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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Insomnia Solutions: Yoga You Can Do in Bed (Rerun)

by Nina

Patterns in a French Garden by Brad Gibson

Did I say “in bed? Yep. It’s normally not a good idea to fall asleep when you are doing yoga (you can overstretch your muscles if you fall asleep in a restorative pose and if you’re practicing conscious relaxation, well, being unconscious pretty much negates the positive effects you’re aiming for). However, there is one exception to this rule of thumb: when you’re lying in bed sleepless due to insomnia.

Whether you have trouble falling asleep initially or can’t fall back to sleep after waking in the middle of the night, instead of working on your To Do list (it’s tempting, I know), try a little yoga. There are a number of yoga practices that just might help you relax enough to finally drift off to sleep and/or improve the quality of your sleep. While practicing any of these techniques, be sure to stay warm and keep the lights off to keep stimulation down to a minimum.

Breath Awareness. This is the simplest yogic breath practice and one of the most basic forms of meditation. Simply bring your awareness to the sensations of your natural inhalations and exhalations. When you notice your mind wandering to your To Do list or elsewhere, gently return your mind to your breath.

Extending Your Exhalation. After observing your natural breath for a few minutes, you can try extending your exhalation (while inhalations are slightly stimulating, exhalations are naturally relaxing). When you reach the end of your exhalation, instead of immediately inhaling, lengthen your inhalation by one or two beats. Keep it relaxed, and if at any point you find the practice irritating, return to your natural breath.

Silently Reciting a Mantra. Just as you would when you are meditating, you can use a silent mantra or any word or phrase in bed to keep your mind from drifting into anxious thoughts. This is helpful for those of you who don’t find focusing on the breath effective (or when you have a cold!). When you notice your mind wandering from your mantra to your To Do list or elsewhere, gently return your mind to your mantra.

Guided Relaxation. Following the instructions for a guided physical relaxation (see here), with or without ear phones, allows you to focus your mind on a soothing voice and your physical sensations, enabling some people to drift off to sleep.

Self-Guided Relaxation. When you are familiar with the basic instructions for deep physical relaxation, it’s simple enough to skip the relaxation track and just gradually relax your body by following your own instructions. Many years ago, my first yoga teacher recommended this as insomnia practice.

Slight Inversion. Take the pillow out from under your head and lie on your back with your knees bent. Lift your pelvis up and place the pillow underneath it. You’re now in a very low version of Supported Bridge pose, a gentle inversion that naturally triggers the relaxation response. Try to stay in the position for five to ten minutes.

Supported Forward Bend. If you sleep alone or aren’t worried about disturbing your partner and you find forward bends soothing, you could try a supported bend in your bed. Sit with your legs straight or in crossed-legs position (whichever is more comfortable and allows a deeper forward bend) and place a stack of pillows on top of your straight legs or in front of your crossed legs. Then lengthen your spine forward and rest your forehead and arms on the pillow and relax. Try to stay at least three minutes. If you can’t get comfortable in the pose, then this one isn’t for you.

If you suffer from insomnia, I sincerely hope you’ll find something on this list that will help. Most of these are techniques are ones I’ve found useful myself (I'm a bit too lazy to sit up and try an actual pose, however). Readers, if you have any additional suggestions, please chime in!

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Never go to bed angry

by Nina

Santa Barbara Botanical Gardens: A Detail by Joan Webster

On Tuesday I read a short little piece in the NY Times questioning the adage “Never go to bed angry” (see here). It was one of those bottom line pieces, and the bottom line was this:

“Going to sleep upset or disturbed preserves the emotion, research suggests.”

In the cited study in The Journal of Neuroscience, scientists exposed 106 men and women to images that elicited various emotions. In some cases the emotions were negative and in other cases the emotions were positive or neutral. The researchers then looked at what happened 12 hours later when the subjects were shown both new images and the previous ones, either in the morning after a night of sleep, or at the end of a full day of wakefulness. The conclusion was:

“The scientists found that staying awake blunted the emotional response to seeing the upsetting images again. But when the subjects were shown the disturbing images after a night of sleep, their response was just as strong as when they had first seen them—suggesting that sleep “protected” the emotional response.”

That doesn’t sound good, does it? Going to bed angry and waking up angry is not only an unpleasant experience for you, but it probably doesn’t enhance your relationships with the people around you. Besides, it's also not a good idea to go to bed angry if you are concerned about getting a good night's sleep. Your stress levels will be high and your sleep, if you can sleep, will be restless—maybe filled with upsetting dreams—and you won’t feel rested in the morning.

