Massage Therapy for Insomnia

What the research says...

Massage therapy has been identified as a potential non-pharmacological intervention for insomnia. Research has shown that massage therapy can have a positive impact on sleep patterns and quality, particularly in postmenopausal women and individuals experiencing insomnia (Hachul et al., 2014; Nerbass et al., 2010). Studies have indicated that massage therapy can help improve sleep initiation and maintenance disorders by reducing stress through decreased cortisol and increased serotonin and dopamine levels (Hrehová & Mezian, 2021). Additionally, massage therapy has been linked to reduced levels of anxiety and depression, which are common comorbidities of insomnia (Cassileth & Vickers, 2004; Patricolo et al., 2017).

Various types of massage therapy, including Swedish massage and aromatherapy massage, have been explored in clinical settings like hospices and cancer centers, demonstrating promising results in alleviating symptoms such as anxiety, pain, and fatigue, which are often interconnected with insomnia (Soden et al., 2004; Cassileth & Vickers, 2004; Patricolo et al., 2017). Additionally, such benefits have been reported in specific patient populations, including adolescents with cancer and individuals undergoing coronary artery bypass graft surgery (Jacobs et al., 2016; Nerbass et al., 2010).

While the precise mechanisms underlying the efficacy of massage therapy for insomnia are still being investigated, existing research emphasizes the holistic benefits of massage in not only addressing sleep disturbances but also managing the psychological and physical symptoms associated with insomnia. By integrating massage therapy into comprehensive treatment plans, healthcare providers, including massage therapists, can offer a valuable adjunct therapy for individuals grappling with insomnia.

Reviewed by Predrag Jancic, MD

References

The beneficial effects of massage therapy for insomnia in postmenopausal women

“…Some studies have shown improvement in insomnia following an anti-stress massage [22,23] . It has also been reported that women experiencing insomnia as a symptom of menopause tend to select alternative therapies, particularly body therapies, as their first choice of therapy [24] . In a recent pilot study to investigate the benefits of massage in postmenopausal women with insomnia, the present research group found improvement in sleep patterns by polysomnography, including a significant decrease in REM latency and sleep stage 1, and a significant increase in sleep stages 3 and 4, in addition to significant improvement in anxiety and depression [25] . …”

Helena Hachul, Denise Silva de Oliveira, Lia Bittencourt et al. 2014

Sleep Science

Effects of massage therapy on sleep quality after coronary artery bypass graft surgery

“…INTRODUCTION: Poor sleep quality is common among patients following cardiopulmonary artery bypass graft surgery. Pain, stress, anxiety and poor sleep quality may be improved by massage therapy.OBJECTIVE:This study evaluated whether massage therapy is an effective technique for improving sleep quality in patients following cardiopulmonary artery bypass graft surgery.METHOD:Participants included cardiopulmonary artery bypass graft surgery patients who were randomized into a control group and a massage therapy group following discharge from the intensive care unit (Day 0), during the postoperative period. The control group and the massage therapy group comprised participants who were subjected to three nights without massage and three nights with massage therapy, respectively. The patients were evaluated on the following mornings (i.e., Day 1 to Day 3) using a visual analogue scale for pain in the chest, back and shoulders, in addition to fatigue and sleep. Participants kept a sleep diary during the study period.RESULTS:Fifty-seven cardiopulmonary artery bypass graft surgery patients were enrolled in the study during the preoperative period, 17 of whom were excluded due to postoperative complications. The remaining 40 participants (male: 67.5%, age: 61.9 years ± 8.9 years, body mass index: 27.2 kg/m2 ± 3.7 kg/m2) were randomized into control (n = 20) and massage therapy (n = 20) groups. Pain in the chest, shoulders, and back decreased significantly in both groups from Day 1 to Day 3. The participants in the massage therapy group had fewer complaints of fatigue on Day 1 (p = 0.006) and Day 2 (p = 0.028) in addition, they reported a more effective sleep during all three days (p = 0.019) when compared with the participants in the control group.CONCLUSION: Massage therapy is an effective technique for improving patient recovery from cardiopulmonary artery bypass graft surgery because it reduces fatigue and improves sleep.…”

Flávia Baggio Nerbass, Maria Ignêz Z. Feltrim, Silvia Alves de Souza et al. 2010

Clinics

Non‐pharmacologic treatment of insomnia in primary care settings

“…In the literature, the influence of massage therapy on the improvement of depression and anxiety was documented. 90 A possible massage therapy mechanism for stress relief is decreased cortisol levels, and an increase in active neurotransmitters, such as serotonin and dopamine 91 Hachul and colleagues reported improved sleep in postmenopausal women with insomnia symptoms after massage therapy. 92 Acupuncture and acupressure arise from traditional Chinese medicine, characterized by the insertion of metallic needles into or through the skin or applying mechanical pressure at specific sites.…”

