Impact of Yoga on Mental Health and Sleep Quality Among Mothers of Children With Intellectual Disability.

OBJECTIVES: Caring for a child with Intellectual Disability Disorder (IDD) is a tremendously stressful task for any mother, leading to poor mental health and compromised quality of life. Anxiety, depression, stress, and poor sleep quality are frequently observed in mothers with Intellectual Disability Disorder child. This study assessed the impact of a 1-month yoga intervention on anxiety, depression, stress and sleep quality in mothers of children with intellectual disabilities. METHODS: We selected 53 mothers of children with intellectual disabilities between the age of 30 and 50 years (mean age, 40.2 ± 7.1 years). Of these mothers, 28 received 1.5 hours of integrated yoga practice consisting of physical postures, breathing techniques, relaxation techniques and meditation every other day for 1 month. The remaining 25 mothers, who served as the control group, participated in a group discussion session twice a week for 1 month. MAIN OUTCOME MEASURES: All mothers were assessed for anxiety and depression with the Hospital Anxiety and Depression Scale (HADS), stress with the Perceived Stress Scale (PSS), and sleep quality with the Pittsburgh Sleep Quality Index (PSQI) at baseline and at 1 month. RESULTS: Significant improvements in anxiety (-24.8%; P < .001), depression (-15.9%; P < .001), sleep quality (-25.1%; P < .05) and stress (-11.4%; P < .001) were observed after 1 month compared with baseline in the yoga group. In a similar fashion, a significant decrease in anxiety (-12.3%; P < .001), depression (-8.6%; P < .001) and sleep quality (-5.6%; P < .001) was seen in the control group as well. The between-group comparison of post-intervention scores revealed a significantly better improvement in anxiety (P <.001), depression (P < .001), perceived stress (P < .001) and sleep quality (P = .012) in the yoga group compared with the control group. CONCLUSIONS: Our study indicates that yoga can be used as an effective intervention to improve psychopathology and sleep quality in mothers of children with intellectual disabilities. We recommend future randomized controlled trials with larger sample sizes and of longer duration to study the long-term effects of yoga.

Effects of Integrated Yoga Intervention on Psychopathologies and Sleep Quality Among Professional Caregivers of Older Adults With Alzheimer's Disease: A Controlled Pilot Study.

CONTEXT: Providing care to patients suffering from chronic neurological problems is a stressful job. While providing care to the patients, professional caregivers experience various kinds of physical and mental challenges that affect their mental health and sleep. Yoga is a form of mind-body medicine shown to be an effective intervention in improving physical and mental health. OBJECTIVE: To examine the effects of an integrated yoga (IY) intervention on anxiety, depression, stress, and sleep quality among professional caregivers of older adults with Alzheimer's disease. SETTING: This study was conducted in an Alzheimer care institution located in Bangalore City in southern India. PARTICIPANTS: Participants were professional female caregivers of older adults with Alzheimer's disease. Participant age range was between 20 and 50 y (mean, 34 ± 8.4 y). A total of 30 participants were enrolled in the study. Seventeen participants followed IY intervention and 13 were considered in a wait-list group. INTERVENTION: Participants in the IY group received a structured IY intervention comprising yoga asanas, pranayama, meditation, and relaxation techniques, 1 h/d, 6 d/wk, for 1 mo. Participants in the wait-list control group followed their daily activities. OUTCOME MEASURES: Blood pressure, heart rate, anxiety, depression, stress, and sleep quality were assessed at baseline after 1 mo for both the groups. Data were analyzed with an appropriate statistical test using SPSS Version 16 software (IBM, Armonk, NY, USA). RESULTS: The IY group showed significant improvement in heart rate, blood pressure, stress, depression, anxiety, and sleep quality after 1 mo compared with baseline. In contrast to the IY group, the wait-listed control group showed significant increase in anxiety, depression, and stress and significant decrease in sleep quality after 1 mo compared with baseline. CONCLUSIONS: The present study showed the potential use of IY intervention in reducing stress, anxiety, and depression. The study also suggests that IY improves sleep quality among professional caregivers. However, further studies using a randomized controlled trial method with a larger sample size and for a longer duration should be conducted to confirm the present findings.

Effects of Yoga in Managing Fatigue in Breast Cancer Patients: A Randomized Controlled Trial.

