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Wednesday, February 25, 2015

Proof that Meditation Helps Improve Sleep

by Nina

The Hammock by Courbet
Yesterday morning I was excited to read a New York Times article Meditation for a Good Night's Sleep about a scientific study that demonstrated that meditation helps improve sleep in older adults. It’s not that this was such a big surprise to me. I’ve been saying for many years now that yoga can help improve your sleep by reducing your overall stress levels (see Yoga for Insomnia: Part 1 and Five Tips for Better Sleep). But it’s always great to have scientific proof to back up these claims. In the past, I was using a combination of two basic arguments to back up my claim: 1) a line of reasoning that because stress can cause insomnia and yoga can reduce stress, using yoga to reduce stress will improve sleep, and 2) using yoga to reduce chronic stress and trigger the Relaxation Response has helped me personally with improving my sleep. 

Now there is a study that was published in JAMA Internal Medicine Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances, in which 50 older adults with moderate sleep problems were assigned to one of two programs. In the first group, the participants learned sleep hygiene behavior (you know, all that stuff they always tell you—does it even work?—like establishing a regular bedtime routine, using your bed for sleep or sex only, etc.). In the second group, the participants took a six-week program on mindfulness meditation led by a certified teacher and practiced meditation “homework.”

The results after a yearlong study were that the participants who meditated had greater improvements in sleep quality and fewer symptoms of insomnia, depression, and fatigue than those who learned sleep hygiene practices. Now you may be wondering, as I did—especially because this study only included meditation and no any other yoga stress management practices—did the scientists conducting the study have ideas about why was the meditation practice so effective for improving sleep? According to the New York Times article: 

“The lead author of the study, David S. Black, said mindfulness meditation probably helped settle the brain’s arousal systems.”

Hmm. Are you thinking what I’m thinking? Is this “brain’s arousal systems” thing the same as chronic stress? I’ve been wondering about this anyway since I read the most typical form of insomnia, sleep maintenance insomnia, was caused by “hyperarousal disorder.” 

Here’s a technical explanation of the phenomenon from the National Institutes of Health:

Insomnia, the most frequently reported sleep disorder, is characterized as a state of hyperarousal in which stress is believed to activate the hypothalamic-pituitary-adrenal axis [41,85]. Vgontzas et al. demonstrated that, compared with healthy subjects, those with chronic insomnia had increased secretion of corticotropin and cortisol throughout the sleep-wake cycle [121]. 

Additionally, Nofzinger and colleagues, using positron emission tomography (PET) studies to assess regional cerebral glucose metabolism, demonstrated that insomnia also is associated with greater whole-brain metabolism during both sleep and wake periods and, notably, a failure of wake-promoting structures to deactivate during the transition from waking to sleep states [78]. Structures regulating the sleep-wake cycle, such as the brainstem, hypothalamus, and basal forebrain, are abnormally overactive during sleep. The ventral emotional neural system also is hyperactive during wakefulness in patients with primary insomnia and insomnia associated with depression, and this abnormal activity persists into NREM sleep [77]. These PET findings of whole brain hypermetabolism during sleep and wake states, and reduced waking metabolism in the prefrontal cortex of patients with insomnia, suggest that they have chronic insufficient sleep, which may explain daytime symptoms of fatigue [78]. The results also may explain why cognitive factors (eg, worry) and environmental cues (eg, light exposure and unstable sleep schedules) perpetuate insomnia.

So, yes, stress is believed to cause hyperarousal because high levels of stress hormones are detected in the hyperarousal state, and, also, interestingly, cognitive factors, such as worrying, can perpetuate the condition. In Timothy McCall’s Yoga As Medicine, Roger Cole describes hyperarousal in simple English:

“Your nervous system is just turned on too high, the sympathetic nervous system is active, the brain circuits that keep you awake are active, and you can’t stop thinking.”

So “settle the brain’s arousal systems” really is the same thing as my number one tip in my post Five Tips for Better Sleep

1. Reduce your overall stress levels. Because insomnia is often caused by chronic stress, regularly practicing conscious relaxation or calming yoga poses can help prevent the busy mind and over-stimulated nervous system that is keeping you awake at night. See The Relaxation Response and Yoga, Yoga for Insomnia: Part 1 and Conscious Relaxation vs. Sleep for information. 

Well, that’s your science lesson for the day. But your takeaway should be exactly what I told Paul Weston (the fictional character on the TV show “In Treatment”) in my post Yoga for Insomnia: Part 1 that if you’re having trouble sleeping, you should give yoga stress management techniques a try. And while mindful meditation, which triggers the Relaxation Response, has been now been proven by a scientific study to be successful at helping people improve their sleep, I have a strong feeling any of the other techniques we have been recommending—all of which have the same effect on your nervous system as meditation—will be equally effective. 

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