Mindfulness For Better Sleep - The Apeiron Life Perspective

9 min read

What it is:

How well a person sleeps provides powerful insight into many other facets of their health and well-being. From physical pain that makes it difficult to get comfortable to a busy mind that prevents a restful slumber, sleep is anything but static, ebbing and flowing in response to waking life.

A myriad of social, behavioral, and environmental factors influence sleep. These include our genetic make-up, thoughts and behaviors, household income, family dynamics, whether we live in the city or the countryside, job and lifestyle, and even whether we are victims of broader social issues such as sexism and racism. Despite the technological advances and many marvels of modern medicine, getting a good night’s sleep is becoming increasingly difficult. And while it’s not a panacea by any means, evidence suggests that our sleep stands to benefit from getting back to basics. In other words, by cultivating more mindfulness and reaping the many positive benefits that it can offer.

The purported claims:

Mindfulness has been shown to improve sleep, mental health, and general well-being. It can include either static or movement-based practices that bring focus and attention to the present moment to help cultivate curiosity and intention. Some tools include:

Yoga
Yoga Nidra or Non-Sleep Deep Rest
Tai Chi and Qigong
Nature-based practices
Meditation

What the science says:

Modern life presents an endless stream of distractions that compete for our attention. These can leave our minds chattering and rob us of the present moment. Instead of paying attention to what’s around us, many of us instead ruminate about all the things we would like to have and don’t. We dread things that may or may not even happen and live with our minds in the future. We find ourselves overwhelmed by everything going on out there, most of which we have little control over.

Practices that narrow our window of focus can offer a powerful path to health and happiness. If performed regularly, they can restore our sense of balance and wellbeing. This allows us to do more when we show up in the world in our various roles.

Our sleep is inextricably linked to our waking life, and we can improve its quality through mindfulness. Instead of getting carried away on a wave of things outside of ourselves, turning our attention inward to something as simple as our breathing can anchor us to the present and remind us about what truly matters.

We have previously discussed the importance of a regular exercise routine and the many ways it can lead to better sleep. Without being particularly conscious of it, most people practice mindfulness in one form or another during exercise. It’s required for hand-eye coordination, such as during martial arts or ball games. But mindfulness also shows up in the form of rhythmic locomotion, such as during swimming or running, when it becomes essential to focus on every inhale and exhale.

Yoga, Yoga Nidra & Non-Sleep Deep Relaxation

Yoga takes this one step further, with a core focus on breathing and the mind-body connection woven throughout its practice. Yoga is accessible to almost everyone, and many different types are available. From Bikram (hot) yoga and ashtanga at the more challenging end of the spectrum to slow and gentle hatha and yin yoga for low impact easy flows.

Yoga can be done anywhere, provided you have a mat or other grippy surface and a bit of time and space. It incorporates stretching, strength training, cardiovascular exercise, and breath work into its sequences. It is also highly modifiable and can be accommodated for injuries, with various poses performed while standing or lying down on one’s back.

While more research needs to be done, several studies from reputable research groups have reported the positive effects of yoga on sleep quality and duration, as well as daytime fatigue. This has even been shown among vulnerable groups, such as cancer survivors. While yoga may improve sleep directly by promoting relaxation, it also produces many other health benefits that may indirectly lead to better sleep, such as reducing pain and inflammation.

One particular form of yoga that offers potent sleep benefits is yoga nidra, also known as yogic sleep. This form of conscious sleep has a long history thought by some to be as old as yoga itself. It is performed in a savasana pose (supine position) and provides a depth of parasympathetic activity that goes beyond simple relaxation. It can decrease stress, induce healing, and offer a deep sense of restoration. Dream-like visual experiences may also accompany it.

Unlike the typical savasana that occurs for just a few minutes at the end of class, yoga nidra can be performed independently and typically lasts for about 20-30 minutes. It can be done preceding bedtime or any other time of day.

Yoga nidra isn’t a substitute for sleep, but it can both promote sleep itself and provide some level of restoration akin to a nap. It’s unclear how time spent doing yoga nidra equates to time spent in true sleep, but it is gaining momentum in mainstream sleep health education, and in time, those studies will likely be done.