But very probably you—unlike the people in the study—can’t just put away an “upsetting image” when you are very angry. In fact, the chances are you’ll keep having one angry thought after another, and with each angry thought you’ll get another jolt of adrenaline (that’s why they call it the “fight or flight response,” people), keeping your stress levels as high as they were before.

The good news is that Baxter says it takes only about 90 seconds to clear the adrenaline released in your system by an angry thought if you switch to a more neutral topic. So to put away your anger, he recommends a structured breath practice, in which you measure your inhalations and exhalations, and count your breaths to engage your mind. If you combine this type of breath practice with a supported inversion (such as Legs Up the Wall pose) or a supported forward bend (if you find those soothing), both of which help switch your nervous system to relaxation mode, you’ll get a double dose of calm.

You could also use a guided relaxation (see here) as a way to engage your mind and relax your nervous system at the same time.

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5 Tips for Better Sleep

by Nina

Field of Tulips by Melina Meza

I recently read a very disappointing list of same-old, same-old tips for better sleep. You know, don’t use your bedroom for anything but sex or sleep, light candles, take supplements, blah, blah, blah—does that stuff even work?—and nothing at all about addressing the root causes of insomnia. And I thought, really I could do a lot better than that. So here goes:

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. 

2. Plan your day. What you do in the hours before bed can affect your state when you get into bed. So schedule your stimulating activities, including aerobic exercise and strong yoga practices, such as flow practices, standing poses and backbends, for earlier in the day. (Of course, you don’t want to be watching an action film in the late evening, either.) Start to wind down before bed with calming practices, such as restorative yoga or meditating, so you’re in a relaxed state when you get into bed. See Day to Night for information.

3. Get comfortable. Physical pain or discomfort can keep you awake, so think about your sleeping position the same way you would about a yoga pose. Use “props” in bed, such as extra pillows, towels, and so on, to help get more comfortable. If you are having back problems, sleeping on your tummy can overarch your lower back, exacerbating back problems. You could try placing a folded blanket or towel under your lower abdomen to see if that helps, or, even better, sleep on your back instead with a pillow under your knees. If you’re having neck problems, sleep on your side or back, rather than on your tummy. If you try sleeping on your side and find that your knees press together uncomfortably, place a pillow between your knees. If nocturnal leg cramps are keeping you awake, stretch your legs before bed (see Nocturnal Leg Cramps and Yoga). 

4. Practice yoga in bed. Sometimes just getting into bed—even if you’ve been relaxing beforehand—can trigger worries about your life or fear about falling asleep. Instead of letting your mind race, try your favorite relaxation practice while you’re falling asleep (in this case, it’s okay if you fall asleep while you’re relaxing) You could practice a guided relaxation or yoga nidra (by listening to an audio recording or just talking yourself through it) or even do a restorative yoga pose, such as Child’s pose, with a mental focus to calm yourself down. See Yoga You Can Do in Bed and Yoga Tricks for Better Sleep for information.

5. Work with your breath. One of the easiest things you can do to calm yourself before you fall asleep or if you wake up in the middle of the night is to work with your breath. This moves your mind away from your worries onto a neutral subject and triggers the Relaxation Response, which will help you fall asleep more quickly and sleep more deeply. You can either practice simple breath awareness or work on gently lengthening your exhalation (see Yoga for Better Sleep). If you have trouble breathing because you have a cold or allergies, try working with a mantra (a phrase you repeat to yourself) of any kind instead. 

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Sleep, Alzheimer's Disease and Yoga

by Nina

Sun Behind Clouds by Melina Meza

One of the worst fears I think we all share about getting older is of developing dementia. Just recently I had a long phone conversation with a woman who is trying to deal with a mother in the early stages of Alzheimer’s Disease, and it was just so sad. I had some advice for her, but no solutions, of course. Then I heard a news piece on NPR “Brains Sweep Themselves Clean of Toxins During Sleep”  that gave me  glimmer of hope.

Scientists have been trying to figure out the purpose of sleep for a very long time. A recent study “Sleep Drives Metabolite Clearance from the Adult Brain”  published in Science Magazine, proposed a fascinating new theory. The team of researchers from the University of Rochester discovered that while the brain sleeps it clears out harmful toxins, a process that may reduce the risk of Alzheimer's. According to the NPR interview, during sleep, the flow of cerebrospinal fluid in the brain increases dramatically, washing away harmful waste proteins that build up between brain cells during waking hours. Professor of Neurosurgery and an author of the study, Dr. Maiken Nedergaard, said, "It's like a dishwasher."