BACKGROUND: Cancer-related fatigue is widely prevalent in cancer patients and affects quality of life in advanced cancer patients. Fatigue is caused due to both psychologic distress and physiological sequel following cancer progression and its treatment. In this study, we evaluate the effects of yogic intervention in managing fatigue in metastatic breast cancer patients. METHODS: Ninety-one patients with metastatic breast cancer were randomized to receive integrated yoga program (n = 46) or supportive therapy and education (n = 45) over a 3-month period. Assessments such as perceived stress, fatigue symptom inventory, diurnal salivary cortisol, and natural killer cell counts were carried out before and after intervention. Analysis was done using an intention-to-treat approach. Postmeasures for the above outcomes were assessed using ANCOVA with respective baseline measure as a covariate. RESULTS: The results suggest that yoga reduces perceived stress (P = 0.001), fatigue frequency (P < 0.001), fatigue severity (P < 0.001), interference (P < 0.001), and diurnal variation (P < 0.001) when compared to supportive therapy. There was a positive correlation of change in fatigue severity with 9 a.m. salivary cortisol levels. CONCLUSION: The results suggest that yoga reduces fatigue in advanced breast cancer patients.

Effect of Yoga on Sleep Quality and Neuroendocrine Immune Response in Metastatic Breast Cancer Patients.

BACKGROUND: Studies have shown that distress and accompanying neuroendocrine stress responses as important predictor of survival in advanced breast cancer patients. Some psychotherapeutic intervention studies have shown have modulation of neuroendocrine-immune responses in advanced breast cancer patients. In this study, we evaluate the effects of yoga on perceived stress, sleep, diurnal cortisol, and natural killer (NK) cell counts in patients with metastatic cancer. METHODS: In this study, 91 patients with metastatic breast cancer who satisfied selection criteria and consented to participate were recruited and randomized to receive "integrated yoga based stress reduction program" (n = 45) or standard "education and supportive therapy sessions" (n = 46) over a 3 month period. Psychometric assessments for sleep quality were done before and after intervention. Blood draws for NK cell counts were collected before and after the intervention. Saliva samples were collected for three consecutive days before and after intervention. Data were analyzed using the analysis of covariance on postmeasures using respective baseline measure as a covariate. RESULTS: There was a significant decrease in scales of symptom distress (P < 0.001), sleep parameters (P = 0.02), and improvement in quality of sleep (P = 0.001) and Insomnia Rating Scale sleep score (P = 0.001) following intervention. There was a decrease in morning waking cortisol in yoga group (P = 0.003) alone following intervention. There was a significant improvement in NK cell percent (P = 0.03) following intervention in yoga group compared to control group. CONCLUSION: The results suggest modulation of neuroendocrine responses and improvement in sleep in patients with advanced breast cancer following yoga intervention.

Effects of an integrated Yoga Program on Self-reported Depression Scores in Breast Cancer Patients Undergoing Conventional Treatment: A Randomized Controlled Trial.

AIM: To compare the effects of yoga program with supportive therapy on self-reported symptoms of depression in breast cancer patients undergoing conventional treatment. PATIENTS AND METHODS: Ninety-eight breast cancer patients with stage II and III disease from a cancer center were randomly assigned to receive yoga (n = 45) and supportive therapy (n = 53) over a 24-week period during which they underwent surgery followed by adjuvant radiotherapy (RT) or chemotherapy (CT) or both. The study stoppage criteria was progressive disease rendering the patient bedridden or any physical musculoskeletal injury resulting from intervention or less than 60% attendance to yoga intervention. Subjects underwent yoga intervention for 60 min daily with control group undergoing supportive therapy during their hospital visits. Beck's Depression Inventory (BDI) and symptom checklist were assessed at baseline, after surgery, before, during, and after RT and six cycles of CT. We used analysis of covariance (intent-to-treat) to study the effects of intervention on depression scores and Pearson correlation analyses to evaluate the bivariate relationships. RESULTS: A total of 69 participants contributed data to the current analysis (yoga, n = 33, and controls, n = 36). There was 29% attrition in this study. The results suggest an overall decrease in self-reported depression with time in both the groups. There was a significant decrease in depression scores in the yoga group as compared to controls following surgery, RT, and CT (P < 0.01). There was a positive correlation (P < 0.001) between depression scores with symptom severity and distress during surgery, RT, and CT. CONCLUSION: The results suggest possible antidepressant effects with yoga intervention in breast cancer patients undergoing conventional treatment.

