When less is more, the benefits of restorative yoga
When it comes to exercise the most common message we get is “DO MORE”. More regularly, more intensely, more in terms of duration and often more extreme activities. Unless we’ve sweat ourselves into a blithering puddle by the end of a session we often don’t feel like we’ve achieved a good workout. But just what are we really achieving, apart from arms so sore we walk around like T-Rex for a week?
Maybe we’re trying to achieve weight loss, increased strength, improved muscle tone, burn off nervous energy or just try something new and challenging. And these are all valid goals, but are there other more gentle ways of reaching some of these goals without causing physical injury, mental fatigue and taxing our adrenal glands? Both research and common sense say YES.
The way we think about exercise and moving the body is constantly evolving. There have been many articles over the past few years suggesting that the traditional cardio slog is not really our best option for overall health. Most fitness experts will advise a combination of cardio and weight training – a good one may even recommend flexibility exercises (like yoga!). Other experts claim that high intensity interval training (HIIT) is way to go. As the name suggests it’s intense - you work out to your maximum capacity for 30 seconds or so and then rest for 90 seconds and repeat around 8 times (each programme varies).
But what I’m personally and professionally finding really interesting is the research into the benefits of calming yin or restorative yoga. This type of yoga is slow paced with students often only doing 5-7 poses, holding each one for anywhere from 3-10 minutes. Restorative yoga uses props such as blankets, bolsters, blocks and straps to allow the participant to remain supported while they go into very deep stretches – though like with all yoga the true challenge is connecting the physical movement to the breath and calming the mind.
So just what benefits can you expect from doing restorative yoga?
Reduction in number and intensity of hot flushes
Increase in energy
Improved cellular function
There have been a handful of clinical studies done on restorative yoga, most of which have been small pilot studies that would ideally undergo further research in the future to provide more definitive results. That being said, the data from these studies was statistically significant and supports what many practitioners instinctively know about yoga and restorative yoga: that it makes us feel better and healthier.
Of the ten studies I reviewed restorative yoga was practiced typically once per week for a duration of between 75 to 90 minutes for a period of 4 to 10 weeks. Interestingly there were 4 studies that specifically looked at the benefit of restorative yoga for women who were either undergoing or had completed treatment for breast or ovarian cancer.
Two of these cancer related studies focussed on quality of life measures such as reduction in stress, anxiety, improvements in mood and sleep, overall energy, emotional wellbeing and ability to manage adverse effect of their cancer treatment. Significant improvements were seen in these parameters compared to before the women started the yoga (baseline) and also compared to the group of women not doing yoga (control group), both during the time they did yoga and when they were followed up two months later. 
The third study that was related to yoga and cancer actually looked at specific markers that indicate the body’s ability keep a balance of healthy functioning cells. Normally the immune system will remove cells that are dysfunctional in a process called apoptosis. Not surprisingly, people undergoing cancer treatment have reduced immune system ability and the body is not as capable of removing dysfunctional cells. When researchers looked that the apoptosis markers in people doing yoga, they found a reduction in cellular dysfunction, compared to healthy people (controls) and people undergoing treatment for cancer.
The fourth study was a larger study that specifically looked at how restorative yoga impacted the sleeping behaviour for people (96% women) who had completed their cancer treatment 2-24 months later and found significant improvements for the group doing yoga compared to the control group receiving standard care.
So what does this all mean? In a nutshell restorative yoga offers benefits that extend well beyond those of many other forms of physical movement and exercise. It may not be the go-to option for stronger toned triceps, but if you’re looking for more energy, better sleep, improved mood, relaxed long muscles and perhaps fat loss and improved cellular function to boot, then get along to your local studio and make restorative yoga part of your weekly exercise routine.
75% continued to practice yoga 3 months after the study. Mean number of hot flushes per week decreased by 30.8% (95% CI 15.6-45.9%) and mean hot flush score decreased 34.2% (95% CI 16.0-52.5%) from baseline to week 8. No adverse events were observed.
Maturitas. 2007 Feb 20;56(2):198-204. Epub 2006 Sep 18.
Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial.
Cohen BE1, Kanaya AM, Macer JL, Shen H, Chang AA, Grady D.
One explanation for the difference may be that restorative yoga reduces levels of cortisol, which rises during times of stress and is known to increase abdominal fat
Araneta M, Allison MA, Barrett-Connor E, Kanaya AM. Overall and regional fat change: results from the Practice of Restorative Yoga or Stretching for Metabolic Syndrome (PRYSMS) study. Results presented at: 73rd Scientific Session of the American Diabetes Association; June 22, 2013; Chicago, IL. - See more at: http://www.ajmc.com/publications/evidence-based-diabetes-management/2013/2013-1-Vol19-sp7/Restorative-Yoga-Better-Than-Stretching-for-Trimming-Subcutaneous-Fat-in-Overweight-Women#sthash.NYkMRkhz.dpuf
All study participants participated in 10 weekly 75-minute RY classes that combined physical postures, breathing, and deep relaxation. Study participants completed questionnaires at baseline, immediately postintervention, and 2 months postintervention. Significant improvements were seen for depression, negative affect, state anxiety, mental health, and overall quality of life. Fatigue decreased between baseline and postintervention follow-up. Health-related quality of life improved between baseline and the 2-month follow-up. Qualitative feedback from participants was predominantly positive; relaxation and shared group experience were two common themes.
