Hypopressive abdominal gymnastics in!uences sleep quality: a pilot study

Abstract

The INT group participated in a 2-month HAG program, consisting of one supervised session per week, while the CTRL group was advised to follow a 2-month HAG program at home. Differences in delta values between the INT and CTRL groups were analyzed using ANCOVA, adjusted for age. The delta values for the total MSQ score (INT: -2.67 + 1.19 a.u.; CTRL: -0.94 + 0.24 a.u.), the sleep component of the MSQ (INT: -1.7 + 0.92 a.u.; CTRL: -0.99 + 0.74 a.u.), and the wake component of the MSQ (INT: -0.97 + 0.46 a.u.; CTRL: 0.05 + 0.03 a.u.) showed a greater reduction in the INT group compared to the CTRL group, suggesting a more pronounced improvement in sleep. Regarding the actigraphic data, the delta percentages of sleep time and immobile time were positive in the INT group (sleep time: 0.62 + 0.35%; immobile time: 0.43 + 0.14%) and negative in the CTRL group (sleep time: -0.38 + 0.22%; immobile time: -0.32 + 0.25%), indicating a tendency toward sleep improvement in the INT group relative to the CTRL group.

Headnote

Keywords: hypopressive exercise, abdominal muscles, pelvic floor muscles, sleep quality.

Introduction. Hypopressive Abdominal Gymnastics (HAG) is a postural technique designed to strengthen the abdominal and pelvic floor muscles. It is primarily practiced by pregnant and postpartum women, as well as individuals with rectus abdominis diastasis, prolapse, urinary incontinence, pelvic floor dysfunction, and chronic low back pain. The technique involves combining expiratory apnoea with abdominal contraction manoeuvres, promoting diaphragm relaxation and reducing intra-abdominal pressure while activating the abdominal and pelvic floor muscles (1). As no previous studies have examined the relationship between HAG and sleep, this study aims to evaluate whether HAG could have positive effects on sleep quality.

Methods Methods. Twenty-eight women (mean age 43.23 + 7.03 years) with rectus abdominis diastasis were randomly assigned to either an intervention group (INT, 17 women) or a control group (CTRL, 11 women). The INT group participated in a 2-month HAG program, consisting of one supervised session per week, while the CTRL group was advised to follow a 2-month HAG program at home. Both groups completed the Mini Sleep Questionnaire (MSQ) to subjectively evaluate sleep and wore an actigraph to obtain objective sleep measurements. MSQ and actigraphy assessments were conducted one week before and one week after the intervention. Differences in delta values between the INT and CTRL groups were analyzed using ANCOVA, adjusted for age.

Results. The delta values for the total MSQ score (INT: -2.67 + 1.19 a.u.; CTRL: -0.94 + 0.24 a.u.), the sleep component of the MSQ (INT: -1.7 + 0.92 a.u.; CTRL: -0.99 + 0.74 a.u.), and the wake component of the MSQ (INT: -0.97 + 0.46 a.u.; CTRL: 0.05 + 0.03 a.u.) showed a greater reduction in the INT group compared to the CTRL group, suggesting a more pronounced improvement in sleep. However, these differences were not statistically significant (p = 0.67, p = 0.82, and p = 0.63, respectively).

Regarding the actigraphic data, the delta percentages of sleep time and immobile time were positive in the INT group (sleep time: 0.62 + 0.35%; immobile time: 0.43 + 0.14%) and negative in the CTRL group (sleep time: -0.38 + 0.22%; immobile time: -0.32 + 0.25%), indicating a tendency toward sleep improvement in the INT group relative to the CTRL group. Again, these differences did not reach statistical significance (p = 0.49 and p = 0.23). No between-group differences were observed for the percentage of sleep efficiency (INT: 1.48 + 1.02%; CTRL: 2.01 + 1.49%).

Conclusion. This pilot study suggests that a 2-month HAG program may have some beneficial effects on sleep quality, with positive trends particularly evident in subjective sleep measures. However, no substantial or statistically significant outcomes were observed, likely due to the limited duration of the intervention. Extending the intervention period and increasing the sample size may lead to more pronounced and conclusive results.

References

References

1. Hernández Rovira, E, et al., What Is Known from the Existing Literature about Hypopressive Exercise? A PAGER-Compliant Scoping Review. Journal of Integrative and Complementary Medicine. 2024.30(10): pp 913-924.