Yoga nidra typically involves a specific set of steps, and listening to a guided meditation either at home or in class can help you stay on track. Many apps, such as Insight Timer, provide guided yoga nidra meditations that you can do at home.

Here is what you can expect in a yoga nidra class or guided meditation:

You will first settle into a comfortable pose on your back and welcome relaxation and stillness by tuning into your breathing. Sometimes it can be helpful to tense all of the muscles in your body before relaxing completely.
Next, you will be asked to choose an affirmation or commitment, known as a “sankalpa" in Sanskrit. The purpose of a sankalpa is to bring about positive change in your life. It can be something as simple as stating “I am at peace” or something as profound as “I no longer judge myself” and can be said either aloud or quietly to yourself.
Next, you will direct your awareness to the various parts of your body, akin to a body scan. This is where having a guide is helpful to keep your attention focused so that your mind doesn’t drift off.
You’ll then turn your attention back to your breathing. Some yoga nidra practices include specific breathing techniques, although relaxed deep breaths are often just as good.
You may then have your attention directed to various visualizations and sensations that play with opposites, such as “cold water on your skin” and “hot steam on your face”, or “floating away light as a balloon” and “being heavy as a boulder”.
Finally, you will be called to repeat your sankalpa before gradually transitioning back to wakefulness.

A recent study in India compared the effects of cognitive behavioral therapy for insomnia (CBTi; the leading treatment recommended for insomnia) and yoga nidra among patients with chronic insomnia. Both groups slept longer, had fewer nighttime awakenings, and fell asleep more quickly. Salivary cortisol was also significantly reduced after practicing yoga nidra.

Another study investigated the effects of yoga nidra on sleep and health among patients with hypertension. Relative to the control group (which received no treatment), the participants who practiced five minutes of Om chanting followed by 20 minutes of yoga nidra each morning upon waking had reduced depressive symptoms, improved sleep quality, and increased heart rate variability.

You do not have to be an avid yogi to practice yoga nidra. It requires no knowledge of typical yoga poses or sequences and is simply a relaxation technique. A similar practice is Non-Sleep Deep Rest (NSDR), a term coined by Stanford neurobiologist, Dr. Andrew Huberman. A 10-minute NSDR practice guided by Dr. Huberman himself can be found in the references section at the end of this article.

Deep relaxation can also be induced by hypnosis and there are many guided self-hypnosis practices available online. One of the leading experts in hypnosis is Stanford’s Dr. David Spiegel. His app, Reveri, provides hypnosis resources for anxiety, changing habits, pain, stress, and insomnia and is linked in the references. There is good evidence to suggest that hypnosis can be beneficial for sleep. A 2018 review of 24 studies found that nearly 60% of them reported improved sleep outcomes.

Tai Chi & Qigong

Qigong (pronounced chee-gung) is an ancient Chinese practice used to cultivate and balance qi, or “life energy” through a series of flowing, low impact movements. Qigong can help with pain, relaxation, and also improve joint mobility.

Tai chi is a type of qigong and is considered to be “meditation in motion” by its practitioners. It consists of gentle movements that promote both strength and relaxation of the body and mind, improving flexibility, structural alignment, and mindfulness. It is associated with improved cognitive performance and was shown in one study to be just as effective as conventional exercise (brisk walking and strength training exercises) at improving sleep. It has also been shown to relieve depression and anxiety symptoms that often concur with insomnia. Given that it is low impact, tai chi is excellent for those with limited mobility of all ages and is often practiced outside, which is a great opportunity to connect with nature during exercise.

Nature Therapies

The benefits of spending time in nature cannot be overstated. A recent review found that time outdoors in green areas reduced work-related stress and fatigue, and improved performance among busy workers. The combination of fresh air, exposure to light (which regulates the body’s circadian rhythms), and mindfulness have deep roots in ancient practices, such as the Japanese practice of Shinrin-yoku, translated as “forest bathing”.

One study found that forest bathing improved self-reported measures of depression, loneliness, and stress among higher-risk populations such as veterans, stressed workers, and college students. Green spaces - particularly within urban environments - offer important mental health benefits. They also mop up air pollutants, such as volatile organic compounds, which are known to exacerbate sleep-disordered breathing conditions such as asthma and sleep apnea.