J Soc Integr Oncol. 2008 Spring;6(2):47-58.
Restorative yoga for women with ovarian or breast cancer: findings from a pilot study.
Danhauer SC1, Tooze JA, Farmer DF, Campbell CR, McQuellon RP, Barrett R, Miller BE.
Group differences favoring the yoga group were seen for mental health, depression, positive affect, and spirituality (peace/meaning). Significant baseline*group interactions were observed for negative affect and emotional well-being. Women with higher negative affect and lower emotional well-being at baseline derived greater benefit from the yoga intervention compared to those with similar values at baseline in the control group. The yoga group demonstrated a significant within-group improvement in fatigue; no significant difference was noted for the control group.
Psychooncology. 2009 Apr;18(4):360-8. doi: 10.1002/pon.1503.
Restorative yoga for women with breast cancer: findings from a randomized pilot study.
Danhauer SC1, Mihalko SL, Russell GB, Campbell CR, Felder L, Daley K, Levine EA.
Cellular dysfunction (QDD) requires restorative mechanisms (AI) to restore the system to a balance. The results of this pilot study show trends, which indicate that in ill-health, there is inadequate restorative mechanisms (AI) although dysfunction (QDD) is high. Through regular practice of yoga, cellular dysfunction can be lowered, thus necessitating reduced restorative mechanisms. AI and QDD could also be useful indicators for predicting the three zones of health viz. disease, health, and positive health.
Int J Yoga. 2013 Jan;6(1):20-5. doi: 10.4103/0973-6131.105938.
Comparison of lymphocyte apoptotic index and qualitative DNA damage in yoga practitioners and breast cancer patients: A pilot study.
Ram A1, Banerjee B, Hosakote VS, Rao RM, Nagarathna R.
In all, 410 survivors suffering from moderate or greater sleep disruption between 2 and 24 months after surgery, chemotherapy, and/or radiation therapy...
...greater improvements in global sleep quality and, secondarily, subjective sleep quality, daytime dysfunction, wake after sleep onset, sleep efficiency, and medication use at post-intervention (all P ≤ .05) compared with standard care participants.
J Clin Oncol. 2013 Sep 10;31(26):3233-41. doi: 10.1200/JCO.2012.43.7707. Epub 2013 Aug 12.
Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors.
Mustian KM1, Sprod LK, Janelsins M, Peppone LJ, Palesh OG, Chandwani K, Reddy PS, Melnik MK, Heckler C, Morrow GR.
 Dr Mercola Peak Fitness programme, http://fitness.mercola.com/sites/fitness/archive/2012/06/01/long-cardio-workout-dangers.aspx
 Mustian KM1, Sprod LK, Janelsins M, Peppone LJ, Palesh OG, Chandwani K, Reddy PS, Melnik MK, Heckler C, Morrow GR, ‘Multicenter, randomized controlled trial of yoga for sleep quality among cancer survivors.’, Journal of Clinical Oncology, 2013 Sep 10;31(26):3233-41.
 Araneta M, Allison MA, Barrett-Connor E, Kanaya AM., ‘Overall and regional fat change: results from the Practice of Restorative Yoga or Stretching for Metabolic Syndrome (PRYSMS) study.’ Results presented at: 73rd Scientific Session of the American Diabetes Association; June 22, 2013; Chicago, IL
 Cohen BE1, Kanaya AM, Macer JL, Shen H, Chang AA, Grady D., ‘Feasibility and acceptability of restorative yoga for treatment of hot flushes: a pilot trial.’ Maturitas, 2007 Feb 20;56(2):198-204
 Ram A, Banerjee B, Hosakote VS, Rao RM, Nagarathna R, ‘Comparison of lymphocyte apoptotic index and qualitative DNA damage in yoga practitioners and breast cancer patients: A pilot study.’ International Journal of Yoga, 2013 Jan;6(1):20-5.
 Danhauer SC, Tooze JA, Farmer DF, Campbell CR, McQuellon RP, Barrett R, Miller BE., ’Restorative yoga for women with ovarian or breast cancer: findings from a pilot study.’ Journal of the Society for Integrated Oncology, 2008 Spring;6(2):47-58.
 Danhauer SC1, Mihalko SL, Russell GB, Campbell CR, Felder L, Daley K, Levine EA.,
’Restorative yoga for women with breast cancer: findings from a randomized pilot study.’ Psychooncology. 2009 Apr;18(4):360-8.