TITLE:
Insomnia in Patients Suffering from Chronic Medical Illnesses: Prevalence and Impact of IAYT
AUTHORS:
Bista Suman, Bhargav Praerna, Metri Kashinath, Bhargav Hemant
KEYWORDS:
Sleep, Insomnia, Chronic Medical Illnesses, Integrated Yoga
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.7 No.10,
October
30,
2017
ABSTRACT: Background: Sleep is an important lifestyle factor to be addressed in patients having chronic non-communicable diseases. Data revealing prevalence of insomnia in chronic medical illnesses (CMIs) in Indian population are lacking. Yoga has been found effective in improving sleep quality in patients with chronic medical illnesses (CMIs). Aim: To find the prevalence of insomnia in major chronic medical illnesses and to assess the effect of Integrated Approach of Yoga Therapy (IAYT) on them. Methods and Material: From the outpatients and inpatients of our integrative therapy clinics, 200 patients (116 males; 84 females) in the age range 49.57 ± 11.71 years, who satisfied the inclusion criteria and were diagnosed by the physician with any of the four major categories of CMIs: cardio-pulmonary, diabetes, musculoskeletal, and psychiatric were screened for insomnia using Insomnia Severity Index (ISI) scale. Those found suffering from clinically significant insomnia (ISI score > 14) were admitted and a residential IAYT intervention was given for a week. Before and after the intervention, ISI and Pittsburg insomnia rating scale (PIRS) were administered to assess extent of insomnia. Data was analyzed before and after the intervention using paired t-test. Results: Taking all patients of CMIs together, we found that 35% suffered from clinical insomnia, out of which, 12.5% had severe and 22.5% had moderate insomnia. We also found that prevalence of clinical insomnia was highest among those suffering from psychiatric illnesses (62.07%) and minimum in those having musculoskeletal disorders (28.05%). Those suffering from diabetes mellitus and cardio-pulmonary disorders reported prevalence of 32.25% and 31.94% respectively. After IAYT intervention of one week, extent of clinical insomnia reduced from 35% at the baseline to 8.5% in all patients of CMIs taken together. Following changes were observed in percentage of patients suffering from clinical insomnia in different CMIs before and after one week of IAYT intervention: 1) In psychiatric patients, the percentage reduced from 62.07% to 24.13%; 2) In diabetic patients, the percentage reduced from 32.27% to 3.0%; 3) In patients having musculoskeletal disorders, the percentage reduced from 28.05% to 8.53%; and 4) In patients having cardio-pulmonary illnesses, the percentage reduced from 31.94% to 2.7%. Conclusion: Prevalence of insomnia is higher in patients suffering from chronic medical illnesses. IAYT intervention of one week may be helpful in reducing extent of insomnia in this population.