BY Samuel Mathis, MD, UTMB
Recently, I listened to a physician’s podcast about Non-Sleep Deep Rest (NSDR). This practice, also called Yoga Nidra, is a way to help the body relax and replenish dopamine levels. The underlying theory of this activity is based on the dopamine depletion theory. As we go throughout the day, our dopamine levels naturally fall during the day and with activities that bring excitement and happiness. Lower levels of dopamine lead to increased feelings of stress, irritability, and anger. These levels are typically replenished through certain activities like good sleep, exercise, listening to music, meditation, and spending time in the sun. Maintaining a healthy diet with appropriate amounts of vegetables, fruits, and low levels of highly processed foods and sugars also helps maintain appropriate dopamine levels. A study published in 2020 found that a high-fat diet and high in refined sugars led to changes in the dopamine precursors, leading to changes in central dopamine levels (Hartmann et al, 2020). In addition to dietary changes, it is also important to find additional ways to maintain and improve standing dopamine levels. This is where NSDR may come into play.
The act of NSDR is to place the body in a deep resting state without falling asleep. Typically, this improvement is achieved through a meditative activity that focuses on a combination of slow deep breaths, guided imagery, and progressive muscle relaxation. This works to slow the cardiovascular rate and is thought to shift brain waves from a beta wave to an increased alpha wave state. By changing the mindfulness state, we improve the body’s response to outside stressors.
Studies looking at yoga nidra have found some positive results regarding levels of stress, anxiety, and depression. One small study even found a reduction in levels of patients’ erythrocyte sedimentation rate ESR after 6 months of consistent practice. Additional benefits found related to the practice are improved pain scores, decreased frequency of headaches, decreased symptoms of disruptive behavior in children, and lower self-reported scales of stress in healthcare professionals. Two studies found that NSDR caused elevations in resting levels of dopamine and improved cerebral blood flow based on neuroimaging after consistent practice (Pandi-Perumal 2022).
So how would one discuss this with patients? One option is to recommend patients identify an online video instruction. A description of the activity is to lay comfortably with eyes closed. After taking a few deep breaths, visualize a light moving up the body. As the light passes over body parts, allow those regions to relax a little more. Pause and take a few more deep breaths then repeat the visualization process, this time performing progressive muscle relaxation (isometric flexing of the muscle for 2-5 seconds then relaxing again). Finish the exercise with a few more deep breaths. This can be done in as quickly as 10 minutes or taking as long as an hour to perform.
Not only does this practice have positive immediate effects on mood, but it may also have long-term benefits. There are numerous studies that now look at the effects of meditation on health. One recent study found that skilled meditators had improved mindfulness levels, a better quality of life, and higher plasma telomerase levels which could lead to longer life expectancy. Some evidence indicates that just 10 minutes of mindfulness, meditation, prayer, or deep breathing exercises can add an estimated 2-7 years to one’s life expectancy (Dasanayaka et al, 2022).
I have been practicing this exercise for the past week and have noticed a more relaxed and happier state in my own life. I’ve started recommending it to patients as well and hope to get some good news back from them soon. Nevertheless, NSDR has the potential to be a great practice for patients who experience significant stress in their lives. I encourage you to consider giving it a try yourself to see if you find any benefit in the practice. We can do anything for 10 minutes a day. Good luck and good health!
References
Hartmann H, Pauli LK, Janssen LK, Huhn S, Ceglarek U, Horstmann A. Preliminary evidence for an association between intake of high-fat high-sugar diet, variations in peripheral dopamine precursor availability and dopamine-dependent cognition in humans. J Neuroendocrinol. 2020;32(12):e12917. doi:10.1111/jne.12917
Pandi-Perumal SR, Spence DW, Srivastava N, et al. The Origin and Clinical Relevance of Yoga Nidra. Sleep Vigil. 2022;6(1):61-84. doi:10.1007/s41782-022-00202-7
Dasanayaka NN, Sirisena ND, Samaranayake N. Impact of Meditation-Based Lifestyle Practices on Mindfulness, Wellbeing, and Plasma Telomerase Levels: A Case-Control Study. Front Psychol. 2022 Mar 4;13:846085. doi: 10.3389/fpsyg.2022.846085. PMID: 35310206; PMCID: PMC8931770.