Effect of yoga therapy on facial emotion recognition deficits, symptoms and functioning in patients with schizophrenia.

OBJECTIVE: Facial emotion recognition deficits have been consistently demonstrated in schizophrenia and can impair socio-occupational functioning in these patients. Treatments to improve these deficits in antipsychotic-stabilized patients have not been well studied. Yoga therapy has been described to improve functioning in various domains in schizophrenia; however, its effect on FERD is not known. METHOD: Antipsychotic-stabilized patients randomized to receive Yoga (n=27), Exercise (n=17) or Waitlist group (n=22) were assessed at baseline, 2nd month, and 4th month of follow-up by raters blind to group status. Assessments included Positive and Negative Syndrome Scale (PANSS), Socio-Occupational Functioning Scale (SOFS), and Tool for Recognition of Emotions in Neuropsychiatric DisorderS (TRENDS). RESULTS: There was a significant positive correlation between baseline FERD and socio-occupational functioning (r=0.3, P=0.01). Paired samples t test showed significant improvement in positive and negative symptoms, socio-occupational functioning and performance on TRENDS (P<0.05) in the Yoga group, but not in the other two groups. Maximum improvement occurred at the end of 2 months, and improvement in positive and negative symptoms persisted at the end of 4 months. CONCLUSION: Yoga therapy can be a useful add-on treatment to improve psychopathology, FERD, and socio-occupational functioning in antipsychotic-stabilized patients with schizophrenia.

Effects of yoga on brain wave coherence in executives.

Aim of this study was to assess the effect of Self Management of Excessive Tension (SMET), a yoga based stress management program on brain wave coherence. Brain wave recordings were taken with Brain Master 2 Channel EEG (version-2.0). The subjects for the study were 72 corporate executives, 48.75 +/- 3.86 years of mean age referred from Oil and Natural Gas Corporation Limited. EEG data was recorded on the first and sixth day of 5 days SMET program. A complete statistical and spectral analysis showed 19.31% increase (p=0.03) in delta, 5.04% increase (p=0.65) in theta, 15.40% increase (p=0.09) in alpha, 1.67% decrease (p=0.54) in beta and 18.68% increase (p=0.07) in gamma wave coherence between pre and post intervention measurements. Taken together, these results suggest that participation in a SMET program was associated with improvement in emotional stability and may have implications for 'Executive Efficiency'. Because before and after designs limit inferences about intervention effects, further research is warranted to explore the effects of SMET program for stress management using a larger, randomized controlled trial.

Role of Mind-Body Intervention on Lipid Profile: A Cross-sectional Study.

BACKGROUND: Yoga is a combination of physical-breathing and meditative techniques that assist in the unification of the mind-body, which improves the quality of life. It was shown that long-term Yoga practitioners had superior control over respiratory rate, reduced stress and anxiety, and a better-controlled lipid profile. PURPOSE: We aimed to investigate the lipid profile of long-term yoga practitioners who were practicing yoga for more than 1 year in comparison with the nonyoga group. METHODS: A nationwide survey was conducted in which the long-term yoga practitioners (n = 76) and nonyoga practitioners (n = 80) were recruited for assessment for the lipid parameters. RESULTS: The mean (standard deviation) values of both groups were within normal range with serum cholesterol at 189.715 ± 20.4 and 180.88 ± 29.7 and triglycerides at 216.72 ± 92.5 and 207.665 ± 88.3, low-density lipoprotein at 126.65 ± 18.5 and 120.775 ± 26.5, and high-density lipoprotein at 47.17 ± 6.6 and 44.99 ± 7.0, respectively, in yoga and no-yoga groups. CONCLUSION: The lipid profile values were similar in yoga and nonyoga practitioners in the 2017 survey.

A Perspective on Yoga as a Preventive Strategy for Coronavirus Disease 2019.

