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Licensed Unlicensed Requires Authentication Published by De Gruyter June 13, 2022

Effect of Om chanting and Yoga Nidra on depression anxiety stress, sleep quality and autonomic functions of hypertensive subjects – a randomized controlled trial

  • Archana Rajagopalan , Anjana Krishna EMAIL logo and Joseph Kurian Mukkadan



Hypertension (HTN) is a common and growing public health challenge with severe risk factors. Hence, this study aimed to assess the effect of Om chanting and Yoga Nidra on depression, anxiety, stress, sleep quality and autonomic functions on individuals with hypertension.


This prospective randomized controlled study was conducted in patients with hypertension at Little Flower Medical Research Center. A total of 80 patients with diagnosed hypertension were recruited and randomized equally to either the experimental group or control group. The experimental group received a combination of Om chanting and Yoga Nidra for five days a week for two months. The control group participants continued with their regular conventional medications. Depression anxiety stress scale (DASS), Pittsburgh sleep quality index (PSQI) and heart rate variability (HRV) scores were assessed at baseline, 30 and 60 day for both the groups.


A total of 34 subjects in the experimental group and 31 subjects in the control group were included in the analysis. There was a significant (p<0.001) reduction in depression, anxiety, stress, and a significant (p<0.001) improvement in PSQI and HRV parameters in the experimental group was observed as compared to the control group. No adverse events were reported during the trial period.


The current study validates the effectiveness of Om chanting and Yoga Nidra in reducing depression, anxiety, stress and improving sleep quality and autonomic functions in hypertensive patients. These interventions could thus be considered a safer form of complementary therapy in managing stress and hypertension.

Corresponding author: Anjana Krishna (B.N.Y.S), (MSc), Department of Physiology, Little Flower Medical Research Center, Angamaly, 683572, Kerala, India, Mobile: +91 8281722752, E-mail:

  1. Research funding: No funding for this study.

  2. Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission. K. Anjana: Conceptualization, Methodology, Formal analysis, Investigation, Resources, Data curation, Validation, Writing–original draft, Visualization.R. Archana: Conceptualization, Methodology, Formal analysis, Validation Writing–review & editing, Supervision. J.K Mukkadan: Conceptualization, Methodology, Supervision.

  3. Conflicts of interest: The authors declare no conflict of interest.

  4. Informed consent: Informed consent was obtained from all individuals included in this study.

  5. Ethical approval: This was registered under clinical trial registry of India and the clinical trial identifier is CTRI/2020/02/023400.


1. Kearney, PM, Whelton, M, Reynolds, K, Muntner, P, Whelton, PK, He, J. Global burden of hypertension: analysis of worldwide data. Lancet 2005;365:217–23. in Google Scholar PubMed

2. Chobanian, AV, Bakris, GL, Black, HR, Cushman, WC, Green, LA, Izzo, JL, et al.. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. JAMA 2003;289:2560–72. in Google Scholar PubMed

3. Biffi, A, Gallo, G, Fernando, F, Sirico, F, Signorello, MG, De Martino, L, et al.. Relationship between cardiorespiratory fitness, baseline blood pressure and hypertensive response to exercise in the ferrari corporate population. High Blood Pres Cardiovasc Prev 2021;29:81–8. in Google Scholar PubMed

4. Bushell, W, Castle, R, Williams, MA, Brouwer, KC, Tanzi, RE, Chopra, D, et al.. Meditation and yoga practices as potential adjunctive treatment of SARS-CoV-2 infection and COVID-19: a brief overview of key subjects. J Alternative Compl Med 2020;26:547–56. in Google Scholar PubMed

5. Li, AW, Goldsmith, CA. The effects of yoga on anxiety and stress. Alternative Med Rev: a journal of clinical therapeutic 2012;17:21–35.Search in Google Scholar

6. Sharma, N, Kauts, A. Effect of yoga on academic performance in relation to stress. Int J Yoga 2009;2:39. in Google Scholar PubMed PubMed Central

7. Saraswati, SS. Yoga Nidra. Munger, India: Yoga Publications Trust; 2003.Search in Google Scholar

8. Telles, S, Kumar, S, Nagendra, H, Manjunath, N, Naveen, K. Meditation on OM: relevance from ancient texts and contemporary science. Int J Yoga 2010;3:2. in Google Scholar PubMed PubMed Central

9. Della Valle, E, Palermi, S, Aloe, I, Marcantonio, R, Spera, R, Montagnani, S, et al.. Effectiveness of workplace yoga interventions to reduce perceived stress in employees: a systematic review and meta-analysis. J Funct Morphol Kinesiol 2020;5:33. in Google Scholar PubMed PubMed Central

10. Bair, P, Bair, S. The effect of vocalized sound on consciousness and energy. SEEM 2006;17:1–15.Search in Google Scholar

11. Alebiosu, OC, Ogunsemi, OO, Familoni, OB, Adebayo, PB, Ayodele, OE. Original research: quality of sleep among hypertensive patients in a semi-urban Nigerian community: a prospective study. PGM (Postgrad Med) 2009;121:166–72. in Google Scholar PubMed

12. Thomas, SJ, Calhoun, D. Sleep, insomnia, and hypertension: current findings and future directions. J Am Soc Hypertens 2017;11:122–9. in Google Scholar PubMed

13. Pepin, J-L, Borel, A-L, Tamisier, R, Baguet, J-P, Levy, P, Dauvilliers, Y. Hypertension and sleep: overview of a tight relationship. Sleep Med Rev 2014;18:509–19. in Google Scholar PubMed

