice of trataka, Yoga (Sivananda Math), Mar 2005, pp. 7-18. Sausys, Antonio. Yoga for Insomnia workshop. Email: antonio@satyoga.com. From Antonio Sausys: Even though insomnia is a problem in itself, the consequences of sleep deprivation are what make this sleep pattern alteration a cause of concern. Amongst them: immune system depression, increased irritability, slowed down reaction time (increasing the likelihood of car crashes and other accidents), acceleration of the aging process and if carried to its ultimate consequences, death. This workshop offers a set of physical and breathing techniques intended to reduce tension levels and retrieve . . . awareness from the challenging matters that help raise them and induce sleep. In this 3 Hour Workshop, [participants] will receive: Theoretical information regarding insomnia, its causes and consequences; instruction regarding the practice and the necessary adjustments according to . . . ability and needs; a handout outlining the practice; a few other helpful tips. Shah, J. T. [Asanas for] Insomnia. In J. T. Shah, Therapeutic Yoga. Mumbai, India: Vakils, Feffer and Simons, 1999, pp. xviii, 10-11, 18-19, 42-43, 52-61, 64-65, 94-95, 98-103. Shapiro, Deane H., Jr. Overview: Clinical and physiological comparison of meditation and other self-control strategies. American Journal of Psychiatry, Mar 1982, 139:267-274. Provides a definition of meditation and then cites literature comparing meditation with such selfregulation strategies as biofeedback, hypnosis, and progressive relaxation. Includes a discussion of insomnia. Sharma, S. K., and Balmukand Singh. Mental disorders (includes poor sleep); Insomnia. In S. K. Sharma and Balmukand Singh, Yoga: A Guide to Healthy Living. New York: Barnes & Noble Books, 1998, p. 74; 77. Shealy, R. C. The effectiveness of various treatment techniques in different degrees and durations of sleep-onset insomnia. In Swami Satyananda Saraswati, Yoga Nidra. 6th ed. Munger, Bihar, India: Bihar School of Yoga, 1998. Shivananda Saraswati, Srimat Swami. Sleeplessness. In Srimat Swami Shivananda Saraswati, Yogic Therapy. 7th ed. Guwahati, Assam: Shivananda Math, 1994, pp. 306-308. Singhi, Sunita. Slip into sleep. Yoga International, Feb/Mar 2002, pp. 36-38. Sisley, R. C. The effects of sleep deprivation on the physiological changes induced by Transcendental Meditation. Postgraduate diploma in arts in psychology thesis, University of Otago, 1971. Sivananda, Swami. How to Get Sound Sleep. Tehri-Garhwal, U.P., Himalayas, India: The Divine Life Society, 2000.

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___________. Philosophy of Dreams. Tehri-Garhwal, U.P., Himalayas, India: The Divine Life Society, 2000. Contents: Songs of dream, Dream, Study of dream-state, Dream philosophy, Philosophy of dream, Who is it that dreams?, Lord creates dream objects, Prophetic dreams, Spiritual enlightenment through dreams, Waking as a dream, The unreality of imagination, Why Jagrat is a dream? Waking experience has relative reality, Waking experience is as false as dream experience, Jagrat is as unreal as dream, Remove the colouring of the mind, Upanishads and dreams, dream, The story of a dream Subhoda, Raja Janakas dream, Goudapadacharya on dreams, Sri Nimbarkacharya on dreams, Dream of Chuang Tze, Dream hints, Dream-symbols and their meanings Sovik, Rolf. Sleeping on the run. Yoga International, Feb/Mar 2002, pp. 40-43. Provides a yogic technique for working with exhaustion. Statistics. According to the latest annual survey conducted by the National Sleep Foundation in 2002, 74% of Americans have trouble sleeping at least a couple of nights a month. That figure is up 5% from the previous year. According to the Better Sleep Council in 2005, 62% of adults in the U.S. experienced a sleep problem a few nights per week or more during the past year. Stigsby, Bent, and Jennifer C. Rodenberg, and Hanne B. Moth. Electroencephalographic findings during mantra meditation (Transcendental Meditation): A controlled, quantitative study of experienced meditators. Electroencephalography and Clinical Neuro-pohysiology, Apr 1981, 51:434-442. The EEGs during TM were not different from those recorded during wakefulness and drowsiness, but clearly different from those recorded during sleep onset and sleep. Stewart, Mary. Insomnia. In Mary Stewart, Teach Yourself Yoga. Lincolnwood (Chicago), Ill.: NTC/Contemporary Publishing/London: Hodder Headline, 1998, p. 130. Surath, Sri. Remedies for some minor health problems as given in Hindu scriptures. In Sri Surath, Scientific Yoga for the Man of Today. Mountain Center, Calif.: Ranney Publications, 1971, pp. 141-142. (Includes remedies for sleeplessness.) Swami Vivekananda Yoga Research Foundation. Yoga for Anxiety/Depression/Insomnia preconference workshop. 10th International Conference on Yoga for Positive Health, Tampa, Florida, 11 Dec 2000. Taylor, Louise, and Betty Bryant. The heart meridian; The governing vessel (the great central meridianback). In Louise Taylor and Betty Bryant, Acupressure, Yoga and You. NewYork/Tokyo: Japan Publications, 1984, pp. 59-64; 113-118. Tibetan Yoga Helps Cancer Patients to Sleep Better. URL: http://www.phayul.com/news/article.aspx?id=6597

