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

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, posttraumatic 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. Conclusion: Yoga nidra can be used as an important adjunct in management of chronic insomnia patients. Trial registration: CTRI/2013/05/003682 [Registered on: 27/05/2013] Trial Registered Retrospectively.