The waste proteins getting washed away during sleep are toxic to brain cells, which could explain why we don't think clearly after a sleepless night and why a prolonged lack of sleep can actually kill an animal or a person. The results appear to offer the best explanation yet of why animals and people need sleep.

“Thus, the restorative function of sleep may be a consequence of the enhanced removal of potentially neurotoxic waste products that accumulate in the awake central nervous system.” Lulu Xie, et al.

Alzheimer's Disease researchers say this research could help explain a number of recent findings related to sleep and AD. Dr. Randall Bateman, Professor of Neurology  at Washington University said this about beta amyloid, which is the main component of certain deposits found in the brains of patients with Alzheimer's Disease.

"Beta amyloid concentrations continue to increase while a person is awake. And then after people go to sleep that concentration of beta amyloid decreases. This report provides a beautiful mechanism by which this may be happening.”

The team of scientists discovered the cleaning process while studying the brains of sleeping mice. Dr. Nedergaard said that during sleep the system that circulates cerebrospinal fluid through the brain and nervous system was "pumping fluid into the brain and removing fluid from the brain in a very rapid pace.” When the mice went to sleep, their brain cells actually shrank, making it easier for the fluid to circulate. But when the mice woke up, their brain cells enlarged again and the flow between cells slowed dramatically.

The researchers speculated that the reason the brain doesn’t do this cleaning all the time is because the cleaning uses a lot of energy, and it’s probably not possible for the brain both to clean itself and at the same time be aware of its surroundings, talk, move, and so on. So getting enough sleep—which we already know is vital for our physical and mental health—may be one key to preventing Alzheimer’s Disease as you age.

But what does all this have to do with yoga? Well, if you’re having trouble sleeping, yoga can help with that. Because insomnia is so often related to stress, yoga’s stress management techniques can help you quiet your nervous system so you fall asleep more quickly and sleep more soundly. For  information on how yoga can help you sleep better, see Yoga for Insomnia, Part 1, Day to Night: Yoga for Better Sleep, and Five Tips for Better Sleep. The Supported Inverted poses I wrote about recently (see All About Supported Inversions) are poses that I've found particularly helpful.

We’re so careful here at YFHA not to make any false promises and of course as this research is new, we can’t promise that getting enough sleep will definitely make a difference for you. But encouraging you to get a good night’s sleep can’t be harmful in any way, and if this gives you more motivation to practice stress management techniques, which are helpful for preventing a whole host of health problems, we’re doing you a favor. And if you'd like to add an additional practices to encourage brain health, start meditating on a regular basis (see Meditation and Brain Strength) and keep practicing your yoga asanas (see Yoga for Brain Health?). 

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Take Your Time: Results from Yoga Practice

by Nina

Horses Grazing by Brad Gibson

It's a running joke in our family that when Brad gets impatient with me—because I often do various household tasks a bit slower than he does—he says to me, "Take your time!" He swears that Bill Murray said this repeatedly in the movie Caddy Shack, but when we watched it again recently, no one actually ever uttered that line. Regardless, I always reply, "You take your time."

But many worthwhile things really do take time. For example, if you want to cook a really good meal instead of eating fast food, you need to shop for fresh ingredients and prepare everything from scratch. And if you want to turn a new acquaintance into a close friend, you need to spend a lot of time together, getting to know and trust each other. The same is true for seeing results from yoga practice. Obviously, one Downward-Facing Dog pose doesn't instantly make your arms stronger, though with regular practice, it definitely will increase your strength. And it also seems obvious that if you want to reduce your stress levels, you'll need to practice stress management regularly over a period of time.

So it was very interesting for me to hear about a recent study at the Feinberg School of Medicine, Northwestern University, that looked at the effect of exercise on insomnia. One of the findings as reported by Gretchen Reynolds in the New York Times post How Exercise Can Help Us Sleep Better was:

"After the first two months of their exercise program, the exercising volunteers (all of them women) were sleeping no better than at the start of the study. Only after four months of the program had their insomnia improved."

Yes, it took four whole months of regular exercising to bring improvements. That's quite a bit of time, don't you think? The women in this study were not practicing yoga for exercise, but it's likely that using yoga as a form of exercise to help with insomnia (something I definitely recommend) might take a similar amount of time. And it also makes sense to me that if you are practicing yoga for insomnia (see Yoga for Insomnia, Part 1) by using stress management techniques, you should also give that some time (though some people report that doing breath practices in the middle of the night produces immediate results). So be patient.