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Researchers at The University of Texas M. D. Anderson Cancer Center found Tibetan Yogas combination of movement and meditation led to a significant sleep improvement for cancer patients. Reported in the April 15 online issue of the journal Cancer, lymphoma patients who practiced Tibetan Yoga for seven weeks went to sleep faster, slept longer, had better overall sleep quality, and used less sleep medication than the control group. There were, however, no differences between the groups in other quality-of-life measures, including anxiety, depression, and fatigue. The studys lead author, Lorenzo Cohen, Ph.D., an associate professor in the Departments of Behavioral Science and Palliative Care & Rehabilitation Medicine, and director of the Integrative Medicine Program at M. D. Anderson Cancer Center, says the reason for the latter is likely the studys short duration, as these techniques usually need to be practiced for at least six months before benefits are seen. Cohen states, The objective of using Yoga in patients who have been, or are being, treated for cancer is not necessarily to increase length of life, but to improve the quality of life. In cancer patients, fatigue is not necessarily directly related to the quality of sleep but given such a small study, the fact that sleep was improved suggests that the health effects of Yoga should be further explored. Two Tibetan practices in particular, Tsa lung and Trul khor, incorporate controlled breathing and visualization, mindfulness techniques, and postures. Because the movements of Tibetan Yoga are gentle and simple and incorporate the latter elements, Cohen believes this form of Yoga may be particularly useful for patients undergoing and recovering from chemotherapy. Cohen and his colleagues are continuing to study Tibetan Yogas effects in cancer patients. One in-progress study in breast cancer patients is examining the effects on stress hormone levels and immune function. Tooley, G. A., S. M. Armstrong, T. R. Norman, and A. Sali. Acute increases in night-time plasma melatonin levels following a period of meditation. Biological Psychology, May 2000, 53(1):69-78. Author email: greggo@deakin.edu.au. PMID: 0010876066. Abstract: To determine whether a period of meditation could influence melatonin levels, two groups of meditators were tested in a repeated measures design for changes in plasma melatonin levels at midnight. Experienced meditators practicing either TM-Sidhi or another internationally well known form of yoga showed significantly higher plasma melatonin levels in the period immediately following meditation compared with the same period at the same time on a control night. It is concluded that meditation, at least in the two forms studied here, can affect plasma melatonin levels. It remains to be determined whether this is achieved through decreased hepatic metabolism of the hormone or via a direct effect on pineal physiology. Either way, facilitation of higher physiological melatonin levels at appropriate times of day might be one avenue through which the claimed health promoting effects of meditation occur. Van Houten, Peter, and Rich (Gyandev) McCord. Yoga Therapy for Overcoming Insomnia. Nevada City, Calif.: Crystal Clarity, 2005. Reviewed by sleep researcher and Kundalini Yoga teacher Sat Bir Singh Khalsa, Ph.D., in the 2005 issue of the International Journal of Yoga Therapy. Vilga, Edward. Yoga in Bed: 20 Asanas to Do in Pajamas.. Running Press, 2005. Voelker, Lakshmi. [Mudra for insomnia]. Available online: http://www.vicus.com/news_views/print_story/1,1213,10003,00.html.

