Even gentle daytime exercise helps sleep

Exercise, tai chi and meditation all seem to be helpful for the treatment of insomnia and sleep problems.

On Monday I wrote about some of the natural ways that insomnia may be treated.  Continuing on the same theme I wanted to look at some new evidence which links different types of physical activity to sleep promotion.

There is recent evidence to suggest that regular daytime exercise can work very well for the treatment of insomnia, especially in women (1,2).  Being physically active seems to be linked to  sleep improvement, totality of sleep time and decreased time to sleep onset.  The same kind of benefit also seems to be gained for simple stretching and strengthening exercises as well as massage and relaxation techniques (2)

Walking has been investigated as a technique to help individuals suffering from anxiety and mild depression with great results.  I would also suggest that it is a simple and effective way to integrate physical activity into any day.  Walking for 20-40minutes a day (not necessarily all in one bout) may well help to reduce anxiety and therefore help alleviate sleep problems and insomnia.  Personally I find walking to be an essential part of my daily routine, it brings me clarity of mind and reduces any tension.  If you wish to try exercise in an attempt to ease sleep difficulties it is usually best to exercise during the day, at least three hours before sleep.  Exercising just before bed tends to wake the body up and may exacerbate sleep problems. 

For a long time individuals practicing relaxation techniques, meditation, Tai Chi and yoga have said that their sleep greatly benefits.  Until recently evidence has been anecdotal but studies are now being carried out on these ancient practices and scientists are finding that these techniques really are usful in aiding calmness and improving sleep quality.

A very recent study (3) assessed the usefulness of Tai Chi exercise for individuals suffering with insomnia.  The study involved 112 healthy adults aged 59-86 years old.  The individuals were either assigned to a health education class for 25 weeks or they undertook Tai Chi classes.  The Tai Chi group received 16 weeks of taught Tai Chi followed by home-practice and an assessment 9 weeks later.  Sleep quality was assessed using a special medically tested sleep quality index.  Tai Chi was found to help improve sleep quality score and participants also reported a greater sleep efficiency, sleep duration and less sleep disturbance.  The authors conclude that Tai Chi is a useful non-pharmacological approach to improving sleep quality.  Tai Chi has also been found to be useful in previous studies (4).  I tried Tai Chi last year and really enjoyed the gentle form of movement.  There was a big focus on correct breathing which was very relaxing in itself, it certainly helped me to sleep more deeply and I would highly recommend trying it out if there are classes in your area.

Many people suffering with insomnia and sleep problems often find that they are going through a period of anxiety or emotional upset.  In such cases talking-therapies or counselling can be helpful to deal with the underlying anxiety and are therefore helpful for sleep.  Meditation techniques are also useful for calming the mind and reducing anxiety.  Simple techniques such as focussing on the breath, bringing yourself back to the moment or repeating a calming word or phrase (a mantra) can be very useful.

Two recent studies (5,6) have found that combining mindfulness meditation with cognitive-behaviour therapy (a form of counselling) is useful in the treatment of insomnia.  These were preliminary studies but the data strongly suggests that this combined form of treatment really does improve sleep quality.  The authors of these studies call for larger trial and additional testing.  This form of combined therapy appears to be particularly useful in relieving insomnia symptoms in individuals suffer from worry and anxiety (6).  CBT is a form of counselling and mindfulness meditation helps individuals to stay in the moment and calm their thoughts.  The Counselling Directory is an online resource that can help you find qualified CBT practitioners in your area, some of these counsellors are also trained in mindfulness meditation techniques.

I do hope that these last two posts have provided some ideas that may help you to sleep more easily this year.

(1)Llanas AC et al.  2008.  Physical therapy reduces insomnia symptoms in postmenopausal women.  Maturitas.  61:281-284
(2)Tworoger SS et al.  2003.   Effects of a Yarlong moderate-intensity exercise and stretching intervention on sleep quality in postmenopausal women. Sleep.  26:830-836
(3)Irwin MR et al.  2008.  Improving sleep quality in older adults with moderate sleep complaints:A randomised controlled trial of Tai Chi Chih.  Sleep.  31:1001-1008
(4)Li F et al.  2004.  Tai Chi and self-rated quality of sleep and daytime sleepiness in older adults: a randomised controlled trial.  J Am Geriatr Soc.  52:892-900
(5)Ong JC et al.  2008.  Combining mindfulness meditation with cognitive-behaviour therapy for insomnia:a treatment-development study.  Behav Ther.  39:171-182
(6) (6)Yook K et al.  2008.  Usefulness of mindfulness-based cognitive therapy for treating insomnia in patients with anxiety disorders:a pilot study.  J Nerv Ment Dis.  196:501-503

Written by Ani Kowal