Table of Contents  
ORIGINAL ARTICLE
Year : 2022  |  Volume : 54  |  Issue : 1  |  Page : 18-23

Effect of yoga nidra on the brain activity in individuals with migraine


1 Associate Professor, Department of Research, SDM College of Yoga and Naturopathy and Yogic Sciences, Ujire, Karnataka, India
2 Principal, Department of Yoga and Naturopathy, SDM College of Yoga and Naturopathy and Yogic Sciences, Ujire, Karnataka, India
3 Department of Yoga and Naturopathy, SDM College of Yoga and Naturopathy and Yogic Sciences, Ujire, Karnataka, India
4 Dean, Department of Yoga Therapeutics, SDM College of Yoga and Naturopathy and Yogic Sciences, Ujire, Karnataka, India

Date of Submission28-Mar-2022
Date of Decision20-Apr-2022
Date of Acceptance21-Jun-2022
Date of Web Publication30-Jun-2022

Correspondence Address:
H C Shashikiran
Department of Research, S.D.M. College of Naturopathy and Yogic Sciences, Ujire, Karnataka, India. Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ym.ym_35_22

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  Abstract 


Background: Migraine is a frequent neurological problem that carries the largest burden in terms of years spent disabled among neurological conditions. The conventional management has not been able to successfully treat migraine and hence, there was a need for combating these disorders through conventional therapies like yoga with an evidence-based approach. As there are only few evidence in this aspect, this research aims at finding evidence for yoga and naturopathy on migraine.
Materials and Methods: Participants (n = 60) were randomly allocated into two groups, control group (n = 30) and intervention group (n = 30). The intervention group received Yoga Nidra and the control group was given supine rest (Rest without conscious awareness). The electroencephalogram data were recorded both at baseline and postintervention for both groups. The data were analyzed using SPSS version 20.0 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Armonk, NY: IBM Corp), and the results were tabulated.
Results: The results of the current study showed increased frequency in alpha waves in the interventional group compared to the control group. The control group showed no significant changes in the brain activity.
Conclusion: The results indicate that Yoga Nidra induces relaxation through enhanced alpha waves. This shows that Yoga Nidra helps in parasympathetic dominance and hence decreases sympathetic activation. Hence, this study suggests that Yoga Nidra could be used as an effective tool in combating stress and neuropsychiatric symptoms in migraine patients.

Keywords: Brain activity, electroencephalogram, migraine, Yoga Nidra


How to cite this article:
Shashikiran H C, Shetty P, Akshay R, Venugopal A, Shetty S. Effect of yoga nidra on the brain activity in individuals with migraine. Yoga Mimamsa 2022;54:18-23

How to cite this URL:
Shashikiran H C, Shetty P, Akshay R, Venugopal A, Shetty S. Effect of yoga nidra on the brain activity in individuals with migraine. Yoga Mimamsa [serial online] 2022 [cited 2022 Sep 28];54:18-23. Available from: https://www.ym-kdham.in/text.asp?2022/54/1/18/348199




  Introduction Top


Migraines are the most common type of vascular headache, affecting 28 million Americans, and cause marked impairment in functioning and quality of life.[1] Migraine headaches are estimated to affect around 231 million people in India.[2] Migraine has been seen to be affected to around 30% of population presented with headache and its age-standardized prevalence in Karnataka has been found to be 25.2%.[3] The prevalence of migraine headaches among both adult and adolescent populations reflects a burdensome and debilitating condition that affects productivity and well-being.[4] Migraine headaches result in estimated annual costs totaling $13 billion to $17 billion in the United States. This estimated figure includes clinical care, medications, emergency room visits, hospitalizations, and management of side effects.[5] The World Health Organization reported migraines as one of the world's most disabling illnesses, which speaks to the need for effective and sustainable treatments.[2]

In addition to being an overall health concern, migraines comprise 4.5% of reported neuropsychiatric conditions, increasing to 7.1% among women of working age.[6] The burdensome effects of a migraine headache are not a matter of mortality or morbidity, but what constraints and limitations it has on overall functioning. Symptoms encountered by migraine sufferers include reduced energy, deregulated mood, pain, and occupational impairment.[7]

