Cheryl Fenner Brown, C-IAYT, E-RYT 500
This article also appeared in the Yoga U Online Wellness Blog, February 2019
You probably know the feeling - lying in bed for hours on end looking at the clock with the mind swirling, chattering and generally keeping you from falling asleep. You re-play the events of the day getting caught in circular thoughts like “Why did I say that?”, “Why didn’t I stand up for myself at work?”, or “How am I going to pay my bills?”. The frustration of insomnia spills over into the next day and you find yourself reaching for another cup of coffee to make it through the day. One in four Americans experience insomnia every year, with 75% of those sufferers recovering without developing chronic insomnia (1).
Cancer, Insomina & Immunity
For cancer patients, the stress of diagnosis and treatment can be cause for greater insomnia. In fact, recently treated cancer patients are twice as likely to develop sleep disturbances as the general population (2). It is not only the swirling stressful thoughts that keep patients awake, but muscle and joint pain may prevent them from finding comfort and achieving deep restful sleep. Many steroidal cancer medications can also cause insomnia, and patients often need prescription sleeping aids to overcome it.
Regular sleep is so important to every aspect of life, from physically feeling better to being able to think more clearly. From being in a better mood to being able to heal more quickly. Sleep enhances immunity at the cellular level allowing immune cells to be created and tissue to be repaired. Unfortunately, stressful sleep-less nights have both and an immediate and long-term detrimental effect on the health of the immune system. (3). For cancer patients or people whose immune systems are already compromised by treatments, sleep is an important part of supporting the body’s natural healing processes.
You Deserve Better Sleep
But how do we get better sleep? There are many ways to increase sleep hygiene including maintaining a set bedtime, creating a relaxing pre-sleep routine like taking a hot bath or drinking herbal tea, limiting light and electronic devices in the bedroom, and creating a warm inviting sleep environment. Yoga practices can also help improve sleep and over 55% of yoga practitioners report that yoga helps them sleep better (4). Specifically, we will be looking at practices that activate the parasympathetic nervous system, or “rest and digest” response. This part of the nervous system counteracts chronic over stimulation of the sympathetic nervous system, or “flight or fight” response caused by living in the modern world.
Yoga for Insomnia
The yoga practice that follows is a combination of practices to enable easier sleep. It consists of mudra to help quiet the late-night ruminations of the mind, gentle spinal movements to ease body aches, calming pranayama to release stress, and a mild inversion to initiate the relaxation response. Practice in the hour before you go to bed to take advantage of the sleep-inducing benefits.
Yoga Practice Tips
Stating Intention with Vajrapradama Mudra
Stating an intention, or sankalpa, is an important first step toward using yoga as a healing practice. Combining intention with the following mudra that settles doubts by enhancing your ability to trust yourself can serve as a reminder of your goals during this time.
When a stiff and achy body contributes to sleepless nights, movement is often needed to release tension, ease pain, and relax muscles so that sleep can come more easily, especially if you experience occasional restless leg syndrome or cramping at night. Try this simple effective series of movements that can be done on the floor or reclining in bed.
A gentle twist can be helpful for releasing muscular tension from the hips and lower back which may help you to be more comfortable when you recline to sleep. Try this version on the floor or on top of your bed.
Chair Forward Fold
A gentle forward bend shares the tension relieving benefits of the reclining twist above as well as calming mental and emotional energy that can help to prepare the body and mind for sleep. Try this version with the head supported by a chair to ensure a sense of surrender and ease.
Chandra Bhedana (Left Nostril Breathing)
Different breathing patterns create different effects and here you will practice a pranayama that can calm a swirling mind. In this pattern you will breathe in through the left nostril which activates ida nadi. This left pranic channel is often called the moon channel and is cooler, calmer and more introspective than the right channel. You will then exhale through the right nostril which is associated with pingala nadi, the more active or solar channel. Imagine that you are allowing calming lunar energy to flow through your active busy mind.
Legs in Chair
Elevating the legs before you go to sleep can help in several ways. It will relax the lower back and help to release deeply-held tension in the hips. The mild inversion also shifts the flow of blood from the feet towards the heart and sends a signal to the parasympathetic nervous system to activate the relaxation response. It takes some time for this internal shift to occur, so rest here for as long as you feel comfortable.
This article also appeared in the Yoga U Online Wellness Blog, December 2018
For most people, a good night’s sleep will set us right when we experience occasional fatigue. Cancer-related fatigue is different and not completely understood by allopathic medicine. This deep tiredness is not alleviated by sleeping and is one of the most common, frustrating, and long-lasting side effects for many survivors.
The fatigue may be caused by the cancer itself making the body’s processes less efficient and requiring more energy. Chemotherapy and radiation may kill cancer cells, but they also lead to a buildup of cell waste, and extra cellular energy is needed to repair damaged tissue. The pain, anxiety, loss of appetite, lack of exercise, insomnia and low blood counts caused by these treatments may also be contributing factors.