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Wachsmuth, D. Zur Psycho-Physiologie ruhevoller Wachheit, EEG und subjektives psychologisches Befinden whrend der Ausbund der TM im Vergleich mit den Schlafstadien dierselben Versuchspersonen [The psychophysiology of EEG and subjective psychological health during the practice of TM in comparison with sleep states of the same]. Ph.D. dissertation, Johann Wolfgang Goethe Universitt, Frankfurt, West Germany, 1978. Was tentatively scheduled for inclusion in Scientific Research on the Transcendental Meditation Program: Collected Papers, Vol. 2. Rheinweiler, West Germany: Maharishi European Research University Press. An analysis of the EEG and EKG patterns during TM, waking, and sleep states for five meditators showing unique neuron-physiological functioning. ___________, T. Dolce, and K. Offenloch. Computerized analysis of the EEG during Transcendental Meditation and sleep. EEG & Clin Neurophysiol, 1980, 48:3,39. Walsh, Laura. Low-income patients beating stress with yoga, meditation class. Worcester Telegram & Gazette, 3 Dec 2004. Article available online: http://www.telegram.com/apps/pbcs.dll/article?AID=/20041203/APN/412030790. Hes a Vietnam vet who wears clunky metal rings on nearly every finger and builds computers for fun, but lately the only place David Wilson wants to be is on his yoga mat. The 50-year-old is homeless, struggles with post-traumatic stress disorder and has chronic pain in his neck and back. And until recently, a good nights sleep meant just two hours of solid snooze time. But since enrolling in a stress reduction class at the Middletown Community Health Center, Wilson says hes finally sleeping through the night. Through yoga and meditation sessions, he is controlling his pain and has learned to focus his breathing . . . Weller, Stella. Insomnia. In Stella Weller, Yoga Therapy. London: Thorsons, 1995, p. 114. West, Michael A. Meditation. British Journal of Psychiatry, Nov 1979, 135:457-467. A literature review covering the psycho-physiological correlates of meditation . . . and the use of meditation as a therapy in psychiatric units in cases of drug addiction, insomnia, and hypertension. Widdowson, Rosalind. Insomnia. In Rosalind Widdowson, The Joy of Yoga. Garden City, N.Y.: Doubleday and Co., 1983, p. 27. Woolfolk, R. L., Lucille Carr-Kaffashan, Terrence F. McNulty, and Paul M. Lehrer. Meditation training as a treatment for insomnia. Behavior Therapy, May 1976, 7(3):359-365. Both meditation and Progressive Relaxation give pronounced improvements measured by the time necessary to fall asleep for insomnia patients compared to untreated control group. Yee, Rodney. The Art of Breath and Relaxation. Two audiocassette set available from Living Arts, 800-254-8464. These restorative exercises . . . help . . . improve sleep.

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Yoga Biomedical Trust Survey. Statistics on insomnia and Yoga. Number of cases: 542; percent claiming benefit: 82%. See http://urt.org/recovery.html. ___________. Insomnia classes. URL: http://freespace.virgin.net/yogabio.med/ (click on Yoga Therapy & How to Try It, then click on Index-Alphabetical, then click on Insomnia). Yoga improves sleep among the aged. 9 Jun 2005. Article available online: http://us.rediff.com/news/2005/jun/09yoga.htm. Yoga can help older people have a sound sleep, a new study has found. The study was conducted among 69 older people, over 60 years of age, residing in a home for the aged in Bangalore. The results of the study suggest that the practice of yoga, which includes physical activity, relaxation and inputs on emotional stability, improved sleep and increased the feeling of being refreshed upon waking among the aged, scientists at the Swami Vivekananda Yoga Research Foundation, Bangalore, said. The old people were divided into three groupsyoga, ayurveda and no intervention. The assessment was done after three and six months of interventions. In the yoga group, the time taken to fall asleep was reduced significantly at three and six months and the duration of sleep each night increased significantly at six months. Other groups showed no significant change, N K Manjunath and Shirley Telles reported in the Indian Journal of Medical Research. Older adults spend more time in bed relative to time spent asleep. This is due to the longer time taken to fall asleep, a longer period of wakefulness during the night and time spent lying awake before rising in the morning, they said. It is well-recognized that the function of sleep in everyday life is crucial to an individuals sense of well-being, with a strong relationship between the quality of sleep and psychological symptoms, they said. Yoga Nidra and sleep. Bindu, no. 11, p. 25. Available online: http://www.scandyoga.org/english/bindu/27e_use.html. Younger, Joel, Wayne Adriance, and Ralph J. Berger. Sleep during TM. Perceptual and Motor Skills, Jun 1975, 40(3): 953-954. Six of the eight subjects spent considerable portions of their meditation periods in unambiguous physiological sleep.