Interestingly, it has been shown that tree coverage is associated with lower crime rates in urban areas. Exposure to green areas can improve cognition and memory, and reduce anger and depression. One study found that viewing a forested area from an urban roof resulted in fewer negative emotions and feeling more “soothed” and “comfortable” than viewing a metropolitan area.

Mindfulness

Living mindfully is being present in the here and now, with curiosity and a lack of judgement. When it comes to sleep, mindfulness can be helpful as it shifts the perspective away from worrying about the future to the present moment, where there are many things to be grateful for. A review published in 2018 compiled data from 18 studies of mindfulness-based interventions and sleep and found good evidence to suggest that these techniques improved sleep quality for many participants.

While the studies have not yet been done, some sleep experts also believe that mindfulness may help those with sleep apnea who require the use of continuous positive airway pressure (CPAP). Nearly half the population discontinues CPAP treatment within the first year due to poor fit of the mask, or common symptoms such as a dry throat, nasal congestion, or skin irritation. While there are many solutions to these complaints, mindfulness may offer a unique way of promoting long-term use by reducing emotional distress and improving subjective well-being during the initial adjustment phase.

Our take:

While science is moving in the right direction, much remains to learn about how mindfulness practices improve sleep in different populations. In the meantime, we can look to the past. With deep roots in many ancient cultures, practices like yoga and tai chi have improved sleep since long before modern scientific journals existed. The good news is that with few adverse side effects, you can experiment until you find the appropriate practice.

Classic meditation, which involves a static hold and focusing of the mind, can be frustrating at first if you’re used to a barrage of racing thoughts. The key to success is finding what works for you. An audio guide can make it a bit easier and prevent you from drifting off. Alternatively, consider a movement practice that allows energy to move through you instead, such as walking while you observe your breath and surroundings.

While these practices aren’t enough to fix a true sleep disorder, you may use them in conjunction with other treatments. They are also particularly useful for certain populations, such as pregnant women, those with insomnia who do not respond to CBTi, and those dependent on hypnotic medications and looking to titrate off into more natural sleep.

Will this benefit you?

The fast pace of modern life means it’s arguably more important than ever to cultivate slow, intentional ways of living that promote relaxation and connection to the breath. More apps than ever can help you do this, but remember that sitting quietly with relaxing music or listening to the birds outside is just as good.

If you’re still curious, here’s what to look out for:

As with most other aspects of healthcare and wellness, there is no “one-size-fits-all” mindfulness practice. Do what you can to be mindful throughout the day, and it will become more natural. Practice slow, belly breaths while driving or waiting in line. Pay attention to the way each sip of your morning coffee tastes. Take five minutes to notice how good stretching feels after sitting at your desk for an hour. Listen intentionally as your partner tells you about their day.

To help yourself ease into sleep, consider budgeting 20 minutes of “worry time” during the day to bring your undivided attention to those things that might otherwise keep you awake at night. This, too, is constructive mindfulness. With practice, it will get easier. In the meantime, remember: you always have your breath.

References and additional materials:

Yoga and sleep in women - https://pubmed.ncbi.nlm.nih.gov/32357858/

Yoga in cancer survivors - https://pubmed.ncbi.nlm.nih.gov/31165647/

Yoga and digestive health - https://pubmed.ncbi.nlm.nih.gov/34391308/

Yoga nidra history - https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9033521/

Andrew Huberman’s 10 minute guided NSDR - https://www.youtube.com/watch?v=AKGrmY8OSHM&t=1s

Yoga nidra and insomnia - https://pubmed.ncbi.nlm.nih.gov/34825538/

Om chanting and yoga nidra - https://pubmed.ncbi.nlm.nih.gov/35689170/

Huberman Lab Podcast - Hypnosis — https://hubermanlab.com/dr-david-spiegel-using-hypnosis-to-enhance-mental-and-physical-health-and-performance/

Reveri Self-hypnosis - https://www.reveri.com/

Hypnosis and sleep - https://pubmed.ncbi.nlm.nih.gov/29198290/

Progressive muscle relaxation and sleep - https://pubmed.ncbi.nlm.nih.gov/32379667/