Yoga no better than physical conditioning for improving sleep in women with incontinence

A 3-month yoga intervention is not superior to general physical conditioning in terms of improving sleep outcomes in women with urinary incontinence, as shown in a study.

Researchers conducted a secondary analysis of a randomized clinical trial involving women aged 45–90 years with daily urinary incontinence. These women had been randomly allocated to the group assigned a yoga intervention involving twice-weekly instruction and once-weekly self-directed practice of hatha yoga techniques or the group assigned a physical conditioning intervention. The intervention lasted 3 months.

The outcomes sleep quality and disruption were evaluated using the Pittsburgh Sleep Quality Index (PSQI) and Pittsburgh Sleep Diary. Nocturnal incontinence and voiding frequency were assessed using voiding diaries.

A total of 240 participants (mean age 62 years, 66.7 percent) were included in the analysis. At baseline, most participants reported poor sleep quality (PSQI >5; 55.4 percent) and awakening at least once per night to use the bathroom (55.7 percent).

At 3 months after the intervention, the PSQI score increased by 0.37 points (95 percent confidence interval [CI], 0.78 to −0.04) in the yoga group vs 0.66 points (95 percent CI, 1.07–0.25) in the physical conditioning group (difference, 0.29 points, 95 percent CI, −0.28 to 0.86). The mean change in wakefulness after sleep onset was 3.82 min (95 percent CI, 8.15 to −0.52) in the yoga group vs 6.97 min (95 percent CI, 11.20–2.74 minutes) in the physical conditioning group (difference, 3.16 min, 95 percent CI, −2.84 to 9.16).

In the entire cohort, greater nocturnal voiding frequency was associated with worse sleep quality. For instance, the mean PSQI score was 5.83 points (95 percent CI, 5.35–6.32) among participants with fewer than one nocturnal voiding episode per night and increased to 6.66 points (95 percent CI, 6.00–7.33 points) among those with at least two episodes per night (p=0.02 for linear trend).