Of Related Interest
Ancoli-Israel, Sonia. Sleep is not tangible or what the Hebrew tradition has to say about sleep. Psychosomatic Medicine, 2001, 63:778-787. Author email: sancoliisrael@ucsd.edu.

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Abstract: Much of what is known about sleep disorders has been uncovered in the last forty years. As scientists, we consider these discoveries to be landmarks. Yet there is a tremendous amount of information written about sleep in the Bible and its commentaries. Sleep, and even sleep disorders, are referred to in many instances and can be directly interpreted by what we know today. Our forefathers and foremothers generally viewed sleep as both pleasant and necessary and were aware that sleep was not one continuous stage. They referred to the function of sleep as being restorative. They deplored sleep deprivation, believing that it impaired life. They felt that excessive sleepiness was harmful. They understood that insomnia could be caused by stress and anxiety and by excessive alcohol, and that physical activity (exercise) and drinking milk could improve sleep. They suggested cures for insomnia, including some of the ideas included in todays sleep hygiene rules. They understood that there was a rhythm or timing to sleep. They even understood that it is easier to delay the circadian rhythm that to advance it. Although naps are not recommended, they sometimes took naps in the afternoon, but suggested just how long that nap should lastabout one-half hour. And they knew that with age, although sleep is advanced, healthy elderly do not have difficulty sleeping. Although we think we have discovered many new features about sleep disorders, much of what we know today was suggested thousands of years ago and documented in the Bible and the Talmud. Associated Press. Theres trouble in slumber-land for Americans, survey shows. 27 Mar 2001. Available online: http://www.healthcentral.com/news/newsfulltext.cfm?ID=50446&src=n1. Americans are sleep-deprived workaholics, with only about a third sleeping the recommended eight hours a night, and about 40 percent say they have trouble staying awake on the job, according to a poll released Tuesday. Frawley, David. Ayurvedic view of dream and sleep, parts 1 and 2. Ayurveda Today, Winter 1991 and Spring 1992. Kripke, Daniel F. Sleep and mortality. Psychosomatic Medicine, 2003, 65:74. Nesarji, Manoj. Anindra (insomnia) and its Ayurvedic management. AyurvedaNews, 11 Mar 2002. Article available online: http://chakrapaniayurveda.com/news/march202.html. Morin, C. M., J. P. Culbert, and S. M. Schwartz. Non-pharmacological interventions for insomnia: A meta-analysis of treatment efficacy. American Journal of Psychiatry, Aug 1994, 151(8):1172-1180. PMID: 8037252. Abstract: OBJECTIVE: Because of the role of psychological factors in insomnia, the shortcomings of hypnotic medications, and patients greater acceptance of non-pharmacological treatments for insomnia, the authors conducted a meta-analysis to examine the efficacy and durability of psychological treatments for the clinical management of chronic insomnia. METHOD: A total of 59 treatment outcome studies, involving 2,102 patients, were selected for review on the basis of the following criteria: 1) the primary target problem was sleep-onset, maintenance, or mixed insomnia, 2) the treatment was non-pharmacological, 3) the study used a group design, and 4) the outcome measures included sleep-onset latency, time awake after sleep onset, number of nighttime awakenings, or total sleep time. RESULTS: Psychological interventions, averaging 5.0 hours of therapy time, produced reliable changes in two of the four sleep measures examined. The average effect sizes (i.e., z scores) were 0.88 for sleep latency and 0.65 for time awake after sleep onset. These results indicate that patients with insomnia were better off after treatment than 81% and 74% of untreated control subjects in terms of sleep induction and sleep maintenance, respectively. Stimulus control and sleep restriction were the