In general, the time you invest in your yoga practice—whether you are practicing for your physical health, your emotional health or both—is what brings the payoffs. After all, yoga sutra 1.14 tells us that equanimity is attained only through steady, dedicated, attentive practice:

Long, uninterrupted, alert practice is the firm foundation for restraining the fluctuations of the mind. —trans. by B.K.S. Iyengar 

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Ssshh! Falling Asleep the Way You Like To

by Nina

"The shoe that fits one person pinches another; there is no recipe for living that suits all cases." Carl Jung

I've had more than one person ask me the same question about my post recommending practicing breath awareness or pranayama in bed for insomnia (see Yoga for Better Sleep: Workshop and Tip). The question had to do with the position you should take while you are practicing in bed:

Was wondering whether this breath practice was to relax you enough so that you can then turn over and fall asleep or to fall asleep while doing this practice? If you are to fall asleep while doing the practice and you happen to be someone who cannot fall asleep laying on your back, do you then do the practice in the position that you fall asleep in?

The simple answer is: it's up to you! The description I provided of practicing on your back with your hands on your belly just happens to be the way I do it, at least most of the time. It was never meant as a prescription.

Although breath awareness and pranayama are typically taught either in seated positions or supine positions (on the back), in this case your aim—the opposite of that for a formal breath practice—is to fall asleep. So you will need to experiment to see what works best for you. Maybe you'll practice on your back until you feel ready to turn over and fall asleep. Or maybe you'll practice in your typical sleeping position and fall asleep while practicing. As it happens, I've also been taught to practice pranayama in supported Child's pose, feeling my breath in my back body, so practicing in a prone position (face down) even turns out to be legit!

Supported Child's Pose

Or, if you practice on your back, you might, to your own surprise, find yourself drifting off to sleep in that position, maybe even turning over in your sleep. (To be honest, I'm pretty sure I've done all these things, at one time or another.) And what works one night (or one month) may not work at another time, for any number of reasons, including physical ones, such as having a cold or a physical problem that requires a change in your sleep position.

The point is: Ssshh! It's dark, no one is looking, and you can do whatever you want!

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Yoga for Better Sleep: Workshop and Tip

by Nina

Cairns by Nina Zolotow

I don’t teach workshops very often, but when I do, I focus on topics I really care about. My upcoming workshop on Saturday April 6th, 2-5pm at Brentwood Yoga Center focuses on one of my favorite topics: Yoga for Better Sleep. (to register, go to http://brentwoodyogacenter.com/workshops ) This is topic is dear to my heart because, well, it’s something I have to practice myself on a regular basis. Even small amounts of stress can disrupt my ability to fall sleep or to sleep soundly (interestingly, that’s something that seems to run in my family). Fortunately I’ve learned a number of techniques both for reducing my stress levels in general and for lulling myself to sleep while I’m in bed. And my feeling about teaching these techniques to others is that if I’ve helped just one person to achieve better sleep, than I’ve been successful!

I’ve written about this topic in general on the blog (see Day to Night and Yoga for Insomnia, Part 1). But the other night as I was lying in bed not sleeping, I realized that if I had to choose one single technique above all the others, it would be the breath practice I turn to almost automatically these days. And I decided then and there I wanted to share it with you all.

For most of us, what is happening when we’re lying in bed sleepless is that our minds are churning, thinking about the day’s events, ruminating about the past or worrying about the future, which stimulates our nervous systems. Turning our minds to a neutral focus, such as the breath, allows us to let go—at least temporarily—of those disturbing thoughts and helps calm the nervous system, switching on the relaxation response. And in my case, after 10 to 20 minutes of breath practice, I almost always end up drifting back to sleep.

Start by practicing simple breath awareness. This means focusing your mind on how your breath moves in your body, perhaps on how your belly rises and falls with your breath or, if it’s easier, how your chest moves with your breath. You could also focus on the more subtle sensations, such as the feeling of your breath moving in and out or your nostrils or, if you prefer, the sound your breath makes in your body. I actually like to lie on my back with my hands on my  belly because that makes it very easy for me to feel the movement in my abdomen.

For some of you, this simple practice may be enough. For myself, I like to use a more structured technique of extending my exhalation. Extending the exhalation in particular helps calm the nervous system (your heart rate slows on your exhalation) but I also find it engages my mind more completely. To do this, when you reach the end of your exhalation, simply add a beat or two—without straining—before turning on to your inhalation. Keep it relaxed and easy. And if the practice aggravates you, simply return to your natural breath.

