Insomnia rates continue to rise, especially among specific populations. Current nonpharmacological treatments rely primarily upon cognitive behavioral therapy for insomnia (CBT-I), which was introduced in the 1970s. Newer treatments have incorporated CBT “third wave” techniques, including mindfulness and acceptance techniques. Yoga practice is well suited to complement existing therapies and to address sleep problems in a more holistic way. Current theoretical and empirical approaches to treating insomnia are discussed, with an emphasis on the role of yoga in addressing precipitating and perpetuating factors in insomnia that have previously been largely overlooked.

An estimated one-third of U.S. adults suffer from insomnia (Chen, Gelaye, & Williams, 2013; Mellinger, Balter, & Uhlenhuth, 1985; Ohayon, 2002), and the problem appears to be growing. While treatment for insomnia has helped to alleviate the problem for some (Irwin, Cole, & Nicassio, 2006; Morin et al., 2009), prevalence of insomnia is on the rise, especially among certain groups, including elderly and military populations (Morin, 2009; Mysliwiec et al., 2013). Rising rates of insomnia have been attributed to changes in lifestyle and environmental factors, including increased reliance on technology and decreased synchrony with natural wake-sleep rhythms (Brahinsky, 2013; Wallace-Guy et al., 2002; Yun, Bazar, Gerber, Lee, & Daniel, 2005).

Afonso, R. F., Hachul, H., Kozasa, E. H., Oliveira, Dde. S., Goto, V., Rodrigues, D., et al. (2012). Yoga decreases insomnia in postmenopausal women: A randomized clinical trial. Menopause, 19(2), 186-193.
Yoga decreases insomnia in postmenopausal women: A randomized clinical trial
Menopause
, vol. 
19
 (pg. 
186
-
193
)
Anonymous (2011). Alternative therapies. Consumer Reports, Sep 2011, 20-25.
Bhat, A., Shafi, F., & El Solh, A.A. (2008). Pharmacotherapy of insomnia. Expert Opinion: Pharmacotherapy, 9(3), 351-362.
Pharmacotherapy of insomnia
Expert Opinion: Pharmacotherapy
, vol. 
9
 (pg. 
351
-
362
)
Brahinsky, R. Sweet Dreams (2013). Yoga Journal. Retrieved Sep 21 2013 from http://www.yogajournal.com/health/2593. http://www.yogajournal.com/health/2593
Chatterjee, A., Ray, K., Koushik, R., Panjwani, U., Thakur, L., & Anand, J. P. (2012). Meditation as an intervention for cognitive disturbances following total sleep deprivation. Indian Journal of Medical Research, 136(6), 1031-1038.
Meditation as an intervention for cognitive disturbances following total sleep deprivation
Indian Journal of Medical Research
, vol. 
136
 (pg. 
1031
-
1038
)
Chen, K. M., Chen M. H., Chao, H. C., Hung, H. M., Lin H. S., & Li, C. H. (2009). Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial. International Journal of Nursing Studies, 46(2), 154-163.
Sleep quality, depression state, and health status of older adults after silver yoga exercises: cluster randomized trial
International Journal of Nursing Studies
, vol. 
46
 (pg. 
154
-
163
)
Chen, K. M., Chen, M. H., Lin M. H., Fan, J. T., Lin H. S., & Li C. H. (2010). Effects of yoga on sleep quality and depression in elders in assisted living facilities. Journal of Nursing Research, 18(1) 53-61.
Effects of yoga on sleep quality and depression in elders in assisted living facilities
Journal of Nursing Research
, vol. 
18
 (pg. 
53
-
61
)
Chen, X., Gelaye, B., & Williams, M. A. (2014). Sleep characteristics and health-related quality of life among a national sample of American young adults: assessment of possible health disparities. Quality of Life Research, 23(2), 613-625.
Sleep characteristics and health-related quality of life among a national sample of American young adults: assessment of possible health disparities
Quality of Life Research
, vol. 
23
 (pg. 
613
-
625
)
Cimini, L. (2010). Posttraumatic stress disorder and the mind-body connection. Handbook for Yoga Warriors Training, Mass Yoga and Wellness, Inc.
