Date of Award

Spring 5-20-2021

Degree Type

Final Project

Degree Name

DNP Doctor of Nursing Practice

Department

Nursing

Advisor

MaryEllen Roberts, D.N.P.

Committee Member

Katherine Hinic, Ph.D.

Committee Member

Katherine Hinic, DO

Abstract

Background: Insomnia is a highly prevalent disorder with deleterious health consequences, including increased risk of high blood pressure, heart disease, diabetes, anxiety, and depression. Current treatment relies on cognitive behavioral therapy and sedative hypnotics. A non-pharmacological approach is needed to manage insomnia in the long term.
Project Aim: The present program aimed to determine whether four weeks of yoga improves insomnia and anxiety severity and reduces medication use. Methods:This was a quality improvement project with a pre-intervention–post-intervention design. Before intervention, patients received standard cognitive behavioral therapy for insomnia from a sleep provider and, if there was no improvement in their insomnia symptoms, enrolled for four weeks of virtual yoga sessions two to three times a week. A total of eight participants started the program, but one withdrew from the program because of work commitments. All seven participants engaged in the 60-minute classes as directed. Their Insomnia Severity Index (ISI), State-Trait Anxiety Inventory (STAI) score, sleep latency, sleep duration, and medication use were assessed at the baseline and again at the completion of the fourweeks of yoga.
Results: After four weeks of performing yoga exercises,the participants’ overall sleep latency improved by 35 minutes on average (49% change),and their sleep duration increased by 1.07 hours on average (18.83% change). Their ISI also improved, with five participants (71%) having subthreshold insomnia and two subjects (29%) exhibiting no clinically significant insomnia. The STAI score is partitioned into the subscales State and Trait; on the State subscale, all participants improved from a median score of 29 before intervention to a median score of 19 post intervention. The Trait subscale score improved, but not markedly, from an average score of 23.71 at the baseline to 20.29 post intervention. There was no signific antchange in medication dose or frequency post intervention.
Conclusion: Four weeks of yoga improved insomnia and anxiety symptoms, shortened sleep latency, and improved sleep duration in women with chronic insomnia. Yoga,in combination with cognitive behavioral therapy for insomnia,may offer providers another non-pharmacological option to make effective and sustainable changes for patients suffering from this sleep disorder.

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