Relaxation techniques
Autogenic training is a technique of passive autosuggestion described in 1932 by a German psychiatrist Johannes Heinrich Schultz. The technique involves a series of mental exercises used to induce a state of relaxation. In their systematic review and meta-analysis, Seo and Kim concluded that autogenic training is effective for adults’ stress management as it decreased anxiety and depression in 11 studies that were analyzed.29 In 2011 Ann Bowden and coauthors published a study of the effectiveness of autogenic training, and 112 subjects with sleep-related problems reported an improvement in several sleep patterns, including sleep onset latency and feeling of sleep refreshment. The program consisted of 8-week training, with no specific focus on sleep.30
Progressive muscle relaxation (PMR) is a deep muscle relaxation method developed by American physician Edmund Jacobson in 1938.31 The goal of PMR is reducing somatic tension and cognitive arousal that negatively affect sleep quality. The effectiveness of PMR in improving sleep quality has been proven in several clinical conditions, e.g., cancer, prenatal anxiety, and COVID-19.32-34
Mindfulness meditation is rooted in Buddhist philosophy and is based on emotional detachment with nonjudgmental awareness in the present moment.35 Focusing on calming and slowing down breathing is often used to achieve an emotionally and mentally clear and stable state. In 2019, Rush and colleagues conducted a systematic review and meta-analysis of the effect of mindfulness meditation on sleep quality in 18 randomized controlled trials (RCT’s), including 1654 patients. Their preliminary findings suggest that mindfulness meditation may improve some aspects of poor sleep quality.36Referring to the study by Liu and Rice, patients less experienced in meditation prefer background sounds without a distinct melody during mindfulness meditation.37
Hypnotherapy is performed by professionals who received training in hypnosis. The alternated state of consciousness, called the hypnotic trance, allows for relaxation, increased suggestibility, and posthypnotic suggestion. Hypnosis has been reported as an effective therapy for several clinical conditions, e.g., relieving cancer treatment side effects and pain management.38,39 In 2018, Chamine and coauthors published a systematic review of 24 articles describing hypnosis interventions on sleep quality. From the analyzed studies, 58.3% reported hypnosis benefit on sleep quality. The incidence of adverse events was reported to be low.40