Laura Hrehová, Kamal Mezian 2021

Int J Clin Pract

Massage therapy for symptom control: outcome study at a major cancer center

“…Massage is increasingly applied to relieve symptoms in patients with cancer. This practice is supported by evidence from small randomized trials. No study has examined massage therapy outcome in a large group of patients. At Memorial Sloan-Kettering Cancer Center, patients report symptom severity pre- and post-massage therapy using 0-10 rating scales of pain, fatigue, stress/anxiety, nausea, depression and "other." Changes in symptom scores and the modifying effects of patient status (in- or outpatient) and type of massage were analyzed. Over a three-year period, 1,290 patients were treated. Symptom scores were reduced by approximately 50%, even for patients reporting high baseline scores. Outpatients improved about 10% more than inpatients. Benefits persisted, with outpatients experiencing no return toward baseline scores throughout the duration of 48-hour follow-up. These data indicate that massage therapy is associated with substantive improvement in cancer patients' symptom scores.…”

Barrie R. Cassileth, Andrew J. Vickers 2004

Journal of Pain and Symptom Management

Beneficial Effects of Guided Imagery or Clinical Massage on the Status of Patients in a Progressive

“…BACKGROUND Patients in the progressive care unit typically experience high levels of pain and anxiety and exhibit difficulty sleeping. OBJECTIVE To determine whether either clinical massage or guided imagery could reduce pain and anxiety and improve sleep. METHODS This study included 288 inpatients on 2 floors of a progressive care unit. On 1 floor, each patient was offered daily a 15-minute complimentary clinical massage, whereas the patients on the other floor were provided access to a 30-minute guided-imagery recording. Patients were asked to rate their pain and anxiety levels immediately before and after the massage intervention or were asked whether the guided-imagery intervention was helpful for pain, anxiety, or insomnia. RESULTS The massage intervention showed an immediate and significant reduction in self-reported pain and anxiety (P < .001); likewise, a significant number of patients self-reported that guided imagery helped alleviate pain, anxiety, and insomnia (P < .001). CONCLUSION The results of this study indicate that clinical massage and guided imagery can benefit patients in the progressive care unit.…”

Gail Elliott Patricolo, Amanda LaVoie, Barbara Slavin et al. 2017

Critical Care Nurse

A randomized controlled trial of aromatherapy massage in a hospice setting

“…Research suggests that patients with cancer, particularly in the palliative care setting, are increasingly using aromatherapy and massage. There is good evidence that these therapies may be helpful for anxiety reduction for short periods, but few studies have looked at the longer term effects. This study was designed to compare the effects of four-week courses of aromatherapy massage and massage alone on physical and psychological symptoms in patients with advanced cancer. Forty-two patients were randomly allocated to receive weekly massages with lavender essential oil and an inert carrier oil (aromatherapy group), an inert carrier oil only (massage group) or no intervention. Outcome measures included a Visual Analogue Scale (VAS) of pain intensity, the Verran and Snyder-Halpern (VSH) sleep scale, the Hospital Anxiety and Depression (HAD) scale and the Rotterdam Symptom Checklist (RSCL). We were unable to demonstrate any significant long-term benefits of aromatherapy or massage in terms of improving pain control, anxiety or quality of life. However, sleep scores improved significantly in both the massage and the combined massage (aromatherapy and massage) groups. There were also statistically significant reductions in depression scores in the massage group. In this study of patients with advanced cancer, the addition of lavender essential oil did not appear to increase the beneficial effects of massage. Our results do suggest, however, that patients with high levels of psychological distress respond best to these therapies.…”

Katie Soden1Karen Vincent, Stephen Craske et al. 2004

Palliat Med

Observation on the Clinical Efficacy of Traditional Chinese Medicine Non-Drug Therapy in the Treatme

“…In addition, it is easy to produce adverse reactions such as fatigue, dizziness, and drowsiness [ 27 , 28 ]. Physical therapy emerging in recent years has been able to improve sleep quality in patients to varying degrees with less adverse reactions, but it has not been clinically promoted because its mechanism of action is not clear [ 29 ]. TCM characteristic therapy has been gradually paid attention and widely used in the treatment of insomnia, especially the traditional external treatment of TCM such as acupuncture and massage developed on the basis of the theory of meridians and viscera in TCM, which has the advantages of good clinical efficacy and less adverse reactions [ 30 ]. …”

Jingqing Zhuang, Jihuai Wu, Li Fan et al. 2022

Computational Intelligence and Neuroscience

Pilot Study of Massage to Improve Sleep and Fatigue in Hospitalized Adolescents With Cancer

The majority (78%) of patients approached for the study consented, and almost all patients in the intervention group (94%) received at least one massage, 69% received two, and rates of completion of instruments among adolescents were high demonstrating feasibility. There were trends toward increased night time and overall sleep in the intervention group compared with standard of care, but no differences between groups in the patient reported outcome measures. Participant and parent feedback on the intervention was positive and was the impetus for starting a clinical massage service at the hospital.

Shana Jacobs, Catriona Mowbray, Lauren Muser Cates et al. 2016

Pediatr Blood Cancer