Migraine sufferers reported that work productivity for both paid work and household chores was reduced, averaging between 2.7 and 8.9 days of lost work per year.[8] These lost work days both in and out of the home carry negative implications for individuals, families, and the workforce. A critical barrier to successfully treating migraines is the misperception that migraine headaches are not a treatable public health problem. This societal misunderstanding leads to underdiagnosis, undertreatment, and continued impairment.[9]

Yoga is an ancient Indian science well known presently all over the world for its potential therapeutic benefits both physical and mental, which commonly include the practice of physical postures (asanas), breathing practices (pranayama), and meditation (dhyana) practices being practiced in India since thousands of years to attain functional harmony between body and mind. Having vast evidence of the beneficial role of immediate and short-term yoga practices over autonomic functions, anxiety, depression, hypertension, and other morbidities of stress, a necessity to understand the regulatory role of yoga in long-term practitioners is warranted.

Nonpharmacological therapies play a major role to relieve stress and anxiety, of which yoga takes first place compared to pharmacological treatment.[10] Yoga is now regarded in the Western world as a holistic medicine and aims at preventive healthcare. It is a division of Complementary and Alternative Medicine (CAM) by the National Institutes of Health.[11] The practice of yoga produces a physiological state opposite to that of the flight-or-fight stress response and with that interruption in the stress response, a sense of balance and union between the mind and body can be achieved.[12] Yoga is a form of mind-body fitness that involves a combination of muscular activity and an internally directed mindful focus on awareness of the self, the breath, and energy. Therapeutic yoga is defined as the application of yoga postures and practice to the treatment of health conditions. Yoga therapy involves instruction in yogic practices and teachings to prevent reduce or alleviate structural, physiological, emotional, and spiritual pain, suffering, or limitations.[13]

Yoga is recognized as a form of mind-body medicine that integrates an individual's physical, mental and spiritual components to improve aspects of health, particularly stress-related illnesses.[14] Evidence shows that stress contributes to the etiology of heart disease, cancer, and stroke as well as other chronic conditions and diseases.[15] Because stress is implicated in numerous diseases, it is a priority to include a focus on stress management and reduction of negative emotional states to reduce the burden of disease. Viewed as a holistic stress management technique, yoga is a form of CAM that produces a physiological sequence of events in the body reducing the stress response. The scientific study of yoga has increased substantially in recent years and many clinical trials have been designed to assess its therapeutic effects and benefits.

In recent years, many studies demonstrated that mindfulness (a “relaxed wakefulness” practice based on the ancient eastern tradition of meditation) reduces pain. “Mindful yoga” was suggested to be a feasible and acceptable approach for pain, fatigue, sleep disturbance, psychological distress, and functional impairment in women with metastatic breast cancer.[16]

Mindful meditation engages multiple unique brain mechanisms and psychological mechanisms by which a yoga intervention attenuates the subjective experience of pain. Relaxation postures and Yoga Nidra have been found to reduce analgesic requirements and improve sleep and reduce fatigue in malignant pain states.[17]

Yoga Nidra is the best-known technique to induce complete physical mental and emotional relaxation. Yoga Nidra is a state of consciousness, which is, neither sleep nor awaken, neither is it concentration nor hypnotism. It can be defined, as an altered state of consciousness.[18]

