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