The pandemic outbreak of coronavirus disease 2019 (COVID-19) infection caused by severe acute respiratory syndrome-coronavirus 2 has led to profound public health crisis. In particular, individuals with preexisting conditions of heart disease, diabetes, cerebrovascular diseases and the elderly are most vulnerable to succumb to this infection. The current COVID-19 emergency calls for rapid development of potential prevention and management strategies against this virus-mediated disease. There is a plethora of evidence that supports the add-on benefits of yoga in stress management, as well as prevention and management of chronic noncommunicable diseases. There are some studies on the effect of yoga in communicable diseases as well but very few for acute conditions and almost none for the rapidly spreading infections resulting in pandemics. Based on the available scientific evidences on yoga in improving respiratory and immune functions, we have formulated very simple doable integrated yoga modules in the form of videos to be practiced for prevention of the disease by children, adults, and the elderly.

Is the Indian Dietary Pattern Associated WithType 2 Diabetes? A Pan-India Randomized Cluster Sample Study.

BACKGROUND: Diabetes is associated strongly with many neurodegenerative diseases and is also a lifestyle disorder. A good glycemic status depends on diet management and physical activity. There are several studies available on the relationship between diet habits and impact on diabetes. PURPOSE: The objective of this study was to check the association of different dietary factors with glucose levels and lipid values in type 2 diabetes from a part of a large nationwide trial. METHODS: This was the data fromapan-India multicentered cluster randomized controlled study covering 60 states and 4 union territories; 17,285 individuals were surveyed for dietary factors. Amongst them, data of 12,500 individuals were analyzed.Males were 54% and 60% individuals were from urban areas. RESULTS: The analysis of the results showed that consumption (usual/often) of milk(odds ratio, OR = 7.180), meat (OR = 6.81), less fiber (OR = 17.77), and less fruits (OR = 14.71) was strongly and positively associated with fasting blood glucose (P<.001). The postprandial blood glucose (PPBG) in diabetes individuals also had a strong positive association (P<.001) with consumption (usual/often) of meat (OR = 22.82) and milk (OR = 17.19). In prediabetes individuals, milk was significantly (P<.001) associated with fasting blood glucose (OR = 2.74). In nondiabetes individuals also, milk was significantly associated with postprandial blood glucose (OR = 2.56). Consumption of meat was associated with high cholesterol (OR = 1.465).Consumption of junk food was associated significantly (P <.001)with the status of known diabetes (OR = 1.345) and known hypertension (OR = 1.247). CONCLUSION: Consumption of milk, meat, less vegetables, less fruits, and junk food has a significant effect on the glycemic status and cholesterol levels, and also on the status of known diabetes and hypertension.

Depression in High-Risk Type 2 Diabetes Adults.

BACKGROUND: Patients suffering from diabetes mellitus are two to three times more vulnerable to develop depressive symptomatology. PURPOSE: To report the association between depression and high-risk diabetes in India. METHODS: A total of 1,606 adults were recruited for the study. A patient health questionnaire was used to determine the depression on the basis of score. A statistical analysis was done using analysis of covariance (ANCOVA) and binary logistic regression to determine the association between diabetes categories and four degrees of depression. RESULTS: Out of 1,606 participants, 52.6% were males and 47.4% were females, 56.4% belonged to the urban area and 43.6% to the rural area. However, 19.5% (314) had diabetes; 29.1% of diabetes individuals had minimal depression, 38.7% had mild, 17.2% moderate, 12.0% moderately severe, and 3.1% had severe depression. In the self-reported diabetic participant group (N = 142), there was a significantly higher degree of severe depression (3.3%) in the uncontrolled group (HbA1c >7%) as compared to the well-controlled diabetes group (HbA1c <7%). ANCOVA in gender differences in the uncontrolled diabetes group showed that male gender had significantly (P = -.02) higher mean scores of depression. CONCLUSION: This study found that there is a positive association between depression and uncontrolled diabetes in male gender.

Development and Testing of an Audio-Visual Self-Help Yoga Manual for Indian Caregivers of Persons with Schizophrenia Living in the Community: A Single-Blind Randomized Controlled Trial.