It means sleep with a trace of awareness.[18] Yoga Nidra has been termed “sleepless sleep” because we learn to enter the state between sleep and wakefulness without loss of awareness. Yoga Nidra is qualitatively different from relaxation. It is a “sleep” where all the burdens are thrown off to attain a more blissful state of awareness, a relaxation much more intense than ordinary sleep. Yoga Nidra helps the mind to achieve relaxation and increase wellness. Researches also indicate that Yoga Nidra can help to cure psychological disorders such as anxiety and insomnia and psychosomatic diseases such as asthma, coronary heart disease, cancer, and hypertension. Yoga Nidra is a simple method of relaxation which is practiced in supine position of shavasana (lying on the back, the arms and legs are spread at about 45°), and following instructions of yoga therapist. It concerns mainly with Pratyahara (the fifth state of Astanga Yoga which involves withdrawal of senses) and Dharana (concentration). It is to be understood that ordinary sleep is not relaxation and tensions cannot always be resolved completely in ordinary sleep. Yoga Nidra is a qualitatively different relaxation. During the practice of Yoga Nidra, consciousness is at different levels. When one practices Yoga Nidra, it opens the deeper phases of the mind.[19]

Yoga being a therapy focuses on the holistic well-being of the individual. The integrated approach of yoga therapy such as yogic asanas, pranayama, kriyas, and relaxation technique also has a significant role in the reduction of migraine headache frequency and associated clinical features.[20]

In conclusion, migraine headache afflicts almost everyone at some time or the other. Migraine is caused by the increased excitability of the central nervous system and ranks among the world's most disabling illnesses. Recurrent attacks of migraine affect the patient's quality of life, social activities, and family life. Even though there are medications available to prevent the frequency of migraine attacks they have side effects on the human body. Though integrated Yoga therapy has been shown to be useful in patients with migraine, efficacy of only Yoga Nidra in patients with migraine has not been explored. Hence, the present study was aimed to evaluate the effect of Yoga Nidra on migraine headaches.


  Materials and Methods Top


Source of data

The participants were screened in a Yoga and Naturopathy Hospital in South Karnataka.

Method of collection of data

Before commencing the study, the participants were screened as per the inclusion and exclusion criteria. A prior permission of ethical clearance was obtained from the institution for conducting the study. A signed informed consent was obtained from the participants by explaining the procedure, study objectives, study methods, and all the rights of the participant pertaining to the conduction of the study both orally and in writing. The data were collected at baseline and postintervention.

Criteria for diagnosis

According to the International Classification of Headache Disorders.

Headache symptoms

  1. Duration: Headache attack lasts 4–72 h (when untreated or unsuccessfully treated)
  2. Characteristics: headache has >2 of the following four characteristics


    • Unilateral location
    • Pulsating quality
    • Moderate or severe pain intensity
    • Aggravation by or causing avoidance of routine physical activity.


Nonheadache symptoms

  • During headache, the patient has >1 of the following


    1. Nausea and/or vomiting
    2. Photophobia and phonophobia.


Inclusion criteria

  • Participants satisfying diagnostic criteria
  • Aged between 18 and 25 years
  • Both male and female
  • Not under any medications for migraine.


Exclusion criteria

  • Associated with any other severe illness
  • Autoimmune disorders
  • Any other associated complications.


Study design

  • Design: A randomized control trial
  • Sample size: n = 60
  • Experimental design:


    • Group 1: Control group, receiving supine rest (rest without conscious awareness)
    • Group 2: Intervention group, Yoga Nidra was given (sleep with conscious awareness, i.e., Jagrutha Nidra).


Data analysis

  • On normality check, paired differences of Theta_ mcV, Gamma_ mcV, Theta_ MPF, Beta_ MPF, Gamma_ MPF, Delta_ MPF has shown normal distribution. Hence, paired t test was used to compare two dependent means.
  • While paired differences of Alpha_ mcV, Beta_ mcV, Delta_ mcV, PowerV2, Alpha_ MPF have shown nonnormal distribution. Hence, Wilcoxon Signed-rank test was used to compare two dependent means.