Yoga for Cancer Related Fatigue
Yoga offers powerful tools that help to relieve cancer-related fatigue such as asana (postures), mudra (hand gestures), pranayama (conscious breath), and relaxation. A recent literature review showed that yoga can improve quality of life by increasing both physical and mental energy. The yoga practice that follows is a combination of gently stimulating mudra, movement and pranayama, followed by a restorative inversion which provides a few moments of rest. Practice time of the day, all or in part.
Yoga Practice Tips
Stating Intention with Uttarabodhi Mudra
Stating an intention, or sankalpa, is an important first step toward using yoga as a healing practice. Combined with a mudra that is stimulating to the immune system, it can serve as a reminder of your goals during this time.
Cancer-related fatigue often creates such tiredness that movement of the body seems like a challenge. When we are sedentary, our energy becomes stagnant and prana cannot flow to the areas of the body where it is needed to keep us healthy. Movement is a simple way to allow both prana and lymph to flow.
The lymphatic system is key to immunity and relies on the pumping of muscles to move lymph through the nodes and vessels. It is especially important for breast cancer patients to move the arms and upper chest; this trio of seated spinal movements moves prana and lymph into the armpit area and increases range of motion in the spine and shoulders.
When moving the arms, it is important to only stretch to a comfortable degree, especially if there are surgery sites or ports in the chest. Alternate arm positions will be given so be sure to choose what is comfortable. Continue to follow the pace of your breath, it is a barometer of how you are feeling in each pose. If you find yourself holding the breath or feeling discomfort, try again a bit more gently.
Seated Lateral Bend:
Reclining Heart Opener
A gentle backbend is helpful for increasing breath capacity as well as uplifting the mood as it enables deeper inhalations throughout the upper chest.
Anuloma Krama (3-Part Inhale)
Practicing pranayama can have a profound effect on your energy levels and mood. Focusing on the inhalation tends to increase energy and lighten the mood. You can practice the three-part inhale from the reclined heart opener described above, or rest on the back with the knees bent and the feet on the floor.
Legs in Chair
Restorative yoga can complete a yoga practice or be done by itself on days when you are highly fatigued and need to reset the body and mind. This posture is a mild inversion that provides a change in your perspective to gravity and encourages deeper breathing, energy absorption and relaxation.
Elevating the legs on the chair helps with fatigue in several ways. Besides allowing the body to be still for a few minutes, this pose allows the venous blood to flow back up the legs toward the heart where it is better circulated. This process sends signals to the parasympathetic nervous system to turn on the “relaxation response”. It does take some time for these internal processes to occur, so rest here for as long as you feel comfortable.
This article also appeared in the Yoga U Online Wellness Blog, November 2018
Although cancer touches one in three women and one in two men nationwide, more people than ever are living longer after treatment. New and promising research heralds the benefits of yoga practice post-treatment. Yoga practices that include movement, breath work, and meditation can help survivors better tolerate residual pain, cancer-related fatigue, lymphedema, peripheral neuropathy, insomnia and anxiety that often accompany treatment and can linger on for years after treatment.
Yoga for Cancer Pain Relief
My clients often report lingering pain from treatment. Some pain is localized to radiation treatment or surgery sites. Certain chemotherapy drugs that are given to prevent recurrence of cancer also cause joint pain. Yoga’s gentle joint mobilization can help to alleviate stiffness and increase flexibility, as well as ensure that the joints stay lubricated and the muscles supple. This short practice is designed to apply a full range of yogic tools, including intention-setting, mudra, asana, pranayama, and relaxation, to alleviating pain.
Yoga Practice Tips
Setting Your Sankalpa with Anjali Mudra
Intention setting, or creating a sankalpa, is an important first step toward using yoga as a healing practice. It serves as a reminder of your goals during this time.
Matsya Mudra for Pain
Matsya mudra may also help you to release muscular tension and send nourishing energy to the joints.
Reclining Floor Flow
The reclining floor flow is a simple series of movements that may help to alleviate pain in the hips, lower spine and shoulders. It can be done on the floor or on a bed.
This reclining pose is helpful if you are feeling especially fatigued. It helps to release tension in the lower back and outer hips.
Adhama Svasa Pranayama (Belly Breath)
Bringing conscious awareness to the natural breathing process can have a profoundly relaxing and healing effect on the mind and body. Breathing consciously into your lower belly breath activates the parasympathetic nervous system which reduces the level of stress hormones in your body and may lessen the experience of pain.
Savasana (Relaxation Pose)
It is important to give yourself a few minutes at the end of your practice to rest in stillness and silence so that the gifts of the practice can be fully integrated into your body and mind.