If at any point you realize your attention has wandered from your breath (it will, of course), simply—and without self judgment—bring your attention back to your breath.

I confess that, in addition to all that, I also count my breaths. I got the idea from Baxter who showed me a technique using your fingers that he learned when he studied at the Krishnamacharya Yoga Madiram. This really helps me keep my mind engaged, and when I start to really lose track of where I am, that’s when I’m starting to fall asleep. However, this may be, well, too anal for you. (Hey, I’m just trying to be honest about what I really do—and what really works for me.) Basically, you need to experiment and see what works for you. Maybe you’ll even come up with new variations. If whatever you are doing is working, then it’s right for you.

You can do this breath practice every night when you get into bed or just on those nights when you start to realize—it sometimes takes a while catch yourself—that you’re having trouble falling asleep or are wide awake in the middle of the night.

I have more tricks up my sleeve and hope to share them with some of you in person at my April workshop, but in the meantime, if I help just one person.....

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Day to Night: Yoga for Better Sleep

by Nina

Buddha in My Garden by Michele Macartney-Filgate

This morning I was talking with Bonnie Maeda, RN and Shari Ser, PT about the workshop we’re going to be teaching on yoga for sleep disorders at the Berkeley Yoga Room, Saturday, June 16, from 2 to 5 (see here for registration information). When I described my 24-hour approach to practicing yoga for better sleep to them, they were very enthusiastic. So I'm going to share it with you today.

Yes, yoga in general is relaxing, but some poses are more relaxing than others while some poses and practices are actually quite stimulating. So if you’re having trouble sleeping, I recommend you plan out your day regarding which poses you do when. I mean, if you’ve been suffering from insomnia, you wouldn’t drink a double espresso right before bed, would you? Standing poses, backbends and vinyasa flows can be almost as stimulating, so a strong practice including those poses done just before bed can keep you awake (trust me, I've tried it). But those poses help keep you strong and flexible, as well as reducing stress by releasing physical tension from your body, so you wouldn’t want to eliminate those poses entirely from your practice. On the other hand, there are relaxing practices you can do right in bed either before sleep or in the middle of the night that will help you fall asleep more quickly and sleep more deeply. Here's how to plan out your day:

Day Time
Getting exercise is important for improving your sleep. So during the day, walk, run, swim, cycle, or do a strong yoga practice that includes forceful, stimulating poses, including standing poses, backbends, twists, and/or Sun Salutations and vinyasa flows.

Early Evening
After work or in the early evening, if you’re up for practicing, it’s best to do poses and practices that calm your nervous system, such as forward bends, inverted poses, and restorative yoga. Meditation, Relaxation pose with a mental focus, and yoga nidra (yogic sleep) are also good stress reducers. If you want to use a guided relaxation, see the Relaxation Tracks tab on at the top of the blog. From this point on it’s best to avoid the simulating poses and practices.

Before Bed
Turn off the TV early or put your book down, and take some time before you get into bed for conscious relaxation. Switching your nervous system from fight or flight to relaxation mode before getting into bed will help you fall asleep more quickly and sleep more deeply. Supported inverted poses, such as Legs Up the Wall pose, Easy Inverted pose (see here), and Bridge pose with straight legs, will calm your nervous system. Some people also like to meditate or practice seated breath awareness before getting into bed.

In Bed
For people suffering from insomnia, just getting into bed can trigger a new bout of stress. If you find your thoughts are racing and you are worrying about falling asleep, you can practice a body scan (Relaxation pose with a mental focus), where you conscious relax various parts of your body. Or you can work with your breath, either practicing general breath awareness or any form of pranayama that lengthens or emphasizes the exhalation. Practicing conscious relaxation before falling asleep will help you sleep more deeply. See my post Yoga You Can Do In Bed for more information on yoga you can do before falling asleep.

In the Middle of the Night
All of us insomniacs are familiar with the terrible moment in the middle of the night when we realize we’re wide awake and the possibility of returning to sleep feels hopeless. However, the worst thing you can do is lie there worrying about not falling back to sleep. Instead, return to the same practices you do before falling asleep, such as Relaxation pose with a mental focus, breath awareness, or extending the exhalation. Although it takes some discipline to focus on these practices (for some reason, worrying seems so much easier in the middle of the night), many people, including me, find that 10 to 20 minutes of practice allows us to fall back into a deep sleep.