  Results Top


A total of 60 participants who met the inclusion and exclusion criteria were included in the study and were divided into two groups control (n = 30) and experimental (n = 30). The experimental group was administered Yoga Nidra and control group was given supine rest. The experimental group received Yoga Nidra which was yogic sleep with mind-body awareness, whereas the control group just was allowed to relax in supine posture which just involved physical rest to the body. The data were collected both at baseline and after the intervention. The electroencephalogram (EEG) was evaluated in numerical terms and waves were analyzed for the study. The EEG data are summarized in [Table 1] (test group) and [Table 2] (control group). There was no clinical significance in the waveforms of both the control and experimental group; however, there was an increase in the alpha wave pattern in the case of the experimental group (p = 0.3) when compared to the control group (p = 0.6). There were no much significant changes noted in the other waveforms of beta and delta waves of the EEG.
Table 1: Electroencephalogram analysis of test group

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Table 2: Electroencephalogram analysis of control group

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  Discussion Top


The present randomized trial comprised of 60 participants with migraine, who were given the intervention of Yoga Nidra showed an improvement in the alpha brain waves when compared to other waves. However, there were no statistically significant changes in the wave patterns of the brain, allowing for further investigations to appropriately prove the benefits of Yoga Nidra practice. Migraine headaches are one of the most prevailing causes of discomfort, especially among young adults. It was found through many studies that migraine was associated with neuropsychiatric disorders such as anxiety and depression.[21] A survey showed that one in every eight members, suffering from migraine had psychiatric problems such as depression and anxiety, making it mandatory to focus on the symptoms of migraine and its management. Nonpharmacological way of treating migraine headaches is one of the important aspects of management. Looking into various complementary therapies in managing migraine, yoga is one of the most important and effective treatment modalities for migraine. An important form of yoga, Yoga Nidra has a substantial effect on mental relaxation and is responsible for alpha dominance in the brain proven by a study. Yoga Nidra is one of the most efficient yoga techniques for both physical and mental relaxation as well as mental preparation for yogic discipline. Individuals learn to enter the condition between sleep and waking without losing consciousness, which is referred to as “sleepless sleep.” Even though Yoga Nidra has been found to have a considerable impact on the relaxation response, no research has looked at the impact of this practice on conditions like migraine and evaluating the brain waves during this condition. Positive changes in brain waves are noticed when complementary therapies such as yoga and meditation are used. Brain relaxation activities have been shown to increase brain wave activity. In the present study, the data analysis showed that there was a slight increase in the frequency (MpF) of alpha waves when compared to other waves. Intergroup analysis showed that the intervention group showed better results than the control group. However, there was no statistical significance noted in the analysis. The pre–post analysis showed better improvement in the frequency of alpha waves when compared to beta and theta waves in the Yoga Nidra group. Alpha waves are seen in the EEG during a normal wakeful state where the subject is quietly resting. Alpha waves play an important role in brain activity, studies show that increase in the alpha wave frequency leads to decrease in anxiety and depression.[22] Yoga Nidra has been found to reduce stress and anxiety levels of college students,[23] and the authors state that it might also have positive results for other age groups. Previous studies have also shown that employing yoga techniques, such as Yoga Nidra, for other conditions (cancer survivors, self-reported emotional distress) results in beneficial effects for depression and mood, as well as anxiety and physical well-being, increase in the alpha brain activity supporting the findings of our study.[24] Thus, this study attributes to the finding that Yoga Nidra can be one of the adjuvant therapies in improving the symptoms of migraine. The strength of the study is that it is the first study done on the effect of Yoga Nidra and its evaluation through EEG in migraine conditions to the best of our knowledge. The major limitation of the study is low sample size which can attribute to the hindrance in correlating the findings to the majority of the population. Further research can be conducted by taking both subjective and objective findings into consideration with a larger sample size as it would be adding more value to the study.
Figure 1: CONSORT chart of the study

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  Conclusion Top


This randomized control trial suggests that Yoga Nidra can be effective in the treatment of migraine associated with neuropsychiatric symptoms. Although there could be no statistical conclusions drawn from the current study, an increase in the alpha wave activity during the Yoga Nidra can be suggestive of a relaxed state of mind that can help in alleviating anxiety and depression.

Financial support and sponsorship

This work was funded by Rajiv Gandhi University of Health Sciences, Bengaluru, Karnataka, India. Project Code: 17Y010.

Conflicts of interest

There are no conflicts of interest.



 
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    Tables

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