Cohen, L., Warneke, C., Fouladi, R. T., Rodriguez, M. A., & Chaoul-Reich, A. (2004). Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer, 100(10), 2253-2260.
Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma
Cancer
, vol. 
100
 (pg. 
2253
-
2260
)
Dalrymple, K. L., Fiorentino, L., Politi, M. C., & Posner, D. (2010). Incorporating principles from acceptance and commitment therapy into cognitive-behavioral therapy for insomnia: A case example. Journal of Contemporary Psychotherapy, 40, 209-217.
Incorporating principles from acceptance and commitment therapy into cognitive-behavioral therapy for insomnia: A case example
Journal of Contemporary Psychotherapy
, vol. 
40
 (pg. 
209
-
217
)
Dowdle, H. (2013, Oct). Sweet Surrender: When you can't sleep, yoga's deeper teachings can help you let go and find rest. Yoga Journal, 89-110.
Sweet Surrender: When you can't sleep, yoga's deeper teachings can help you let go and find rest
Yoga Journal
(pg. 
89
-
110
)
Field, T. Diego, M., Delgado J., & Medina, L. (2013). Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances. Complementary Therapy in Clinical Practice, 19(1), 6-10.
Tai chi/yoga reduces prenatal depression, anxiety and sleep disturbances
Complementary Therapy in Clinical Practice
, vol. 
19
 (pg. 
6
-
10
)
Gross, C. R., Kreitzer, M. J., Reilly-Spong, M., Wall, M., Winbush, N. Y., Patterson, R., et al. (2011). Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: A randomized controlled trial. Explore (NY), 9(2), 76-87.
Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: A randomized controlled trial
Explore (NY)
, vol. 
9
 (pg. 
76
-
87
)
Hall, M., Buysse, D. J., Dew, M. A., Prigerson, H. G., Kupfer, D. J., & Reynolds, M. D. III. (1997). Intrusive thoughts and avoidance behaviors are associated with sleep disturbances in bereavement-related depression. Depression and Anxiety, 6, 106-112.
Intrusive thoughts and avoidance behaviors are associated with sleep disturbances in bereavement-related depression
Depression and Anxiety
, vol. 
6
 (pg. 
106
-
112
)
Hall, M., Thayer, J. F., Germain, A., Moul, D., Vasko, R., Puhl, M., et al. (2007). Psychological stress is associated with heightened physiological arousal during NREM sleep in primary insomnia. Behavioral Sleep Medicine, 5(3), 178-193.
Psychological stress is associated with heightened physiological arousal during NREM sleep in primary insomnia
Behavioral Sleep Medicine
, vol. 
5
 (pg. 
178
-
193
)
Hariprasad, V. R., Sivakumar, P. T., Koparde, V., Varmaally, S., Thirthalli, J., Varghese, M., et al. (2013). Effect of yoga intervention on sleep and quality-of-life in elderly: A randomized controlled trial. Indian Journal of Psychiatry, 55 (Suppl 3), S364-S368.
Effect of yoga intervention on sleep and quality-of-life in elderly: A randomized controlled trial
Indian Journal of Psychiatry
, vol. 
55
 (pg. 
S364
-
S368
)
Harvey, A. G. (2003). The attempted thought suppression of pre-sleep cognitive activity in insomnia. Cognitive Therapy and Research, 27, 593-602.
The attempted thought suppression of pre-sleep cognitive activity in insomnia
Cognitive Therapy and Research
, vol. 
27
 (pg. 
593
-
602
)
Hayes, S. C. & Smith, S. (2005). Get out of your mind and into your life: The new acceptance and commitment therapy. Oakland, CA: New Harbinger Publications.
Get out of your mind and into your life: The new acceptance and commitment therapy
Heidenreich, T., Tuin, I., Pflug, B., Michal, M., & Michalak, J. (2006). Mindfulness-based cognitive therapy for persistent insomnia: A pilot study. Psychotherapy and Psychosomatics, 75(3), 188-189.
Mindfulness-based cognitive therapy for persistent insomnia: A pilot study
Psychotherapy and Psychosomatics
, vol. 
75
 (pg. 
188
-
189
)
Innes, K. E. & Selfe, T. K. (2012). The effects of a gentle yoga program on sleep, mood, and blood pressure in older women with restless legs syndrome (RLS): A preliminary randomized controlled trial. Evidence Based Complementary and Alternative Medicine, 2012, Article ID 294058.
