Three types of exercises may be more effective for insomnia than therapy and other treatments, a new review suggests.

Researchers in China analyzed 22 studies that looked at over a dozen treatments for insomnia, including aerobic exercise, strength training, acupuncture and therapy. 

The team found people who did yoga regularly slept nearly two extra hours every night. And when they woke up in the middle of the night, they lay awake for an hour less on average.

Walking or jogging also reduced insomnia severity, while tai chi added an extra hour of sleep and made participants fall asleep nearly 30 minutes earlier than before treatment. 

Though exercise reigned supreme, the team also found cognitive behavioral therapy improved sleep time and quality compared to other methods like acupuncture.

The researchers suggested low-impact exercises like yoga, walking and tai chi emphasize breath control and lower the effects of stress hormones like cortisol, easing anxiety and promoting a sense of calm.

This may help people with insomnia be less distracted and anxious when they try to fall asleep each night. 

The findings come as about one in eight Americans, or 40million, suffer from insomnia, which causes issues falling or staying asleep.

Researchers in China found three exercises may help improve insomnia (stock image)

Researchers in China found three exercises may help improve insomnia (stock image)

Your browser does not support iframes.

The review, published in the the BMJ Evidence-Based Medicine journal, looked at 22 studies involving 1,348 patients, all of whom were diagnosed with insomnia.

The studies included 13 methods for improving sleep, seven of which were exercises.

The researchers looked at aerobic exercise plus strength or therapy, mixed aerobic exercises, walking or jogging, strength, Ayurveda (traditional Indian medicine focused on balancing the body, mind and spirit), yoga, sleep hygiene (general healthy sleep habits), cognitive behavioral therapy, tai chi and acupuncture and massage.

There was an active control group that regularly exercised and a waitlist control group that received no treatment.

Participants followed the interventions for anywhere from two weeks to two years.

Yoga led to the greatest improvements in sleep duration, with an extra 111 minutes per night on average. Overall sleep quality increased 16 percent with this exercise. 

People who did yoga also fell asleep 29 minutes faster than those who had no treatment. And the amount of time they lay awake after waking up in the middle of the night decreased by 56 minutes.

Walking or jogging also reduced severe insomnia by 10 points on the insomnia severity index (ISI), a questionnaire doctors use to determine the extent of a patient’s insomnia. Higher scores indicate worse insomnia.

Tai chi, meanwhile, lowered the ISI score by four points and helped participants sleep an extra 52 minutes on average. They also spent 36 fewer minutes lying awake in the middle of the night, and they fell asleep 25 minutes earlier.

Though exercise had the biggest impact, cognitive behavioral therapy also added 48 minutes of sleep time on average.   

The researchers suggested exercises like yoga and walking may lower stress hormones like cortisol and promote relaxation (stock image)

The researchers suggested exercises like yoga and walking may lower stress hormones like cortisol and promote relaxation (stock image)

While it’s unclear exactly why yoga was the most effective, the researchers suggested it could be that the controlled breathing and focus needed during yoga may relax brain activity and ease symptoms of anxiety and depression that could drive insomnia.

Breath control in tai chi has also been shown to decrease activity in the sympathetic nervous system, which activates the body’s ‘fight-or-flight’ response, promoting calm. 

Research also shows walking and jogging lowers the stress hormone cortisol and boost the production of melatonin, a hormone that regulates sleep.

The researchers did not specify how often participants did these activities or how much activity people with insomnia should get, but federal guidelines recommend adults get 150 to 300 minutes of moderate aerobic exercise each week, or 75 to 150 minutes of vigorous activity.

There were several limitations to the new review, including a lack of consistency on exercise duration and the length of time. The studies also tended to have small sample sizes, which can create bias.