Some practitioners I know do soothing poses in the middle of the night, such as supported forward beds (in bed with pillows) or even Legs Up the Wall pose. You can try this if seems appealing; just make sure you move slowly, stay warm, and keep the lights as low as possible. You could even play a guided relaxation track at this point. Again, see my post Yoga You Can Do In Bed for more information.

Morning
Good morning! I hope you slept better last night. Now, if you feel like gently stimulating your nervous system by moving with your breath, doing a few standing poses, or even doing a full yoga practice, go for it!

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Three Happy Endings: Yoga for Better Sleep

by Nina

My friend Liz has a chronic disease but she takes great care of herself. She eats a healthy diet, and, when she is up to it, takes long walks and yoga classes at her neighborhood yoga studio. Because she has sleep problems, she recently decided to start practicing yoga at home as well, after she comes home at night. “It works!” she told me happily. “I sleep like a baby after doing yoga.” Today I decided to ask her what kind of yoga she does, and she said something very interesting. “It depends on what time I get home.” She went on to explain, “If I get home around 6:00 pm, I’ll do some flow yoga, with poses like Warrior 1, 2, and 3, and Half Moon pose. But If can’t practice until 8:00 or 8:30, that’s counter productive.”

“That makes perfect sense to me,” I said.

“Really?” Liz looked intrigued.

“Yes,” I explained. “Standing poses and vinyasa yoga are stimulating to your nervous system. When you stand up, your blood pressure has to rise to keep the blood pumping up toward your head. So if you do stimulating poses too close to bedtime, it’s going to be hard to go to sleep soon afterward. It’s like drinking a cup of coffee too late in the day.” Then I asked her what kind of poses she does if she can’t practice until 8:00 or 8:30.”

“Legs Up the Wall pose,” she replied. “And Shoulderstand and Plow pose. I also like to do that restorative yoga pose where you lie back on a bolster with your knees apart and the soles of your feet touching.”

“That’s perfect!” I said. “The first three are inverted poses, which automatically trigger the relaxation response. These are exactly the poses that are best to do right before bed to help you to sleep better. And that restorative pose is Supta Baddha Konasana or Reclined Bound Angle Pose, and it’s one of the most soothing and relaxing restorative poses.”

Flowers in the Shade by Brad Gibson

I went on to tell her that this is exactly the way I teach yoga for better sleep. It is important to get exercise during the day, but any vigorous exercise, including yoga, too late in the day can be over stimulating. So if you are having sleep problems, this is something you should consider when you are planning your day. Do your vigorous exercise, including standing poses, flow yoga, and backbends, earlier in the day. And try doing inverted poses, forward bends, or restorative yoga in the evening before bed to see if they help improve your sleep.

There’s no hard and fast rules, however. Liz discovered the best times for herself to practice vigorous versus relaxing yoga by experimenting. And the only way for you to find out the best times for yourself is by going through a similar process. However, I can tell you that if you take a nighttime yoga class and have difficulty sleeping afterward, when you come home, instead of getting right into bed, try practicing your favorite calming pose first and see if that helps.

Liz improving her sleep by practicing yoga at home is just one of the happy endings to this story. The second happy ending is that she made her home yoga practice her own by experimenting, observing, and coming up with her own yoga solutions that suited her particular needs and concerns. That, I told her, is advanced practice.

The third happy ending is that I asked Liz for her permission to write about her today, and she said yes. Thanks, Liz!

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Yoga You Can Do In Bed

by Nina

Patterns in a French Garden by Brad Gibson

Did I say “in bed? Yep. It’s normally not a good idea to fall asleep when you are doing yoga (you can overstretch your muscles if you fall asleep in a restorative pose and if you’re practicing conscious relaxation, well, being unconscious pretty much negates the positive effects you’re aiming for). However, there is one exception to this rule of thumb: when you’re lying in bed sleepless due to insomnia.

Whether you have trouble falling asleep initially or can’t fall back to sleep after waking in the middle of the night, instead of working on your To Do list (it’s tempting, I know), try a little yoga. There are a number of yoga practices that just might help you relax enough to finally drift off to sleep and/or improve the quality of your sleep. While practicing any of these techniques, be sure to stay warm and keep the lights off to keep stimulation down to a minimum.

Breath Awareness. This is the simplest yogic breath practice and one of the most basic forms of meditation. Simply bring your awareness to the sensations of your natural inhalations and exhalations. When you notice your mind wandering to your To Do list or elsewhere, gently return your mind to your breath.

