For more than two decades, cognitive behavioural therapy for insomnia (CBT-I) has been the undisputed first-line treatment for chronic sleeplessness — the approach sleep specialists reach for before reaching for a prescription pad. Now a new randomised trial suggests a structured yoga programme can go toe-to-toe with it. Published in the Springer Nature journal Sleep and Vigilance in August 2026, the study found that yoga-based therapy was statistically equivalent to CBT-I in easing chronic insomnia over 16 weeks.
What Happened
The trial, led by Dr. M. Raghvendra Rao and colleagues in Bengaluru, India (registered as CTRI/2020/09/027943), was a randomised, single-blind equivalence study — a design built specifically to test whether two treatments produce comparable results, rather than whether one beats the other. Adults with chronic insomnia, all scoring 15 or higher on the Insomnia Severity Index (ISI), were randomly assigned to either a yoga-based therapy (YBT) programme or a course of CBT-I, and followed for 16 weeks.
Both groups also received lorazepam 2 mg daily from the first day of the study, reflecting how insomnia is often treated in real clinical settings, alongside medication. The researchers tracked outcomes with the ISI, the Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and objective polysomnography (an overnight sleep-lab recording) in half of the participants. The data were analysed using Generalised Estimating Equations and the Two One-Sided Tests (TOST) procedure, the standard statistical method for confirming equivalence.
The headline result: across the primary outcome, yoga-based therapy and CBT-I came out statistically equivalent. In plain terms, participants who practised a structured yoga programme improved about as much as those who received the gold-standard psychological therapy — neither approach pulled meaningfully ahead of the other.
Why It Matters
CBT-I works — that is not in dispute. The problem is access. There are far too few clinicians trained to deliver it, waitlists can stretch for months, and one-on-one sessions are expensive or simply unavailable in much of the world. That access gap is why so many people with insomnia end up on long-term sleeping pills instead, despite guidelines that recommend behavioural therapy first.
A yoga programme that performs comparably is compelling precisely because it scales. Yoga can be taught in groups, practised at home, and sustained cheaply once learned. If the finding holds up in larger and more diverse samples, it points to a genuinely accessible option for people who can’t get to a CBT-I specialist.
It is worth being clear-eyed about the caveats. This is a single trial from one region, both arms used an adjunctive sedative, and an equivalence result shows the two therapies moved together — it is not, on its own, proof that either would beat a placebo in this specific cohort. Still, the result does not sit in isolation. It lines up with a growing evidence base: a 2026 systematic review found yoga nidra shows real promise for insomnia, a broad look at the science of yoga for better sleep reached similar conclusions, and a separate landmark study reported that higher-intensity yoga outperformed other forms of exercise for sleep. Taken together, the direction of travel is consistent.
What This Means for You
First, the responsible caveat: if you are already taking sleep medication, do not stop or change it based on a single study — talk to your doctor, because abrupt withdrawal from drugs like lorazepam can be dangerous. Yoga is best thought of as a tool that complements medical care, not a replacement for it. That said, the practices used in trials like this one are simple, safe for most people, and easy to fold into an evening wind-down. Here are a few that repeatedly show up in the sleep research:
Legs-Up-the-Wall (Viparita Karani). Lie on your back and rest your legs vertically up a wall, arms relaxed at your sides. Stay for 5–10 minutes with slow breathing. This gentle inversion is a classic downshift for the nervous system and a low-effort way to signal the body toward rest.
Reclining Bound Angle (Supta Baddha Konasana). Lie back, bring the soles of your feet together and let the knees fall open, supporting them with cushions if needed. It opens the hips and chest while keeping the body fully supported — ideal for the last stretch before bed.
Seated or Standing Forward Fold. A soft, unforced fold with a rounded, relaxed spine helps release tension through the back and quiet a busy mind. Keep the knees bent and let the head hang heavy; comfort matters more than reach.
Extended-exhale breathing. Sitting or lying comfortably, breathe in for a count of four and out for a count of six or more. Lengthening the exhale nudges the parasympathetic “rest and digest” system into gear and slows a racing heart rate before sleep.Yoga Nidra. This guided “yogic sleep” practice walks you through a body scan while you lie still in savasana. It is one of the most evidence-backed sleep tools in the yoga toolkit, and it requires nothing more than a quiet space and a recording to follow. If restlessness in the legs is part of what keeps you up, our guide to yoga for restless legs syndrome offers a few more targeted options.
Key Takeaways
- A 2026 randomised equivalence trial in Sleep and Vigilance found yoga-based therapy statistically equivalent to CBT-I for chronic insomnia over 16 weeks.
- Both groups also received low-dose lorazepam, and outcomes were tracked with validated questionnaires plus objective sleep-lab recordings in half the sample.
- The significance is access: yoga scales in ways one-on-one CBT-I cannot, offering a potential option where trained therapists are scarce.
- Caveats remain — one trial, one region, adjunctive medication in both arms — but the result fits a growing body of yoga-and-sleep evidence.
- Practical takeaway: gentle evening practices like Legs-Up-the-Wall, Reclining Bound Angle, extended-exhale breathing and Yoga Nidra are low-risk ways to support better sleep alongside, not instead of, medical care.
If persistent insomnia is affecting your mood or daily functioning, it’s worth speaking with a doctor or a qualified sleep professional, who can help you find the right combination of approaches for your situation.