BACKGROUND: To test the feasibility and effectiveness of an audio-visual self-help audio-visual yoga manual on burden of Indian caregivers of persons with schizophrenia, living in the community. METHODS: An earlier developed yoga program for caregivers of schizophrenia was remodeled into an audio-visual self-help manual in three languages and validated by mental health and yoga experts. 48 consenting primary family caregivers of outpatients with schizophrenia were screened, recruited, and allotted randomly to Yoga or Care as Usual Group. Participants in Yoga group were taught yoga from the self-help manual (1 session of 1 h every month for 5 months). The caregivers were asked to follow the manual for the remaining month at home. Assessments of burden, perceived stress, quality of life, and anxiety-depression were conducted by a rater blind to the group status at baseline and at the end of every month. RESULTS: Post factoring for missing data, Repeatedmeasure ANOVA was conducted; which showed that there was no significant difference between the group that practiced the selfhelp yoga manual and the care as usual group. The caregivers who practiced yoga at home maintained an average of 50% attendance and "very well" level of yoga performance. CONCLUSION: The audio-visual self-help yoga manual was found to be feasible to use by the caregivers even though its effectiveness could not be ascertained due to high attrition.

Effects of a yoga program on cortisol rhythm and mood states in early breast cancer patients undergoing adjuvant radiotherapy: a randomized controlled trial.

UNLABELLED: Objectives. This study compares the effects of an integrated yoga program with brief supportive therapy in breast cancer outpatients undergoing adjuvant radiotherapy at a cancer center. METHODS: Eighty-eight stage II and III breast cancer outpatients are randomly assigned to receive yoga (n = 44) or brief supportive therapy (n = 44) prior to radiotherapy treatment. Assessments include diurnal salivary cortisol levels 3 days before and after radiotherapy and self-ratings of anxiety, depression, and stress collected before and after 6 weeks of radiotherapy. RESULTS: Analysis of covariance reveals significant decreases in anxiety (P < .001), depression (P = .002), perceived stress (P < .001), 6 a.m. salivary cortisol (P = .009), and pooled mean cortisol (P = .03) in the yoga group compared with controls. There is a significant positive correlation between morning salivary cortisol level and anxiety and depression. CONCLUSION: Yoga might have a role in managing self-reported psychological distress and modulating circadian patterns of stress hormones in early breast cancer patients undergoing adjuvant radiotherapy.

Effect of Residential Yoga Camp on Psychosocial Fitness of Adolescents.

BACKGROUND: Adolescence is a key phase of socialization, where improved psychosocial fitness helps to promote socioeconomic productivity in societies. Psychosocial fitness also has an impact on the academic performance, overall health, and quality of life, throughout life. The present study evaluates the effect of yoga intervention on psychosocial fitness among adolescents. MATERIALS AND METHODS: A single group, pre and post yoga interventional study was carried out in three independent cohorts (batches 1, 2, and 3), having sample size of 148, 167, and 195 respectively. A 7-day integrated yoga intervention was given in a residential setting. Psychosocial assessments included social competence, empathy, altruism, parent relationship, and peer friendship. Data were collected from the participants and their parents using respective versions of the scales. While pre- and post-data were collected from all the adolescent participants, pre- and post-data from parents were collected for 340 and 43 parents only. The objective of the analyses was to evaluate the effect of the yoga program and check the consistency of these effects. RESULTS: Significant changes (P < 0.05) were seen in social competence, empathy, and altruism in batches 2 and 3, whereas changes in batch 1 showed nonsignificant improvements. Analyses of the parental data indicated a significant improvement in parent relationship (P = 0.035) and also nonsignificant improvement in all other outcomes. CONCLUSION: Results suggested that yoga intervention might help in improving psychosocial fitness in adolescents. It also helped to demonstrate that administering yoga was acceptable and feasible in a residential setting.

Traditional practices and recent advances in Nadi Pariksha: A comprehensive review.

The significance of Nadi Pariksha is well understood and effectively used by Ayurveda practioners for assessing Tridoshas and various physiological and psychological states of the patient. The traditional texts Sarangadhara Samhita, YogaRatnakara, Basavarajeeyam and Bhavaprakasha have discussed the details of Nadi Pariksha in succinct set of slokas. Ayurveda has thousands of years of rich experience in Nadi Pariksha with strong literature support but is subjective in nature and the need for studying nadi with a scientific approach is well understood. Recently, pulse wave velocity has gained significant research interest as it is considered to be a strong indicator of cardiovascular disease; however, the relevance of pulse wave analysis to Nadi Pariksha has not been studied. In this review, traditional methods of Nadi Pariksha as defined in Ayurveda classics and the recent advances in pulse wave analysis are discussed. As per classical texts, qualities or properties of pulse such as pulse movement (gati), speed of the pulse (vega), stability of the pulse (sthiratva) and hardness of the artery (kathinya) play major role in Nadi Pariksha and in the current review these properties were analyzed and compared with the modern pulse parameters namely pulse wave velocity, pulse rate variability and arterial stiffness. The significance of pulse wave velocity in cardiovascular studies is discussed and the need for extending these studies to Ayurveda is highlighted.

