Yoga for insomnia

Yoga for insomnia improves sleep quality and has not been shown to treat insomnia itself. That distinction sounds like hair splitting and it is the single most important thing on this page, because the trials have measured both and they came out differently.

The clearest evidence comes from a 2020 systematic review and meta-analysis in BMC Psychiatry covering 19 randomised trials and 1,832 women with sleep problems. Pooled across everything, yoga improved sleep, a standardised mean difference of 0.327. Measured with the Pittsburgh Sleep Quality Index across 16 trials, the improvement was larger, 0.54. But the three trials that used the Insomnia Severity Index, the instrument designed to measure insomnia as a disorder, found nothing: a standardised mean difference of 0.13 with a confidence interval running from minus 0.74 to plus 0.48. Two subgroups also showed no benefit at all, women with breast cancer across seven trials and peri and postmenopausal women across four. No serious adverse events were reported anywhere.

Read that honestly and you get: yoga helps people sleep better, particularly people whose sleep is poor rather than disordered, and the evidence that it shifts clinical insomnia is absent rather than negative. The reviewers also found a direct relationship between total class time and the benefit, which argues for a regular practice rather than a bedtime trick.

Yoga nidra specifically has its own small literature. A randomised controlled trial published in The National Medical Journal of India found improvement in sleep in patients with chronic insomnia, and early sleep laboratory work on yoga nidra has been reviewed since. These are small studies, and I would describe the practice as the most promising thing on this page rather than as an established treatment.

One more thing belongs here for honesty's sake. The treatment with the strongest evidence for chronic insomnia is not yoga. It is cognitive behavioural therapy for insomnia, which is recommended as the first line treatment for the disorder, and its central instructions are behavioural rather than postural: a fixed waking time, getting out of bed when you cannot sleep, and not spending eight hours in bed to get six hours of sleep. If you have had insomnia for months, that is the door to go through, and a practice sits alongside it comfortably. Yoga may support your sleep alongside proper care. It is not a treatment for a sleep disorder, and persistent insomnia deserves a doctor's attention rather than a longer sequence.

This site already has the two practice pages this condition points at, and this page is deliberately the entry point rather than a copy of them: yoga nidra has the full script and timings, and the bedtime yoga sequence has the fifteen minute routine pose by pose.

The avoid list on this page is unusual, because the things most likely to wreck your night are breathing practices rather than postures, and they are practices Indian students are taught early and enthusiastically.

• Kapalbhati in the evening. Forceful abdominal pumping, taught almost everywhere as a general purpose morning practice. It is stimulating, which is the point of it, and that is exactly wrong at nine at night. Students who cannot understand why an evening practice leaves them wide awake have very often put this in it.
• Bhastrika, the bellows breath. The same objection with more force behind it. This is a morning practice or no practice.
• Surya Bhedana, right nostril breathing. The traditional description of it is warming and activating, and the traditional counterpart chandra bhedana, left nostril breathing, is the cooling one. Whatever you make of the classical reasoning, the practical point stands: if you are going to pick between them at bedtime, pick the left one.
• Breath retention of any kind, in the evening. Holding the breath is effortful and the effort is the problem. Every breathing practice on this page is done without retention.
• Naukasana and strong abdominal or core work after eight in the evening. Not dangerous. Just an obstacle. Hard muscular effort late raises body temperature and heart rate at the hour you want both falling.
• Sirsasana and the strong inversions. Leaving aside the neck objection that applies at any hour, these are the opposite of a wind down and they need concentration, which is the thing you are trying to let go of.
• A long strong vinyasa class ending at nine. This is the commonest version of the mistake, and it is worth being fair about it: the research on evening exercise and sleep is more forgiving than it used to be, and moderate activity in the evening does not appear to harm sleep. It is the vigorous session finishing within about an hour of bed that tends to. The practical rule I use is that whatever leaves you breathing hard belongs before eight o'clock.

And two things that are not practices at all, and which in my experience beat every pose on this page. A screen in bed, and a variable waking time. If either of those is in place, no sequence is going to rescue the night, and fixing them is free.

The whole page in one table. Start with two, and if you only ever do one thing from this page, do the humming breath, because it takes three minutes and can be done in bed.

Nothing in the avoid column is wrong in itself. Most of it is simply in the wrong half of the day, which is a distinction almost no page on yoga for sleep bothers to make.

The shape of an evening practice is the reverse of a morning one. Fewer positions, all of them supported, none of them held by muscular effort, and the breathing given more time than the asana. Nothing new is learned at night.

The fifteen minute version, which is the one most of my students actually keep. Three minutes of balasana with the forehead on a cushion. Two minutes a side of supta matsyendrasana with the knees supported. Five to eight minutes of viparita karani with the legs up a wall. Then nine rounds of bhramari sitting on the edge of the bed, and straight under the covers. The bedtime yoga sequence is this written out pose by pose with the minutes.