Irwin, M. R., Cole, J. C., & Nicassio, P. M. (2006). Comparative metaanalysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and older adults 55+ years of age. Health Psychology, 25(1), 3-14.
Comparative metaanalysis of behavioral interventions for insomnia and their efficacy in middle-aged adults and older adults 55+ years of age
Health Psychology
, vol. 
25
 (pg. 
3
-
14
)
Kabat-Zinn, J. (2005). Wherever you go, there you are: Mindfulness meditation in everyday life. New York: Hyperion.
Wherever you go, there you are: Mindfulness meditation in everyday life
Kaul, P., Passafium, J., Sargent, C. R., & O'Hara, B. F. (2010). Meditation acutely improves psychomotor vigilance, and may decrease sleep need. Behavioral and Brain Functions, 6, 47.
Meditation acutely improves psychomotor vigilance, and may decrease sleep need
Behavioral and Brain Functions
, vol. 
6
 pg. 
47
 
Khalsa, S. B. S. (2004). Treatment of chronic insomnia with yoga: A preliminary study with sleep-wake diaries. Applied Psychophysiology and Biofeedback, 29(4), 269-278.
Treatment of chronic insomnia with yoga: A preliminary study with sleep-wake diaries
Applied Psychophysiology and Biofeedback
, vol. 
29
 (pg. 
269
-
278
)
Kudesia, R. S. & Bianchi M.T. (2012). Decreased nocturnal awakenings in young adults performing Bikram yoga: A low-constraint home sleep monitoring study. ISRN Neurology 2012, Article ID 153745.
Kyle, S. D., Crawford, M. F., & Espie, C. A. (2013). From bedside back to bench? A commentary on: “The future of cognitive behavioral therapy for insomnia: What important research remains to be done?” Journal of Clinical Psychology, 69(10), 1022-1025.
From bedside back to bench? A commentary on: “The future of cognitive behavioral therapy for insomnia: What important research remains to be done?”
Journal of Clinical Psychology
, vol. 
69
 (pg. 
1022
-
1025
)
Lundh, L. G. (2005). The role of acceptance and mindfulness in the treatment of insomnia. Journal of Cognitive Psychotherapy, 19(1): 29-39.
The role of acceptance and mindfulness in the treatment of insomnia
Journal of Cognitive Psychotherapy
, vol. 
19
 (pg. 
29
-
39
)
Lundh, L. G. & Hindmarsh, H. (2002). Can meta-cognitive observation be used in the treatment of insomnia? A pilot study of a cognitive-emotional self-observation task. Behavioural and Cognitive Psychotherapy, 30, 239-242.
Can meta-cognitive observation be used in the treatment of insomnia? A pilot study of a cognitive-emotional self-observation task
Behavioural and Cognitive Psychotherapy
, vol. 
30
 (pg. 
239
-
242
)
Manjunath, N. K. & Telles, S. (2005). Influence of yoga and Ayurveda on self-rated sleep in a geriatric population. Indian Journal of Medial Research, 121(5), 683-690.
Influence of yoga and Ayurveda on self-rated sleep in a geriatric population
Indian Journal of Medial Research
, vol. 
121
 (pg. 
683
-
690
)
Matthews, E. E., Arnedt, J. T., McCarthy, M. S., Cuddihy, L. J., & Aloia, M. (2013). Adherence to cognitive behavioral therapy for insomnia: A systematic review. Sleep Medicine Reviews (in press).
McCracken, L. M., Williams, J. L., & Tang, N. K. (2011). Psychological flexibility may reduce insomnia in persons with chronic pain: a preliminary retrospective study. Pain Medicine 12(6), 904-912.
Psychological flexibility may reduce insomnia in persons with chronic pain: a preliminary retrospective study
Pain Medicine
, vol. 
12
 (pg. 
904
-
912
)
Mellinger, G. D., Balter, M. B., & Uhlenhuth, E. H. (1985). Insomnia and its treatment: Prevalence and correlates. JAMA Psychiatry, 42(3), 225-232.
Insomnia and its treatment: Prevalence and correlates
JAMA Psychiatry
, vol. 