Association between Cyclic Meditation and Creative Cognition: Optimizing Connectivity between the Frontal and Parietal Lobes.

BACKGROUND: Important stages of creativity include preparation, incubation, illumination, and verification. Earlier studies have reported that some techniques of meditation promote creativity but have not specified which stage is enhanced. Here, we report the influence of cyclic meditation (CM) on creative cognition measured by a divergent thinking task. Our aim was to determine the degree of association between the two. METHODS: Twenty-four university students were randomly assigned to an experimental group (CM) and controls (Supine Rest), 35 min/day for 7 days. Creativity performance was assessed pre and post using Abbreviated Torrance Test for Adults (ATTA), while 64-channel electroencephalography (EEG) was used to measure brain activity during both CM/SH and the creativity test. RESULTS: Results indicated that CM training improved creativity performance, producing a shift to predominant gamma activity during creativity compared controls who showed delta activity. Furthermore, the experimental group showed more activation of frontal and parietal regions (EEG leads F3, F4 and P3, P4) than controls, i.e., the regions of the executive network responsible for creative cognition, our particular regions of interest where specialized knowledge is being stored. CONCLUSION: Improvement on creativity test performance indicates that CM increases association and strengthens the connectivity between frontal and parietal lobes, the major nodes of default mode network and executive attention network, enhancing the important stages of creativity such as preparation, incubation, and illumination.

Lifestyle - A Common Denominator for the Onset and Management of Migraine Headache: Complementing Traditional Approaches with Scientific Evidence.

BACKGROUND: Ayurveda and Yoga have gained popularity in the management of various chronic health problems associated with pain including migraine headache. It is evident from both scientific as well as traditional literature that stress, diet, sleep, and exposure to extreme climatic conditions act as triggering factors for the onset of migraine. Hence, it is essential to focus on lifestyle including diet as important factors for prevention and as adjuvant factors in the management of migraine headache. AIM: The aim was to propose a new perspective to the understanding of migraine headache keeping in view the role of lifestyle including diet. METHODS: Classical Ayurveda texts and traditional Yoga scriptures were used to compile information on the role of lifestyle including diet in the onset and management of migraine headache. This was complemented by PubMed-based review of scientific literature. OUTCOME: Ayurveda texts provide an extensive information about the basic understanding, causes, precipitating factors, and management of migraine headache, while Yoga texts refer to the concept of mental stress (adhi) leading to physical health problems (vyadhi). It is evident from the literature that diet, sleep, exposure to extreme climatic conditions, and mental stress play an important role in the onset and management of migraine headache. CONCLUSION: Lifestyle appears to be the common factor for both onset and management of migraine headache.

Effect of anapanasati meditation on anxiety: a randomized control trial.

BACKGROUND: Meditation has shown positive results in improving the psychological disorders such as anxiety. There is a need to study the therapeutic benefits of Anapanasati meditation, a mindfulness meditation technique. PURPOSE: The study aims at investigating the effect of Anapanasati meditation on individuals with moderate anxiety. METHODS: A total of 112 participants who were willing to participate in the study were recruited for the study. Anapanasati meditation was used as an intervention. The participants were divided into two groups experiment and control groups. Experiment group had 56 persons performing Anapanasati meditation and Control group had 56 persons not performing any type of meditation. The experiment group practiced one hour of Anapanasati meditation daily under the supervision of experts for six months and continued their daily routine and control group was not given any intervention, but they continued their daily routine. State Trait Anxiety Inventory (STAI) is used to assess the anxiety level. RESULTS: The STAI score before and after Anapanasati meditation was analysed for both experiment and control groups using Paired Samples T test. The experiment group has shown significant reduction in the STAI (P < 0.05) score after the intervention whereas in the control group the reduction in STAI score was not significant. CONCLUSION: This study has shown that after six months of intervention, the subjects with moderate anxiety who practiced Anapanasati meditation had a significant decrease in their STAI score and the control group has not shown significant change in the STAI score.