Extending Your Exhalation. After observing your natural breath for a few minutes, you can try extending your exhalation (while inhalations are slightly stimulating, exhalations are naturally relaxing). When you reach the end of your exhalation, instead of immediately inhaling, lengthen your inhalation by one or two beats. Keep it relaxed, and if at any point you find the practice irritating, return to your natural breath.

Silently Reciting a Mantra. Just as you would when you are meditating, you can use a silent mantra or any word or phrase in bed to keep your mind from drifting into anxious thoughts. This is helpful for those of you who don’t find focusing on the breath effective (or when you have a cold!). When you notice your mind wandering from your mantra to your To Do list or elsewhere, gently return your mind to your mantra.

Guided Relaxation. Following the instructions for a guided physical relaxation (see here), with or without ear phones, allows you to focus your mind on a soothing voice and your physical sensations, enabling some people to drift off to sleep.

Self-Guided Relaxation. When you are familiar with the basic instructions for deep physical relaxation, it’s simple enough to skip the relaxation track and just gradually relax your body by following your own instructions. Many years ago, my first yoga teacher recommended this as insomnia practice.

Slight Inversion. Take the pillow out from under your head and lie on your back with your knees bent. Lift your pelvis up and place the pillow underneath it. You’re now in a very low version of Supported Bridge pose, a gentle inversion that naturally triggers the relaxation response. Try to stay in the position for five to ten minutes.

Supported Forward Bend. If you sleep alone or aren’t worried about disturbing your partner and you find forward bends soothing, you could try a supported bend in your bed. Sit with your legs straight or in crossed-legs position (whichever is more comfortable and allows a deeper forward bend) and place a stack of pillows on top of your straight legs or in front of your crossed legs. Then lengthen your spine forward and rest your forehead and arms on the pillow and relax. Try to stay at least three minutes. If you can’t get comfortable in the pose, then this one isn’t for you.

If you suffer from insomnia, I sincerely hope you’ll something on this list that will help. Most of these are techniques are ones I’ve found useful myself (I'm a bit too lazy to sit up and try an actual pose, however). Readers, if you have any additional suggestions, please chime in!

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What I'd Say to Paul (Yoga for Insomnia)

by Nina

Paul Weston and his new therapist from "In Treatment"

There I was on Saturday night, doing that thing where you talk out loud to a fictional character on your TV screen. But, really, Paul Weston in Season 3 of “In Treatment” was asking his new therapist for another Ambien prescription. And when he told her that he’d been taking Ambien every night for over a year, I just lost it. I said, “That’s addiction, not a solution! You need to help him wean himself off the pills!” But his therapist wouldn’t listen to me. And then Paul told her that even with the pills he didn’t sleep through the night, but always woke from a nightmare after several hours, and then had trouble going back to sleep, often taking another Ambien to get himself through the second part of the night. He was worried that he might have Parkinson’s Disease. But even though I begged her to offer him an alternative, in the end his therapist wrote him another prescription and said he could come back and talk to her if he wished, so besides the pills all she had to offer him was long-term talk therapy.

Then on Sunday morning I was doing it again because I read an article in the NY Times “Sleep Medication: Mother’s New Little Helper” (see here) about mothers who can’t sleep because they are too stressed out about all the little things they had to do, and instead spend hours in the middle of the night fretting over their “To Do” lists. Both the author of the article and the women themselves seemed to think the only options these women had were sleeping pills or lack of sleep. “Conscious relaxation!” I shouted to the author and the women in the article, but to no avail. It is just part of being a mom these days, they claimed. Some of them even talked about how useful it was to have time to themselves in the middle of the night, when they could get even more work done. 

It’s a good thing I can rant in this post today! I do think sleeping pills can be useful on a short-term basis to get you through a short, difficult spell, but they are not a long-term solution because they do not solve the underlying problems (and you do, in fact, become addicted after just two weeks). If you read my first post on chronic stress (see here) you will know that what’s keeping both Paul and the women in the NY Times article from sleeping well is chronic stress. And a different solution to their insomnia could be practicing yoga stress management techniques. So what would I prescribe for Paul Weston?

During the afternoon or evening, Paul should practice calming yoga poses, such as restorative poses, supported forward bends or supported inversions (such as Legs Up the Wall Pose). Seated meditation is another good option for this time of day. If Paul can do Savavana or yoga nidra without falling asleep, these practices would also be effective, but taking a nap won’t be effective. The idea is for him to switch his nervous system from chronic stress to the relaxation response, providing him with time in a state of conscious relaxation. (See here for info on the difference between conscious relaxation and sleep.)

