Study finds yoga improves menopause symptoms of insomnia but not hot flashes
By Andy Koopmans
Regular yoga may provide some relief from insomnia as a symptom of menopause, but didn’t have an effect on reducing hot flashes, according to a recent paper in Menopause: The Journal of the North American Menopause Society.
The study’s authors included Fred Hutchinson Cancer Research Center Drs. Andrea LaCroix, Katherine Guthrie and Garnet Anderson. Drs. LaCroix and Guthrie are co-principal investigators of the FHCRC-based Data Coordinating Center for the MsFLASH (Menopause Strategies: Finding Lasting Answers for Symptoms and Health) Network.
The researchers conducted a randomized 12-week trial of 249 women between the ages 40 and 62 in Seattle, Oakland and Indianapolis. Participants self-reported at least two hot flashes or night sweats a day for a period of three weeks prior to the study. Many also reported other common secondary menopausal symptoms, including insomnia, anxiety, sleep disturbance and depression.
About 100 women were randomly assigned to a regimen of yoga – two 90-minute yoga classes a week and 20-minutes at home on the days they didn’t attend class. The others in the study were instructed to maintain their usual activity as a control and asked not to do yoga. Because the trial also included an aerobic exercise arm, none of the women in the trial were doing large amounts of exercise or yoga prior to enrolling. All of the women in the trial were also randomized to fish oil capsules or placebo capsules. At intervals before and during the study, participants were asked to keep a diary tracking the frequency and severity of their hot flashes and night sweats as well as their quality and amount of sleep.
The results of the study showed the 12-week program of yoga had no effect on the frequency or severity of hot flashes, anxiety, sleep quality or depressive symptoms. However, the study found yoga significantly improved insomnia symptoms as measured on the Insomnia Severity Index, a self-report questionnaire assessing the nature, severity and impact of insomnia.
Researchers note the limitations of the study, which include that the women who signed up were motivated to seek treatment and thus results might not be generalizable across all women. Further, they said that other yoga styles or practices might have different results.
The yoga program used in the trial was developed by the Group Health study investigators who worked with instructors and consultants from the National Center for Complementary and Alternative Medicine. They created a program of 11 to 13 poses emphasizing the practice of cooling breathing exercises and yoga postures, called asanas, believed to be useful for menopausal vasomotor symptoms. As part of the classes, instructors also led participants in about 20 minutes of a meditative process called yoga nidra, or “yoga sleep.”
Study author LaCroix participated in a few sessions and noted the practice of yoga nidra was profoundly relaxing. “When I practiced, I could barely get up afterwards. Other students in the class were so relaxed they had to walk around a bit before driving home,” she said.
LaCroix also said that while the study’s results did not show diminishment in hot flashes, it provides an option for treating insomnia.
“Yoga adds an option to interventions that help with menopause symptoms, but not the main symptom of hot flashes. Some women are more bothered by insomnia, so yoga may be more helpful for them,” LaCroix said. “There are serious risks associated with hormone therapies, so if there are alternative interventions women can try, then all the better.”
For decades, many women were prescribed hormone replacement therapy to alleviate their menopausal symptoms, but in the early 2000s, Women’s Health Initiative studies revealed associations of heart attack, stroke, breast cancer and other serious health issues with these therapies. Since then, they have been prescribed less and alternatives have been sought by researchers.