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most effective single therapy procedures, whereas sleep hygiene education was not effective when used alone. Clinical improvements seen at treatment completion were well maintained at follow-ups averaging 6 months in duration. CONCLUSIONS: The findings indicate that nonpharmacological interventions produce reliable and durable changes in the sleep patterns of patients with chronic insomnia. ___________, Sylvie Rodrigue, and Hans Ivers. Role of stress, arousal, and coping skills in primary insomnia. Psychosomatic Medicine, 2003, 65:259-267. Author email: cmorin@psy.ulaval.ca. Abstract: OBJECTIVE: Although stress is often presumed to cause sleep disturbances, little research has documented the role of stressful life events in primary insomnia. The present study examined the relationship of stress and coping skills, and the potential mediating role of pre-sleep arousal, to sleep patterns in good sleepers and insomnia sufferers. METHODS: The sample was composed of 67 participants (38 women, 29 men; mean age, 39.6 years), 40 individuals with insomnia and 27 good sleepers. Subjects completed prospective, daily measures of stressful events, pre-sleep arousal, and sleep for 21 consecutive days. In addition, they completed several retrospective and global measures of depression, anxiety, stressful life events, and coping skills. RESULTS: The results showed that poor and good sleepers reported equivalent numbers of minor stressful life events. However, insomniacs rated both the impact of daily minor stressors and the intensity of major negative life events higher than did good sleepers. In addition, insomniacs perceived their lives as more stressful, relied more on emotion-oriented coping strategies, and reported greater pre-sleep arousal than good sleepers. Prospective daily data showed significant relationships between daytime stress and nighttime sleep, but pre-sleep arousal and coping skills played an important mediating role. CONCLUSIONS: The findings suggest that the appraisal of stressors and the perceived lack of control over stressful events, rather than the number of stressful events per se, enhance the vulnerability to insomnia. Arousal and coping skills play an important mediating role between stress and sleep. The main implication of these results is that insomnia treatments should incorporate clinical methods designed to teach effective stress appraisal and coping skills. Murtagh, D. R., and K. M. Greenwood. Identifying effective psychological treatments for insomnia: A meta-analysis. Journal of Consulting and Clinical Psychology, Feb 1995, 63(1):7989. PMID: 7896994. Abstract: Insomnia is a debilitating and widespread complaint. Concern over the iatrogenic effects of pharmacological therapies has led to the development of several psychological treatments for insomnia. To clarify the effects of these treatments, 66 outcome studies representing 139 treatment groups were included in a meta-analysis. The results indicated that psychological treatments produce considerable enhancement of both sleep patterns and the subjective experience of sleep. In terms of enhancing sleep onset, active treatments were all superior to placebo therapies but did not differ greatly in efficacy. Greater therapeutic gains were available for participants who were clinically referred and who were not regular users of sedative hypnotics. Future research directions are suggested. NIH Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia. Integration of behavioral and relaxation approaches into the treatment of chronic pain and insomnia. Journal of the American Medical Association, 1996, 276:313-318.

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Petit, Lyndal, Nahid Azad, Anna Byszewski, Francine F.-A. Sarazan, and Barbara Power. Non-pharmacological management of primary and secondary insomnia among older people: Review of assessment tools and treatments. Age and Ageing, 2003, 32(1):19-25. Abstract: Background: primary and secondary insomnia, especially among older adults, is frequently encountered by family physicians. Pharmacological interventions, although effective in some circumstances, can be detrimental in others. Non-pharmacological management of insomnia may allow the patients to self-administer the treatment. Objectives: review of published literature of assessment tools and treatments for primary and secondary insomnia. Results: two frequently used self-reporting methods for obtaining sleep data are sleep diaries and Pittsburg Sleep Quality Index. A large amount of research supports the use of non-pharmacologicaltreatments such as stimulus control, sleep restriction, sleep hygiene education, cognitive therapy, multi-component therapy and paradoxical intention. Conclusion: assessing the nature of insomnia by using an effective assessment tool and providing patients with a non-pharmacologicaltreatment should be the first intervention for insomnia. It is shown that non-pharmacological treatments for primary and secondary insomnia are feasible and effective alternatives to the use of benzodiazepines, and that family physicians should consider these when managing older patients with insomnia. Reuters Health. Stress hormones can interfere with sleep [in middle -aged men]. 1 May 2001. Article available online: http://www.healthcentral.com/news/newsfulltext.cfm?ID=52217&src=n1. (Summarizes research reported in Journal of Clinical Endocrinology and Metabolism, 2001, 86:1489-1495. See entry below for Alexandros N. Vgontzas et al.) Reuters Health. Lack of sleep increases diabetes risk. Philadelphia: 26 Jun 2001. Article available online: http://www.healthcentral.com/news/newsfulltext.cfm?ID=55033&src=n1. ___________. Insomniacs have hyperactive stress system. New York: Reuters Health, 16 Aug 2001. Article available online: http://www.healthcentral.com/news/newsfulltext.cfm?ID=57525&src=n1. Tetley, Michael. Instinctive sleeping and resting postures: An anthropological and zoological approach to treatment of low back and joint pain. British Medical Journal, 23-30 Dec 2000, 321:1616-1618. Vgontzas, Alexandros N., Edward O. Bixler, Annmarie M. Wittman, Keith Zachman, Hung-Mo Lin, Antonio Vela-Bueno, Anthony Kales and George P. Chrousos. Middle-aged men show higher sensitivity of sleep to the arousing effects of corticotropin-releasing hormone than young men: Clinical implications. Journal of Clinical Endocrinology and Metabolism, Apr 2001, 86:1489-1495. Author email (Alexandros Vgontzas, M.D.): axv3@psu.edu. Abstract: The prevalence of insomnia associated with emotional stress increases markedly in middle-age. Both the top and end hormones of the hypothalamic -pituitary-adrenal axis, i.e. CRH and glucocorticoids, stimulate arousal/wakefulness and inhibit slow wave (deep) sleep in experimental animals and man. The objective of this study was to test the hypothesis that middle age is characterized by increased sensitivity to the sleep-disturbing effects of the hypothalamic pituitary-adrenal axis . . . We conclude that middle -aged men show increased vulnerability of sleep to stress hormones, possibly resulting in impairments in the quality of sleep during periods of stress. We suggest that changes in sleep physiology associated with middle -age play a significant role in the marked increase of prevalence of insomnia in middle -age. [The authors