Then when Paul is in bed trying to fall asleep, I’d recommend either yogic breath awareness (or extending the exhalation) or a self-guided Savasana (such as progressive physical relaxation of different body parts) so that when he falls asleep he will be more relaxed (and will hopefully sleep deeper and longer). Even though he has important things to worry about, the key is to keep his mind on neutral subjects when he is going to sleep (he can always do his worrying the next day!). 

Finally, if Paul wakes in the middle of the night, rather than getting up and turning on the light to read a book, work on the computer, or watch TV (these activities are mildly stimulating), I’d recommend that Paul stay in bed in the dark, and again do a yogic breath practice or a self-guided Savasana. There is a good chance this will help him get back to sleep again. Granted, worrying is very tempting; in the middle of the night it feels like important work. But like any other practice, moving the mind away from worry to a more neutral subject gets easier and easier with experience. 

“Paul,” I’d say, “I’ve been there, too. And these are all practices that have helped me learn to sleep better, even during stressful times.”

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Chronic Stress: An Introduction

by Nina

Wounded Bird by Brad Gibson

An ongoing theme that we’ll be exploring in depth on this blog is the negative effects of chronic stress on long-term health and the need for stress management as an important aspect of healthy aging. So perhaps it’s a good time for me to define exactly what we mean by “chronic stress” and to let you know a little about why it is such a serious problem.

I learned about dangers of chronic stress the hard way. Back in the early nineties, I had a job as the documentation manager and lead technical writer at a software start-up company, while at the same time I was raising two children. As you might imagine, the pressure was intense as our small company struggled to meet our first deadline, the first test of the product by real customers (who needed my manuals to teach them how to use the product!). As the deadline approached and I started working overtime, I began having difficulty sleeping. I also started losing weight because the stress made me so feel nauseated that I lost my appetite. Eventually I was so anxious, exhausted and nauseated that even though I met my deadline (and the company went on to success), I couldn’t bounce back to normal health. It took a year and half of therapy, medication, and lifestyle changes to recover completely.

Feeling stressed is not always a bad thing, however. It’s your body’s normal response to perceived danger or extreme physical activity (often called the “fight or flight response”), which is vital in keeping you safe and active. When you encounter a stressful situation, whether it is a grizzly bear or a stack of tax forms, your body releases hormones (adrenaline and noradrenaline) to provide you with the energy and alertness needed to cope with the situation. And anyone who has almost been run over an SUV knows the feeling: heart racing, rapid breathing, gut clenching. This is because in stress mode, your nervous system stimulates your organs and mobilizes energy by: 

• raising your blood pressure 
• increasing your heart rate and the blood supply to your skeletal muscles (and away from your gut) 
• dilating your pupils and bronchioles, providing improved vision and oxygenation 
• generating needed energy by breaking down sugar and fat stores for immediate use 

Between stressful situations, your body needs to rest, recover, and acquire new energy, so your nervous system responds by:

• lowering your blood pressure 
• reducing your heart rate, diverting blood back to the skin and gastrointestinal tract 
• contracting your pupils and your bronchioles for reduced oxygenation 
• stimulating your salivary gland secretion, accelerating digestion, and promoting normal movement of food through the gut 

But what if the stress is long term? When you almost get hit by a car, escape from a bear or finish your taxes, the incident is over quickly and you bounce back to normal soon after. But if the stress is ongoing or “chronic,” maybe because of continuing job pressures (like mine at the software company), marriage problems, health problems, and so on, your nervous system is continuously on the alert and this can overtax your body potentially causing:

• heart disease 
• hypertension (high blood pressure) 
• insomnia and/or fatigue 
• digestive disorders 
• headaches 
• chronic anxiety or depression 
• weakened immune system 

(Hmm, I just counted, and it seems I developed almost half of those symptoms, rather impressive in a weird sort of way.)

Of course, these symptoms are not only unpleasant but will seriously compromise your long-term health if you can’t manage to bring them under control. In addition, several age-related diseases, such as Alzheimer’s, Parkinson’s, and Diabetes are exacerbated by stress, and some theories of aging itself (such as the telomere theory I discussed last week) propose stress as a factor in the aging process itself.

I hope you’re not getting too stressed out by reading all of this! I credit yoga with helping me stay well since that breakdown. And in the coming weeks, we’ll be offering many different alternatives for managing your stress even as you take on the many challenges that life has to offer.

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