ObjectivesHectic, late-night lifestyle has reduced 90 min sleep in 20% adults resulting in insomnia and excessive daytime sleepiness (EDS). We assess the scope of Sudarshan Kriya Yoga (SKY), a 4-component, breathing process in reducing EDS, generally and situationally.MethodsThis is a prospective, controlled study involving randomized subjects without any sleep-wake cycle anomalies and prior experience in SKY. Subjects (n=52) performed 30 min of SKY for 6 days/week for 8 weeks, while controls (n=53) performed sitting activity and Suryanamaskar for 4-weeks each. Epworth Sleepiness Scale (ESS) was used to measure EDS at 0, 4, and 8 weeks.ResultsSKY group showed significant ESS score improvements between 0–4 weeks and 4–8 weeks of 1.22 (p=0.0001) and 1.66 (p=0.001) respectively. Controls however failed to improve with score differences of 0.02 (p=0.892) and 0.02 (p=0.8212) respectively. SKY group showed significant ESS score improvement over controls at 4-weeks (difference=1.74; p=0.013) and 8-weeks (difference eight; p=0.0001). Improvement was most for obese people and those sitting in a halted car.ConclusionsImprovement in subjects’ nighttime sleep and daytime wakefulness in SKY practitioners can be attributed to polyvagal theory. Increased heart rate variability (HRV) alterations and sympathetic hyperarousal in chronic insomnia; and cholinergic and GABAergic dysregulation in anxiety disorders are countered by regulated vagal nerve stimulation post SKY. Our study establishes effectivity of SKY in reducing EDS (total and situational), provides a clinical correlation for prior polysomnographic evidence and paves way for larger trials directed towards SKY prescriptions for insomnia.

Non-motor symptoms of Parkinson's disease (PD), such as insomnia and restless legs syndrome (RLS), tend to worsen and become refractory as neurodegeneration progresses. We report the case of a 72-year-old female with a six-year history of PD and two-and-half-year history of insomnia and refractory RLS. We added a neuroprotective agent, Withania somnifera, to the existing treatment regimen for her insomnia. Besides the partial remission of her insomnia and motor symptoms of PD, there was a complete reversal of the RLS symptoms. Withania somnifera has been shown to improve PD symptoms by preventing oxidative damage of the nigrostriatal dopaminergic neurons and improving dopamine levels in the midbrain and corpus striatum. Our case provides the first-time evidence where Withania somnifera added for insomnia caused a complete remission of refractory RLS, possibly due to its anti-apoptotic and pro-dopaminergic actions. Withania somnifera could prove beneficial in cases where the disease advances but further addition of dopamine agonists for refractory RLS is not possible due to the risk of dopamine augmentation.