14. Sevre, K, Lefrandt, JD, Nordby, G, Os, I, Mulder, M, Gans, ROB, et al.. Autonomic function in hypertensive and normotensive subjects. Hypertension 2001;37:1351–6. in Google Scholar PubMed

15. Ming, EE, Adler, GK, Kessler, RC, Fogg, LF, Matthews, KA, Herd, JA, et al.. Cardiovascular reactivity to work stress predicts subsequent onset of hypertension: the Air Traffic Controller Health Change Study. Psychosom Med 2004;66:459–65. in Google Scholar PubMed

16. Gangwisch, JE, Feskanich, D, Malaspina, D, Shen, S, Forman, JP. Sleep duration and risk for hypertension in women: results from the nurses’ health study. Am J Hypertens 2013;26:903–11. in Google Scholar PubMed PubMed Central

17. Amerena, J, Julius, S. The role of the autonomic nervous system in hypertension. Hypertens Res 1995;18:99–110. in Google Scholar PubMed

18. McEwen, B. Protective and damaging effects of mediators of stress and adaptation: central role of the brain. Brain Behav Immun 2132;25:S240.10.1016/j.bbi.2011.07.216Search in Google Scholar

19. Kim, H-G, Cheon, E-J, Bai, D-S, Lee, YH, Koo, B-H. Stress and Heart Rate Variability: A Meta-Analysis and Review of the Literature. Psychiatry Investig.15; 2018. 235–45. in Google Scholar PubMed PubMed Central

20. Voss, A, Schroeder, R, Heitmann, A, Peters, A, Perz, S. Short-term heart rate variability—influence of gender and age in healthy subjects. PLoS One 2015;10:e0118308, in Google Scholar PubMed PubMed Central

21. Lovibond, SH, Lovibond, PF. Manual for the depression anxiety & Stress Scales, 2nd ed. Sydney: Psychology Foundation; 1995.10.1037/t01004-000Search in Google Scholar

22. Maheshkumar, K, Dilara, K, Maruthy, K, Sundareswaren, L. Validation of PC-based sound card with Biopac for digitalization of ECG recording in short-term HRV analysis. N Am J Med Sci 2016;8:307. in Google Scholar PubMed PubMed Central

23. Buysse, DJ, Reynolds, CF, Monk, TH, Berman, SR, Kupfer, DJ. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193–213.10.1016/0165-1781(89)90047-4Search in Google Scholar PubMed

24. Wikipedia contributors. Meditation. Wikipedia. Available from: [Accessed 11 Nov 2020].Search in Google Scholar

25. Relaxation response. (n.d.) farlex partner medical dictionary. 2012. Available from: [Accessed 1 Dec 2020].Search in Google Scholar

26. Bhasin, MK, Dusek, JA, Chang, B-H, Joseph, MG, Denninger, JW, Fricchione, GL, et al.. Relaxation response induces temporal transcriptome changes in energy metabolism, insulin secretion and inflammatory pathways. [published correction appears in PLoS One. 2017 Feb 21;12 (2):e0172873]. PLoS One 2013;8:e62817 in Google Scholar PubMed PubMed Central

27. Brown, RP, Gerbarg, PL, Muench, F. Breathing practices for treatment of psychiatric and stress-related medical conditions. Psychiatr Clin 2013;36:121–40. in Google Scholar PubMed

28. Iyengar, BKS, Patanjali. light on the yoga sutras of Patanjali. New Delhi: Harpercollins; 2005.Search in Google Scholar

29. Sivananda, S. Kundalini yoga: illustrated. Shivanandanagar: Divine Life Society; 2010.Search in Google Scholar

30. Rao, N, Varambally, S, Gangadhar, B. Yoga school of thought and psychiatry: therapeutic potential. Indian J Psychiatr 2013;55:145. in Google Scholar PubMed PubMed Central

31. Bhagat, OL, Kharya, C, Jaryal, A, Deepak, KK. Acute effects on cardiovascular oscillations during controlled slow yogic breathing. Indian J Med Res 2017;145:503–12. in Google Scholar PubMed PubMed Central

32. Zou, L, Sasaki, J, Wei, G-X, Huang, T, Yeung, A, Neto, O, et al.. Effects of mind–body exercises (tai chi/yoga) on heart rate variability parameters and perceived stress: a systematic review with meta-analysis of randomized controlled trials. J Clin Med 2018;7:404.10.3390/jcm7110404Search in Google Scholar PubMed PubMed Central

33. Rajagopalan, A, Krishna, A, Mukkadan, JK. Abstracts from the international science symposium on HIV and infectious diseases (ISSHID 2019): proceedings. BMC Proc 2020;14:5.Search in Google Scholar

34. Dwivedi, MK, Singh, SK. Yoga Nidra as a stress management intervention strategy. Purushartha 2016;IX:18–25.Search in Google Scholar

35. Brook, RD, Appel, LJ, Rubenfire, M, Ogedegbe, G, Bisognano, JD, Elliott, WJ, et al.. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the american heart association. Hypertension 2013;61:1360–83. in Google Scholar

36. Palermi, S, Sacco, AM, Belviso, I, Marino, N, Gambardella, F, Loiacono, C, et al.. Effectiveness of tai chi on balance improvement in type 2 diabetes patients: a systematic review and meta-analysis. J Aging Phys Activ 2019:1–11. in Google Scholar PubMed

Received: 2022-04-27
Accepted: 2022-05-09
Published Online: 2022-06-13

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