Numerous controlled studies have evaluated relaxation therapies for the treatment of
These studies are difficult to summarize because many involved therapy combined with other methods such as biofeedback, sleep restriction, and paradoxical intent (trying
to sleep). The type of relaxation therapy used in the majority of these trials was progressive muscle relaxation (PMR). Many of these trials used the clever form of placebo treatment described above; others simply compared relaxation therapy to no treatment.
Overall, the evidence indicates that relaxation therapies may be somewhat helpful for insomnia, although not dramatically so. For example, in a controlled study of 70 people with insomnia, participants using progressive relaxation showed no meaningful improvement in the time to fall asleep or the duration of sleep, but they reported feeling more rested in the morning.
In another study, 20 minutes of relaxation practice was required to increase sleeping time by 30 minutes.
There is a fair amount of evidence in support of relaxation therapies as means to treat the symptoms of
, at least in the short-term.
In a 2008 review of 27 studies, researchers concluded that relaxation therapies (including Jacobson's progressive relaxation, autogenic training, applied relaxation, and meditation) were effective against anxiety.
However, these favorable findings should be tempered by the fact that not all of the studies were randomized, controlled trials.
It seems intuitive that relaxation should lower blood pressure. Indeed, many studies have evaluated the benefits of relaxation therapies for
and related cardiovascular risks.
The results, however, have been mixed at best. In a review of 25 studies of various relaxation therapies for high blood pressure (totaling 1,198 participants), researchers found that those studies employing a control group had no significant effect on lowering blood pressure compared to sham (placebo) therapies.
On the other hand, a separate review of nine randomized trials concluded that the regular use of transcendental meditation may significantly reduce both systolic and diastolic blood pressure compared to a control.
Similarly, an analysis of 17 randomized controlled trials of various relaxation therapies, found that only transcendental meditation resulted in significant reductions in blood pressure; biofeedback, progressive muscle relaxation, and stress management training produced no such benefit.
In addition, a trial of 86 patients with hypertension suggested that daily, music-guided slow breathing reduced systolic blood pressure measured over a 24-hour period.
Other conditions that have at least minimal supporting evidence for response to relaxation therapies include the following:
- Bulimia nervosa32
- Cancer treatment support
including cancer pain
Chronic pain in general
and depressive symptoms in people with chronic pain
- Congestive heart failure60
- Interstitial cystitis66
- Irritable bowel syndrome37,63,81,83,89
- Menopause38, 61
- Obsessive-compulsive disorder (OCD)78
- Premenstrual syndrome (PMS)39
- Pregnancy support
(reducing perceived stress)
- Rheumatoid arthritis41-43,65
- Stroke rehabilitation44
- Surgery support
(primarily reducing pain and stress before or after surgery)
- Tension headaches45,46,88
- Type 2 diabetes94 (may help improve mental health)
- Ulcerative colitis47
In many cases the results are marginal at best, and contradictory outcomes between trials are common.
One study suggests that the use of visualizations prior to
cannot only reduce the need for pain medications, it can also help prevent hematomas (collections of blood under the skin).
However, more study would be needed to verify this somewhat difficult-to-believe result. A more easily accepted study found that either relaxation therapy or aerobic exercise can improve symptoms of fatigue after cancer surgery, and that each approach is about as effective as the other.
Cancer Treatment Support
A study found that cancer patients exposed to empathetic care along with self-hypnotic relaxation experienced significantly less pain and anxiety during an uncomfortable, invasive procedure than similar patients receiving only empathetic or usual care. These interesting results suggest that pain under these circumstances is more effectively relieved when the patient relies on his or her own self-coping abilities rather than someone else’s kindness.
Researchers in Taiwain have also studied the role of relaxing music in reducing cancer pain. One hundred and twenty-six hospitalized patients were randomly selected to listen to music for 30 minutes and take pain medication or just take the medication. Patients were given the choice of folk songs, Buddhist hymns (Taiwanese music), plus harp, or piano (American). The group who listened to music experienced significantly more pain relief compared to the group that did not.
A 2012 review of the literature found evidence to support the use of relaxation therapies in people with cancer.
The review, which included 19 studies involving 1,118 patients, focused on minfulness-based stress reduction therapies, like yoga, relaxation exercises, and meditation. The researchers reported that these interventions resulted in improved mood and quality life. Without proper control groups, however, it is unclear whether or not the therapies themselves directly contributed to these benefits.
Numerous studies have also investigated the benefits of relaxation therapies on patients with
. A careful review of 35 randomized trials found that relaxation therapies may be generally helpful at improving the quality of life of HIV-positive patients and in reducing their
These interventions, though, had no significant effect on the growth of the virus, nor did they influence immunologic or hormonal activity. Subsequently, however, a small study involving 48 HIV patients found that mindfulness meditation—a popular method for inducing the relaxation response—slowed the loss of the specific immune cells destroyed by the virus, though more research needs to be done to confirm this result.
The standard treatment for HIV is highly active antiretroviral therapy (HAART). Often people who take HAART have gastrointestinal (GI) side effects, like diarrhea and nausea. In one study, 130 HIV patients on HAART were randomized to receive 1 of 4 treatments:
plus relaxation therapy, acupuncture plus health education, sham acupuncture plus relaxation therapy, or sham acupuncture plus health education.
After 4 weeks of treatment, the people in the acupuncture plus relaxation group experienced a greater improvement in their GI symptoms compared to the other groups.
A careful review of 20 trials found psychological interventions such as cognitive behavioral therapy, biofeedback, relaxation and coping were associated with reduced chronic headache or
pain in 589 children as compared to sham (placebo), standard therapies, waiting list control or other active treatments.
A review of 8 randomized trials involving 483 people with schizophrenia found that
along with standard care helped to improve various measures of their mental state more than standard care alone.
These results, however, varied considerably across different studies depending on the quality and number of music therapy sessions.
Other Types of Relaxation Therapies
Some studies have evaluated highly specific guided visualizations, rather than general relaxation. For example, it has been suggested that a systematic program of imagining microscopic soldiers shooting down one’s cancer cells can improve the chances of
. Unfortunately, despite much enthusiasm shown by some patients and practitioners, there is still no meaningful evidence to support this appealing idea at present.
Nonetheless, there is some evidence from a set of small trials that specific immune-oriented visualizations can provide enhanced protection against
flare-ups and winter
Transcendental Meditation (TM)
Contrary to common claims, published evidence does
demonstrate that transcendental meditation (TM) improves mental functioning.
There is a bit of evidence, however, that TM might be helpful for improving exercise capacity and general quality of life in people with
congestive heart failure