42
 (pg. 
225
-
232
)
Morin, C. M., Vallieres, A., Guay, B., Ivers, H., Savard, J., Merette, C., et al. (2009). Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: A randomized controlled trial. JAMA, 301(19), 2005-2015.
Cognitive behavioral therapy, singly and combined with medication, for persistent insomnia: A randomized controlled trial
JAMA
, vol. 
301
 (pg. 
2005
-
2015
)
Mustian, I. M., Sprod, L. K., Janelsins, M., Peppone, L. J., Palesh, O. G., Chandwani, K., et al. (2013). Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors. Journal of Clinical Oncology, 31(26): 3233-3241.
Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors
Journal of Clinical Oncology
, vol. 
31
 (pg. 
3233
-
3241
)
Mysliwiec, V., McGraw, L., pierce, R., Smith, P., Trapp, B., & Bernard, J.R. (2013). Sleep disorders and associated medical comorbidities in active duty military personnel. Sleep, 36(2), 167-74.
Sleep disorders and associated medical comorbidities in active duty military personnel
Sleep
, vol. 
36
 (pg. 
167
-
74
)
Nagendra, R. P., Maruthai, N., & Kutty B. M. (2012). Meditation and its regulatory role on sleep. Frontiers in Neurology, 18(3), 1-4.
Meditation and its regulatory role on sleep
Frontiers in Neurology
, vol. 
18
 (pg. 
1
-
4
)
Naiman, R. (2009). Healing Night: The science and spirit of sleeping, dreaming, and awakening. Minneapolis, MN: Syren Book Company.
Healing Night: The science and spirit of sleeping, dreaming, and awakening
Naiman, R. (2013, Jul 7). Why sleep tips don't work. Huffington Post. Retrieved November 2, 2013 from http://www.huffingtonpost.com/rubinnaiman-phd/why-sleep-tips-dont-work_b_3587451.html. http://www.huffingtonpost.com/rubinnaiman-phd/why-sleep-tips-dont-work_b_3587451.html
Ohayon, M. (2002). Epidemiology of insomnia: what we know and what we still need to learn. Sleep Medicine Review, 6(2), 97-111.
Epidemiology of insomnia: what we know and what we still need to learn
Sleep Medicine Review
, vol. 
6
 (pg. 
97
-
111
)
Ong, J. C., Shapiro, S. L., & Manber, R. (2008). Combining mindfulness meditation with cognitive-behavior therapy for insomnia: A treatment development study. Behavior Therapy, 29(2), 171-182.
Combining mindfulness meditation with cognitive-behavior therapy for insomnia: A treatment development study
Behavior Therapy
, vol. 
29
 (pg. 
171
-
182
)
Ong, J. C., Shapiro, S. L., & Manber R. (2009). Mindfulness meditation and cognitive behavioral therapy for insomnia: a naturalistic 12-month follow-up. Explore (NY) 5(1), 30-36.
Mindfulness meditation and cognitive behavioral therapy for insomnia: a naturalistic 12-month follow-up
Explore (NY)
, vol. 
5
 (pg. 
30
-
36
)
Ong, J. C., Ulmer, C. S., & Manber, R. (2012). Improving sleep with mindfulness and acceptance: A metacognitive model of insomnia. Behaviour Research and Therapy, 50(11), p. 651-660.
Improving sleep with mindfulness and acceptance: A metacognitive model of insomnia
Behaviour Research and Therapy
, vol. 
50
 (pg. 
651
-
660
)
Passos, G. S., Poyares D. L., Santana M. G., Tufik, S., & Mello M. T. (2012). Is exercise an alternative treatment for chronic insomnia? Clinics (Sao Paulo), 67(6), 653-660.
Is exercise an alternative treatment for chronic insomnia?
Clinics (Sao Paulo)
, vol. 
67
 (pg. 
653
-
660
)
Patra, S. & Telles, S. (2009). Positive impact of cyclic meditation on subsequent sleep. Medical Science Monitor, 15(7), CR375-CR381.
Positive impact of cyclic meditation on subsequent sleep
Medical Science Monitor
, vol. 
15
 (pg. 