Cheryl Fenner Brown, C-IAYT, E-RYT 500
Ever since I was 13 years old I have had bouts of insomnia, sometimes lasting for months where I would stay awake until the wee hours, unable to stop the incessant worrying and chatter of my mind and emotions. As a child I had no real tools at my disposal, but I would read, watch TV - do something to try to distract myself from my inability to sleep. I remember one night during a particularly bad time, watching myself breathing as I lay in bed while lying on my back. I closed my eyes and noticed that I was breathing in and out through my nose. I knew that I would likely fall asleep when I stopped being aware of my breath. I would try to ‘catch’ myself becoming unaware of my breath. Now that I understand the process I was engaging in was a rudimentary attempt at a pranayama practice, I realize that I was attempting the impossible all those years ago.
Now in my mid-forties, I will have months at a time where I sleep well, wake refreshed and have no trouble with waking during the night. But every so often, I still get a few nights in a row where my sleep cycle is disturbed. Either I am waking many times due to intense dreams, or the need to vacate my bladder, or more often, I lay in bed and cannot fall asleep. Either my body is restless or my mind is whirling with all the events, hopes and regrets from the day. During these three decades of insomnia, I have come up with some easy to follow, nearly sure-fire ways to help myself get to sleep more easily.
Studies have shown that mild to moderate aerobic exercise is beneficial for improving insomnia. (Passos 2011, Milne 2016) And it does not seem to matter whether the exercise is taken at the beginning of the day or in the evening in terms of its effectiveness. (LeCheminant 2016) Exercise can release muscular tension and restless leg syndrome and make it easier for the body to release into sleep. But what about the more meditative movement of yoga, can yoga also help to prepare the body for sleep? Yoga enables us to connect to and calm not just our physical bodies, but also our energetic system, and our often swirling mental and emotional states. Think back to how relaxed you feel after you come out of savasana at the end of a yoga class. Imagine how easy it would be to fall asleep from that state of ease. You have likely experienced for yourself how yoga can soften around the edges of worry and muscular tension during the day and the restful effects can last the rest of your day. Many recent studies delve into the beneficial effects that yoga and other meditative movement therapies have on insomnia. (Wang 2015)
When is Your Bedtime?
According to Ayurveda, the three doshas are embedded in our daily cycles and certain times of day support specific activities, including sleeping, waking, and eating. It is recommended that you rise before the sun, during the time that the airy vata dosha is dominant, between 2-6 a.m. This time is best for rising and engaging in morning meditation, yoga practice, and your cleansing and grooming routine. When we sleep in past this time, we enter into the time when earthy kapha dosha dominates, from 6-10 a.m. Ever notice how sleeping late sometimes makes you feel more tired and groggy? This is due to kapha’s dense pull. As the morning progresses, from 10 a.m. till 2 p.m., the fiery pitta dosha dominates, take your mid-day and largest meal here while digestive fire burns strongest. In the latter half of the day, the cycle repeats. From 2-6 p.m., the vata dosha dominates and presides over a time of increased mental capacity. Then from 6-10 p.m., begin winding down for the day, eat a light supper so as to not overtax your digestive system, and try to get to bed by 10 p.m. If you stay up later, you enter into the pitta time from 10 p.m. till 2 a.m., which is why you may feel a second wind come on and have difficulty getting to sleep until much later.
The Importance of Routine
Besides following our natural circadian rhythms and getting to bed at a reasonable hour, implementing a bedtime routine can help to prepare both the body and mind for sleep. Beginning 60-90 minutes before bedtime, limit your exposure to electronic devices, this includes the television, e-reader, and cell phone. Not only do these LED-screened devices engage the mind, but they also emit a specific blue wavelength light that inhibits the body’s production of melatonin, a hormone that encourages drowsiness enabling you to get to sleep and stay asleep. (Cajochen 2011) (Wood 2012)
You may also want to consider these other relaxing additions to your bedtime routine: sipping calming herbal tea, a warm bath or shower, self-oleation massage, diffusing lavender or other relaxing essential oils, a gentle yoga sequence, or yoga nidra. Yoga nidra is a guided form of meditation that can be very helpful for insomnia because it enables you to connect to your witness consciousness, releasing self-judgment and doubt, thus gentling the mind into a relaxed state of awareness. You could also try this special yoga nidra for insomnia that will lead you from relaxed awareness into sleep. With a little planning and patience, you can reset your circadian rhythms and begin to get the sleep that is your birthright.
This seated twist involves stretching the torso in several directions at once, it is a forward fold and twist.
I attend Cheryl's class regularly and feel that my practice has improved immensely over the past few years due to her expert coaching. Her teaching style is clear and compassionate and her previous experience in teaching adults is evident in her organized approach and easy to understand instructions. I also appreciate that Cheryl not only teaches us about how to correctly position ourselves, but also touches on many aspects of yoga philosophy, which in turn has deepened my personal practice and heightened my awareness of the connection between mind and body, breath and relaxation.