The three minute version, for the nights when the fifteen is not going to happen. Nine rounds of bhramari, in bed, lying on your side if you prefer. I am not being modest about this: the students who report the biggest change are more often the ones who do the three minutes every night than the ones who do the fifteen twice a week. The meta-analysis found benefit scaling with total class time, and the way you accumulate total time is by doing something you will not skip.

The twenty minute version, for a wakeful night. If you are awake at two in the morning, yoga nidra is the practice for it, lying still, eyes covered, following a guided rotation of attention through the body. It asks nothing and it does not require you to fall asleep, which is what makes it usable when the trying itself has become the problem. If you fall asleep in the middle of it at night, that is fine. In a daytime practice it is not the aim.

And the two that are not on the mat. A fixed waking time, seven days a week, including Sunday. And morning light, ideally outdoors, within an hour of waking. Neither is yoga, both have better evidence than anything above, and I mention them in class every week because they are the reason some students improve in a fortnight and others do not improve at all.

If the sleeplessness is anxiety wearing a different coat, which is often the case, the anxiety page is the more useful one to read.

Insomnia is common and most of it responds to behaviour and to time. Some sleeplessness is a symptom of something else, and yoga is not the right first response to any of the following.

• Loud snoring with pauses in breathing, gasping or choking at night, or somebody telling you that you stop breathing. That is a sleep apnoea question and it matters, because untreated apnoea affects the heart and blood pressure.
• Falling asleep during the day despite being in bed for eight hours, or falling asleep while driving.
• Insomnia lasting more than three months. That is the definition of chronic insomnia and it has a specific first line treatment, cognitive behavioural therapy for insomnia, which works better than any practice on this page.
• Persistent low mood, loss of interest, or early morning waking with dread. Sleeplessness and depression run together in both directions and the mood is what needs treating.
• An irresistible urge to move the legs in the evening, relieved by moving them, which is a specific and treatable condition.
• Sleeplessness that began with a new medicine, or with steroids, thyroid treatment, or a change in dose. See yoga for thyroid if that is where the change came from.
• Night sweats with weight loss, or chest pain or breathlessness lying flat.
• Any use of sleeping tablets for more than a few weeks, which is worth a conversation with a doctor rather than a quiet continuation.

None of that rules out a practice. It changes what the practice is for, which becomes support rather than treatment.

Night one to three: some students fall asleep during the very first yoga nidra and conclude the problem is solved, and some lie there irritated for twenty minutes. Both are normal and neither means anything yet.

Week one to two: the first change is usually not falling asleep faster. It is that the time spent awake is less unpleasant, because you have something to do with it other than watching the clock. That sounds like a consolation prize and it is actually the mechanism by which the rest follows.

Week three to six: falling asleep gets quicker for most people, and the practice stops being a decision. The meta-analysis found benefit scaling with total practice time, which is the argument for every night rather than three good nights.

Week eight to twelve: this is where the trial evidence sits, on sleep quality. Note what it does not say: the three trials that measured insomnia severity as a disorder found nothing. If your sleep was poor, expect it to be better. If you have chronic insomnia, expect a practice to help you live with it while the actual treatment does the work.

Beyond three months: it holds while it holds, and the fixed waking time is the part that keeps holding when the practice lapses.

Write these down in the morning, in under a minute, and not in the middle of the night. Watching the clock at three in the morning makes everything worse and is the one habit worth actively breaking.

1. How long it took to fall asleep, estimated, in fifteen minute blocks. Estimated is fine. Precision here is neither possible nor useful.
2. How many times you woke, and roughly how long you were awake in total. One long waking and four short ones are different problems and want different advice.
3. Hours actually asleep, against hours in bed. This ratio is the one clinicians use, and it is the number that exposes the commonest self inflicted problem: nine hours in bed chasing six hours of sleep, which reliably makes sleep worse.
4. How you felt at four in the afternoon, nought to ten. Daytime function is the outcome that matters. Plenty of people sleep less than they would like and function perfectly well, and the goal is not a number of hours.

Two weeks of this is worth more than any amount of describing your sleep from memory, and it is exactly what a doctor will ask for if you end up needing one.

The odd thing about learning this with a teacher is that the pose correction hardly matters here. Nobody is going to hurt themselves lying down with their legs up a wall. What a teacher gives you for sleep is two other things. The first is a voice: yoga nidra is genuinely easier to follow when somebody else is speaking, which is why the practice exists as a guided one, and having heard it in a room a few times is what makes doing it alone at two in the morning possible at all. The second is being asked the right question. Falling asleep, staying asleep, and waking at four are three different complaints, and almost every page on the internet gives all three the same sequence.

The classes here are traditional yoga taught slowly by one teacher across about forty years, at a residents' association hall, to students of all ages. If you have been searching for yoga for sleep or for insomnia near you, the in person classes run in north Bangalore, in the hall at MSR Nagar, with students from Mathikere, Malleswaram and Yeshwanthpur. If your problem is the evening specifically, the live online classes are the better fit, because you finish the practice already at home, in the room you are going to sleep in, with no journey between the last long exhale and your own bed. The first class is free. Come and say which of the three it is.