CR375
-
CR381
)
Patra, S. & Telles S. (2010). Heart rate variability during sleep following the practice of cyclic meditation and supine rest. Applied Psychophysiology and Biofeedback, 35(2), 135-140.
Heart rate variability during sleep following the practice of cyclic meditation and supine rest
Applied Psychophysiology and Biofeedback
, vol. 
35
 (pg. 
135
-
140
)
Pietrzak, R. H., Morgan, C. A., & Southwick, S. M. (2010). Sleep quality in treatment-seeking veterans of operations enduring freedom and Iraqi freedom: The role of cognitive coping strategies and unit cohesion. Journal of Psychosomatic Research, 69(5), 441-448.
Sleep quality in treatment-seeking veterans of operations enduring freedom and Iraqi freedom: The role of cognitive coping strategies and unit cohesion
Journal of Psychosomatic Research
, vol. 
69
 (pg. 
441
-
448
)
Pigeon, W. R. (2010). Treatment of adult insomnia with cognitive behavior therapy. Journal of Clinical Psychology, 66(11), 1148-1160.
Treatment of adult insomnia with cognitive behavior therapy
Journal of Clinical Psychology
, vol. 
66
 (pg. 
1148
-
1160
)
Sarris, J. & Byrne G. J. (2011). A systematic review of insomnia and complementary medicine. Sleep Medicine Review, 15(2), 99-106.
A systematic review of insomnia and complementary medicine
Sleep Medicine Review
, vol. 
15
 (pg. 
99
-
106
)
Shapiro, S. L., Bootzin, R. R., Figueredo, A. J., Lopez, A. M., & Schwartz, G. E. (2003). The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: An exploratory study. Journal of Psychosomatic Research, 54(2003), 85-91.
The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: An exploratory study
Journal of Psychosomatic Research
, vol. 
54
 (pg. 
85
-
91
)
Taibi, D. M. & Vitiello, M. V. (2011). A pilot study of gentle yoga for sleep disturbance in women with osteoarthritis. Sleep Medicine, 12(5), 512-517.
A pilot study of gentle yoga for sleep disturbance in women with osteoarthritis
Sleep Medicine
, vol. 
12
 (pg. 
512
-
517
)
Uchida, S., Shioda, K., Morita Y., Kubota, C., Ganeko, M., & Takeda, N. (2012). Exercise effects on sleep physiology. Frontiers in Neurology, 3(48), 1-5.
Exercise effects on sleep physiology
Frontiers in Neurology
, vol. 
3
 (pg. 
1
-
5
)
Vera, F. M., Manzaneque, J. M., Maldonado, E. F., Carranque, G. A., Rodriguea, F. M., Blanca, M. J., et al. (2009). Subjective sleep quality and hormonal modulation in long-term yoga practitioners. Biological Psychology, 81:, 164-8.
Subjective sleep quality and hormonal modulation in long-term yoga practitioners
Biological Psychology
, vol. 
81
 (pg. 
164
-
8
)
Vitello, M. V., McCurry, S. M., & Rybarczyk, B. D. (2013). The future of cognitive behavioral therapy for insomnia: What important research remains to be done? Journal of Clinical Psychology, 69(10), 1013-1021.
The future of cognitive behavioral therapy for insomnia: What important research remains to be done?
Journal of Clinical Psychology
, vol. 
69
 (pg. 
1013
-
1021
)
Wallace-Guy, G. M., Kripke, D. F., Jean-Louis, G., Langer, R. D., Elliott, J. A., & Tuunainen, A. (2002). Evening light exposure: Implications for sleep and depression. Journal of the American Geriatrics Society, 50(4), 738-739.
Evening light exposure: Implications for sleep and depression
Journal of the American Geriatrics Society
, vol. 
50
 (pg. 
738
-
739
)
Yun, A. J., Bazar, K. A., Gerber, A., Lee, P. Y., & Daniel, S. M. (2005). The dynamic range of biologic functions and variation of many environmental cues may be declining in the modern age: implications for diseases and therapeutics. Medical Hypotheses, 65, 173-178.
The dynamic range of biologic functions and variation of many environmental cues may be declining in the modern age: implications for diseases and therapeutics
Medical Hypotheses
, vol. 
65
 (pg. 
173
-
178
)
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