Introduction:

Well-being is a required part of family medicine (FM) residency training, as dictated by the Accreditation Council for Graduate Medical Education (ACGME) Program Requirements. Accordingly, FM residency programs have integrated a variety of well-being initiatives. Yoga nidra (“yogic sleep”) is one well-being strategy that is associated with improvements in stress, anxiety, depression, menstrual irregularities, blood pressure, sleep, and tension headaches._1,2 Yoga nidra is a specific type of yoga that includes guided breathing, attention, imagery, and Sankalpa (“heartfelt intention”) with the intention to elicit complete relaxation while awake.1 Currently, there is no research on effects of yoga nidra for family medicine residents (FMRs) or their attitudes of yoga nidra practice for personal and clinical practice. The objective of this study was to evaluate effects of yoga nidra on FMRs on anxiety, attitudes, and beliefs.

Method:

Participants included 16 FMRs out of 28 in the Mayo Clinic Family Medicine Residency program in Rochester, Minnesota, who engaged in a 45-minute yoga nidra session with brief education during their scheduled well-being hour. A doctorate-level clinical health psychologist and certified yoga teacher led the session. State anxiety was measured pre and post session with the State and Trait Anxiety Inventory–Short Form (STAI-SF).₃ Demographic information collected included year in program (PGY) and previous experience with yoga. A linear mixed model design was utilized to compare effect. A post-session 16-item questionnaire was administered to evaluate attitudes and beliefs on yoga nidra in personal and clinical practice. Frequencies and descriptive statistics were utilized to analyze FMRs’ attitudes and beliefs from the post-session questionnaire.

Results:

Participants included FMRs, with 41% PGY1s, 29% PGY2s, 12% PGY3s, and 18% did not respond. FMRs had a significant decrease in their post-session anxiety scores (Mpre=45.92, Mpost=30.01, p<.001; Figure 1), with no difference between PGY year or previous yoga experience. Scores reflect that FMRs’ average anxiety was in the “high anxiety” range before yoga nidra and decreased to the “no or low anxiety” range. Majority of residents agreed that consistent practice of yoga nidra can help reduce stress (87%, N=13), anxiety (87%, N=13), and daytime fatigue (67%, N=10). Majority of residents reported that they agreed that consistent yoga nidra can improve overall health and well-being (87%, N=13), cognitive functioning (60%, N=9), and promote better sleep (87%, N=13). Most residents endorsed that they found personal benefit from the practice (80%, N=12) and would be open to practicing yoga nidra in the future (93%, N=14). Majority of residents agreed that they would recommend yoga nidra to their patients to help with stress and anxiety (80%, N=12) and sleep difficulties (73%, N=11). Some residents reported that they would recommend yoga nidra for patients with high blood pressure, Type 2 diabetes, and menstrual irregularities.

Discussion:

Yoga nidra is a relaxation method that can improve well-being for FMRs. Residents reported favorable beliefs and attitudes regarding use of yoga nidra for their personal well-being, with nearly all residents being open to future practice. It is accessible to individuals with varying physical abilities and yoga experiences. This brief intervention has potential down-stream benefits for clinical care. Limitations include small sample size, one residency program, and no follow-up. In conclusion, one 45-minute yoga nidra practice with brief education demonstrated a significant decrease in anxiety for FMRs. Yoga nidra was endorsed as acceptable and feasible well-being strategy that can be incorporated into well-being initiatives in FM residency programs. Additional studies are warranted to further investigate the effectiveness of yoga nidra for FMR well-being and benefits in clinical work.

Figure 1.

References

1. Pandi-Perumal, S.R., Spence, D.W., Srivastava, N., Kanchibhotla, D., Kumar, K., Sharma, G.S., Gupta, R. and Batmanabane, G., 2022. The origin and clinical relevance of yoga nidra. Sleep and vigilance, 6(1), pp.61-84.

2. Anjana, K., Archana, R. and Mukkadan, J.K., 2022. Effect of om chanting and yoga nidra on blood pressure and lipid profile in hypertension–A randomized controlled trial. Journal of Ayurveda and Integrative Medicine, 13(4), p.100657.

3. Marteau, T.M. and Bekker, H., 1992. The development of a six‐item short‐form of the state scale of the Spielberger State—Trait Anxiety Inventory (STAI). British journal of clinical Psychology, 31(3), pp.301-306.