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recommend Yoga for stress reduction.]

IAYT Members Specializing in Yoga Therapy for Sleep Disorders

Caroline Schairer, R.N., M.S.N., C.M.H. Milford, MI chsmith@botsford.org

Ongoing Research Sat Bir Singh Khalsa, Ph.D.

Division of Sleep Medicine, BWH Harvard Medical School 221 Longwood Avenue Boston, MA 02115 617-732-7994 khalsa@hms.harvard.edu URL: http://www.clinicaltrials.gov/show/NCT00033865 Dr. Khalsa began an NIH-funded (NCCAM) research study evaluating the effectiveness of a Kundalini-Yoga treatment for insomnia at Brigham and Womens Hospital, Harvard Medical School, in Spring 2001. For information on Dr. Singhs pilot study, see the article above by Alanna Fincke. Further details: Insomnia is a sleep disorder characterized by a chronic difficulty in initiating and maintaining sleep which has a relatively high prevalence and a significant socioeconomic cost. There is good evidence that cognitive and/or physiological arousal, associated with sustained sympathetic activation, is one of the underlying causes of insomnia. Relaxation treatments such as progressive relaxation and meditation which address the cognitive and somatic arousal associated with insomnia have been found to be effective. Yoga is a comprehensive discipline which includes physical exercises, postures, breathing techniques, and meditation, for the purpose of improving health and well being. Research studies have documented the effectiveness of yoga in reducing sympathetic activation and cognitive and somatic arousal and in the treatment of specific medical disorders. Although it has been used and recommended for the treatment of insomnia, its effectiveness has not been evaluated in a randomized, controlled study. The aim of this proposal is to evaluate the effectiveness of yoga, relaxation exercises or sleep hygiene in the treatment of chronic psycho-physiological insomnia. A subjective measure of sleep onset latency will be derived from daily sleep diaries, and an objective measure will be drawn from polysomnographic recordings. Sleep onset latency will be evaluated before and after a two month treatment period in a total of 48 young men and women who have been carefully screened for psychiatric and medical disorders. Subjects will be assigned to a yoga, relaxation exercise, or sleep hygiene treatment group. We anticipate that yoga practice will prove to be an effective treatment for insomnia which will yield significant improvements in sleep onset latency. We also anticipate that these improvements will be maintained at long-term follow up evaluation.

Gabriel Jaraba
Institute for Transpersonal Psychology Barcelona, Spain gjaraba.k@tvcatalunya.com

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34 93 499 93 33 Yoga therapy applied to insomnia and sleep disease (with Dr. Eduard Estivill, Institute Dexeus, the main private hospital in Barcelona).

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