慢性原发性入睡期失眠的昆达里尼瑜伽治疗：与主动睡眠卫生比较的随机对照试验。
Treatment of chronic primary sleep onset insomnia with Kundalini yoga: a randomized controlled trial with active sleep hygiene comparison.
机构信息
Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts.
Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts.
出版信息
J Clin Sleep Med. 2021 Sep 1;17(9):1841-1852. doi: 10.5664/jcsm.9320.
STUDY OBJECTIVES
Prior studies have suggested a benefit of yoga for alleviating sleep disturbance; however, many studies have had methodological limitations. This trial study aimed to extend that literature by including an active sleep hygiene comparison.
METHODS
Participants aged 25-59 years with a primary complaint of sleep onset insomnia lasting at least 6 months were block randomized to an 8-week Kundalini yoga or sleep hygiene intervention, both consisting of initial 60-minute instruction and weekly check-ins. Daily sleep diaries and questionnaires were collected at baseline, throughout the intervention, and at 6-month follow-up. Data were analyzed using linear mixed models (n = 20 in each group).
RESULTS
Participant ratings of the interventions did not significantly differ. Sleep hygiene improved several diary and questionnaire outcomes, however, yoga resulted in even greater improvements corresponding to medium-to-large between-group effect sizes. Total sleep time increased progressively across yoga treatment ( = 0.95, = .002), concurrent with increased sleep efficiency ( = 1.36, < .001) and decreased sleep onset latency ( = -1.16, < .001), but without changes in pre-sleep arousal ( =-0.30, = .59). Remission rates were also higher for yoga compared to sleep hygiene, with ≥ 80% of yoga participants reporting average sleep onset latency < 30 minutes and sleep efficiency > 80% at 6-month follow-up. For over 50% of yoga participants, the insomnia severity index decreased by at least 8 points at end of treatment and follow-up.
CONCLUSIONS
Yoga, taught in a self-care framework with minimal instructor burden, was associated with self-reported improvements above and beyond an active sleep hygiene comparison, sustained at 6-month follow-up. Follow-up studies are needed to assess actigraphy and polysomnography outcomes, as well as possible mechanisms of change.
CLINICAL TRIAL REGISTRATION
Registry: ClinicalTrials.gov; Name: Yoga as a Treatment for Insomnia; URL: https://clinicaltrials.gov/ct2/show/NCT00033865; Identifier: NCT00033865.
CITATION
Khalsa SBS, Goldstein MR. Treatment of chronic primary sleep onset insomnia with Kundalini yoga: a randomized controlled trial with active sleep hygiene comparison. . 2021;17(9):1841-1852.
研究目的
先前的研究表明瑜伽有益于缓解睡眠障碍；然而，许多研究都存在方法学上的局限性。本试验研究旨在通过纳入主动睡眠卫生对照来扩展这一文献。
方法
参与者年龄在 25-59 岁之间，主要抱怨入睡困难，持续至少 6 个月，采用块随机分组，分别接受 8 周的昆达利尼瑜伽或睡眠卫生干预，均包括最初的 60 分钟指导和每周检查。在基线、干预期间和 6 个月随访时收集每日睡眠日记和问卷。使用线性混合模型（每组 20 名参与者）进行数据分析。
结果
参与者对干预的评价没有显著差异。睡眠卫生改善了几项日记和问卷结果，但瑜伽的效果更好，对应于中到大的组间效应大小。随着瑜伽治疗的进展，总睡眠时间逐渐增加（=0.95，=0.002），同时睡眠效率增加（=1.36，<0.001），入睡潜伏期缩短（=−1.16，<0.001），但睡前觉醒没有变化（=−0.30，=0.59）。与睡眠卫生相比，瑜伽的缓解率也更高，6 个月随访时，≥80%的瑜伽参与者报告平均入睡潜伏期<30 分钟，睡眠效率>80%。对于超过 50%的瑜伽参与者，在治疗结束和随访时，失眠严重程度指数至少下降了 8 分。
结论
在最小的指导负担下，以自我保健为框架教授的瑜伽与积极的睡眠卫生对照相比，与自我报告的改善相关，在 6 个月随访时仍可持续。需要进一步的研究来评估活动记录仪和多导睡眠图的结果，以及可能的变化机制。
临床试验注册
注册处：ClinicalTrials.gov；名称：瑜伽治疗失眠；网址：https://clinicaltrials.gov/ct2/show/NCT00033865；标识符：NCT00033865。
引文
Khalsa SBS，Goldstein MR。昆达利尼瑜伽治疗慢性原发性入睡困难：一项与主动睡眠卫生对照的随机对照试验。睡眠 2021；17(9)：1841-1852。
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