Can massage improve sleep?

Clients often report having a great night's sleep after receiving a massage. Why is this and is there any evidence to support massage as an effective tool to help us sleep?

Firstly, why is sleep so important?

Sleep is vitally important and here are just a few reasons why:

• It supports the growth and development of children and teens.
• The heart rate and blood pressure fall in REM sleep and raise to normal levels again upon waking. Not achieving this state could lead to heart problems.
• It helps regulate hormones throughout different phases of life. One such hormone helps with muscle repair and the growth hormone is released more during REM sleep.
• Inadequate sleep can affect metabolism which may make it harder to lose weight and/or manage insulin levels.
• Sleep activates a specific immune defence, leaving those who sleep less more susceptible to colds.
• Sleep helps us process information and form memories. A lack of sleep can lead to difficulties in learning and performing tasks.

Proving our worth as massage therapists

It is notoriously hard to provide clear scientific evidence to prove the effects we see so frequently with our clients. Despite efforts to find the reasons behind the results, many studies are flawed or find it hard to measure exactly what is happening in the body. But there are some agreed physiological changes after massage and many studies reveal positive results after receiving massage from its participants. With the huge variety of human beings and limitations in research, we shouldn’t ignore the overwhelmingly positive effects felt by participants and our clients.

What can we prove?

Scientific studies have measured the sympathetic and parasympathetic nervous systems and found a triggering of neurochemical reactions following a massage (1). The participants reported improvements in:

• feelings of relaxation
• improved sleep
• tranquillity
• well-being
• decreased heart rate and breathing
• peristalsis
• dysmenorrhea (menstrual pain) reduction 

It is believed that the massage techniques of touch, pressure, heat, vibration and pain, all contribute to these effects by interacting with the muscle-cutaneous receptors (1).

Sleep and insomnia in the elderly

There have been some studies investigating sleep and insomnia and the effects of massage yielding very promising results. An improvement in insomnia was observed following an anti-stress massage, especially in the elderly (2,3). This is a wonderful finding as the older population is generally more susceptible to insomnia due to stressful life events or medical conditions that may disrupt sleep.

Other people with an increased risk of insomnia are those with respiratory symptoms, physical disability, and fair to poor perceived health. A massage could be truly effective when used alongside or as a change to medication which may already be in abundance.

Menopause and post-menopause

A hot topic at the moment – excuse the pun – and better late than never considering one referenced study dates back to 2002! (By no means the oldest in existence either.) But at least we are in a great position to apply the findings.

Sleep disturbance and insomnia are symptoms experienced by many women pre, during and post-menopause, with many looking at all avenues of treatment including holistic and alternative therapies. Massage in particular has been found to be the most popular first-choice therapy (4).

A 2011 study investigating the benefits of massage in post-menopausal women with insomnia found a significant improvement in sleep patterns by using polysomnography. They recorded a decrease in REM latency (the measure of time it takes to reach REM sleep – an important phase of sleep as outlined above).

In addition to an increase in sleep stages three and four, they also found improvement in anxiety and depression (5).

In addition to quantitative data results, they also used a sleep diary to measure
subjective qualitative information. With this data, they found that all participants fell asleep faster, experienced improved sleep quality and felt better upon waking (5).

A follow-up to this study the following year also found a significant decrease in
depression, insomnia, and increased quality of life. This concluded massage’s
effectiveness in treating perimenopausal symptoms (6), later confirmed by further research in 2014 on insomnia in postmenopausal women (7).

Cancer and fibromyalgia

Cancer survivors often struggle with sleep following the treatment toll on their body along with the stress and anxiety that the whole journey has caused. Many people would love to reduce the pharmacology involved in their treatment yet many are given medication to help with their sleep. If only there was another way...

In 2021, researchers set out to investigate the effect of massage and relaxation therapy to help cancer survivors sleep, giving them a break from additional medication. They found statistically significant improvements in sleep quality and number of long sleep episodes in cancer survivors, a major clinical benefit (8). These results are also in agreement with a study looking at sleep in fibromyalgia patients (9).

My conclusion

With many people around the world suffering from these and other conditions bringing about insomnia and sleep disturbance, it is encouraging to read how far-reaching the effects of massage can be.

In clinical practice, we are seeing many more people opting for self-paying treatments due to the delays and strains on the NHS, and although the cost is one of the very few drawbacks of massage therapy, the benefits will improve quality of life, relationships and happiness – a no brainer, I’d say.

Contact us or your massage therapist to discuss how we can help you.

References

1. Chang H.H., Aubry J. Pergaminho; Lisboa: 1999. O fantástico Mundo Do Do-In
Chinês.

2. Schiff A. Literature review of back massage and similar techniques to promote sleep in elderly people. Pflege. 2006;19:163–173.

3. Zhou Y.F., Wei Y.L., Zhang P.L., Gao S., Ning G.L., Zhang Z.Q. Multi-central
controlled study on three-part massage therapy for treatment of insomnia of deficiency of both the heart and spleen. Zhongguo Zhen Jiu. 2006;26:385–388.

4. Newton K.M., Buist D.S.M., Keenan N.L., Anderson L.A., LaCroix A.Z. Use of
alternative therapies for menopause symptoms: results of a population-based survey. Obstet Gynecol. 2002;100:18–25.

5. Oliveira D.S., Hachul H., Tufik S., Bittencourt L. Effect of massage in postmenopausal women with insomnia – pilot study. Clinics. 2011;66(2):343–346.

6. Oliveira D.S., Hachul H., Goto V., Tufik S., Bittencourt L.R. Effect of therapeutic
massage on insomnia and climacteric symptoms in postmenopausal women. Climacteric. 2012 Feb;15(1):21–29.

7. Hachul H, Oliveira DS, Bittencourt LRA, Andersen ML, Tufik S. The beneficial effects of massage therapy for insomnia in postmenopausal women. Sleep Sci.
2014;7(2):114–6. https://doi.org/10.1016/j.slsci.2014.09.005.

8. Samuel. S,Rachita Gururaj,1 K. Vijaya Kumar, 1 Prina Vira,1 P. U. Prakash
Saxena,2 and J William L Keogh1,3,4 Randomized control trial evidence for the benefits of massage and relaxation therapy on sleep in cancer survivors – a systematic review. J Cancer Surviv. 2021; 15(5): 799–810.

9. Yuan SL, Matsutani LA, Marques AP. Effectiveness of different styles of massage therapy in fibromyalgia: a systematic review and meta-analysis. Man Ther. 2015;20(2):257–64. https://doi.org/10.1016/j.math.2014.09.003