None listed
Conditions
Brief summary
Brief Summary: Insomnia is very common in the elderly population and is associated with increased morbidity and a detrimental effect on quality of life. The main form of current therapy for insomnia is sedative-hypnotic drugs which can have serious negative side effects and cause adverse effects when used with alcohol or other medications. Thus there is an imperative to find other forms of safe and effective therapy for insomnia in the growing elderly population. Yoga includes a series of integrated activities that include physical exercises along with meditation, breathing and relaxation and these activities have previously been shown to influence psychophysiological, neuroendocrine, and autonomic parameters. Preliminary research suggests that yoga also provides benefit for people with insomnia but there is little rigorous research to confirm this and no research to determine if yoga or other forms of exercise can influence objective indicators of sleep or if it can be successfully adapted to an elderly population in Australia. This study primarily aims to examine the effectiveness of yoga as an intervention for geriatric insomnia and to determine the ability of yoga to enhance quality of life, mood and cognitive function. This study will build upon previous knowledge of yoga with a comprehensive 6-month, randomised, controlled trial of yoga for the treatment of insomnia in an elderly Australian population. The trial will involve 120 subjects randomized to either an integrated yoga intervention or a callisthenics control group. The study will aim to answer the following questions: 1. Does an integrated yoga intervention improve subjective and objective sleep quality and/or quality of life in elderly people with insomnia? 2. Does participation in yoga improve mood and/or cognitive function in elderly people with insomnia 3. Does participation in yoga reduce health resource utilization in elderly people with insomnia 4. Is yoga safe and acceptable for elderly people?
Interventions
The active intervention will involve two 60 minute yoga classes per week for 3 months by a qualified yoga teacher. Participants will be given a choice of at least five classes (daytime, evening and weekend) and each class will be limited to 20 participants to allow the teachers to give personal attention to each participant. Classes will include breathing exercises, relaxation exercises and meditation exercises. Each class will involve yoga postures, include standing poses chosen specifically to
The active intervention will involve two 60 minute yoga classes per week for 3 months by a qualified yoga teacher. Participants will be given a choice of at least five classes (daytime, evening and weekend) and each class will be limited to 20 participants to allow the teachers to give personal attention to each participant. Classes will include breathing exercises, relaxation exercises and meditation exercises. Each class will involve yoga postures, include standing poses chosen specifically to incorporate weight bearing and gentle aerobic conditioning elements to help improve and maintain skeletal health, improve balance and coordination to help prevent accidents and falls and improve cardiovascular fitness as well as prone and supine stomach and back exercises chosen specifically to strengthen abdominal and back postural muscles to improve and maintain spinal health. Each class will also incorporate breathing exercises chosen specifically to relax the sympathetic nervous system and enhance parasympathetic activity as well as Yoga Nidra ('sleeping yoga') progressive relaxation exercises to promote deeper relaxation of the whole body and train the relaxation response along with a period of yogic meditation aimed at creating a deeper state of calmness. These elements have been adapted and extended from the 2 published trials of yoga and sleep Classes will be highly structured and standardised so that a number of different yoga teachers are able to facilitate classes. All poses will include variations to suit individual limitations or preference so they can be practiced with ease and no evidence of strain. A class length of 60 minutes is used for many strengthening and other programs for the elderly. The yoga protocol is not vigorous and includes time spent in physical activity, relaxation and regulated breathing. Participants will be given a CD which will include instructions about exercises to be practised at home at least four times per week.
Sponsors
Royal Melbourne Institute of Technology (RMIT) University
Study design
Allocation
Randomised controlled trial
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
60 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
Individuals aged 60 and above who are sedentary (structured exercise < once/week); sleep complaints of at least 3 times a week for at least 1 month (Diagnostic and Statistical Manual IV(DSM-IV) classification with a Pittsburgh Sleep Quality Index (PSQI) score of > 5 currently; willingness to accept random assignment and comply with study protocols.
Exclusion criteria
Failure to keep a two-week sleep log during the run-in period; Evidence of primary sleep disorders (sleep apnoea, restless leg syndrome, periodic leg movement) by history or polysomnography, myocardial infarction (within 6 months), unstable medical conditions (e.g. diabetes, hypertension or ischaemic heart disease); Peri-menopausal women with symptoms of hot flushes and/or night sweats; Major mental illness or dementia by DSM-IV criteria or Geriatric Depression Scale (GDS) score > 13 (range 0-30); Use of sedative-hypnotic / non-prescription sleep medications / antidepressants in the last month; Alcohol intake greater than 20 grams (2 drinks) per day on average; planned life stressors (moving, divorce, etc.), shift work, or transcontinental travel; medical causes of insomnia, Congestive Health Failure (CHF), nocturia, Benign Prostatic Hyperplasia (BPH), diabetic neuropathy, musculoskeletal pain from arthritis or other cause, restless bed partner, medications disrupting sleep, or an unwillingness or inability to give consent.
Outcome results
None listed