THREE SPEEDS of YOGA and the EFFECTS on SALIVARY CORTISOL LEVELS in FEMALE NURSING STUDENTS Meagan Hennekens [email protected]
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Northern Michigan University NMU Commons All NMU Master's Theses Student Works 5-2018 THREE SPEEDS OF YOGA AND THE EFFECTS ON SALIVARY CORTISOL LEVELS IN FEMALE NURSING STUDENTS Meagan Hennekens [email protected] Follow this and additional works at: https://commons.nmu.edu/theses Part of the Alternative and Complementary Medicine Commons, Other Medical Sciences Commons, and the Other Nursing Commons Recommended Citation Hennekens, Meagan, "THREE SPEEDS OF YOGA AND THE EFFECTS ON SALIVARY CORTISOL LEVELS IN FEMALE NURSING STUDENTS" (2018). All NMU Master's Theses. 537. https://commons.nmu.edu/theses/537 This Open Access is brought to you for free and open access by the Student Works at NMU Commons. It has been accepted for inclusion in All NMU Master's Theses by an authorized administrator of NMU Commons. For more information, please contact [email protected],[email protected]. THREE SPEEDS OF YOGA AND THE EFFECTS ON SALIVARY CORTISOL LEVELS IN FEMALE NURSING STUDENTS By Meagan R. Hennekens THESIS Submitted to Northern Michigan University In partial fulfillment of the requirements For the degree of MASTER OF SCIENCE IN EXERCISE SCIENCE Office of Graduate Education and Research March 2018 SIGNATURE APPROVAL FORM THREE SPEEDS OF YOGA AND THE EFFECTS ON SALIVARY CORTISOL IN FEMALE NURSING STUDENTS This thesis by Meagan R. Hennekens was recommended for approval by the student’s Thesis Committee and Department Head in the School of Health and Human Performance and by the Assistant Provost of Graduate Education and Research. __________________________________________________________ Committee Chair: Dr. Lanae Joubert Date __________________________________________________________ First Reader: Dr. Scott Drum Date __________________________________________________________ Second Reader: Dr. Erich Ottem Date __________________________________________________________ Department Head: Dr. Elizabeth Wuorinen Date __________________________________________________________ Dr. Lisa S. Eckert Date Interim Director of Graduate Education ABSTRACT By Meagan R. Hennekens Purpose: Nursing students are prone to stress-related diseases, such as depression and anxiety, which are associated with chronically elevated cortisol levels due to the excessive firing of the Hypothalamic Pituitary Adrenal (HPA) axis. This study assessed three speeds of yoga and how they acutely affected salivary cortisol levels within female nursing students. Methods: Students participated in three yoga sessions cadenced at different speeds in a non-randomized order: (i) standard-speed yoga (SSY), (ii) high- speed yoga (HSY), and (iii) slow-speed yoga (SLSY). Each class integrated sequencing concepts from the brahmana/langhana strategy (BLS) and the Para Yoga Blueprint (PYB). Cortisol samples were collected at four time-points: (i) pre-asana (PREA), (ii) immediately post-asana (POA), (iii) immediately post-savasana/pranayama/dhyana (POSPD), and (iv) 15 min post-session (15-PO) during all three yoga sessions. Results: ReANOVA showed no significant differences in cortisol within the main effect of yoga speeds (p = 0.094) or between the yoga speed x time-points interaction (p = 0.231). The main effect across the four time-points were significantly different from each other (p < 0.001) and pairwise comparison showed significant decreases in cortisol from the PREA measurements to the three post-measurements (p = < 0.05). Conclusions: Yoga infused with PYB and BLS sequencing reduced salivary cortisol in nursing students. Further research may identify appropriate yoga interventions to help mitigate stress and prevent chronic stress-related disease in nursing students. i Copyright© by MEAGAN R. HENNEKENS 2018 ii DEDICATION To the connection of Eastern and Western sciences. iii ACKNOWLEDGMENTS A sincere thank you doesn’t even skim the depths of gratitude I have for my thesis committee: director, Dr. Lanae Joubert, for her guidance, patience, and infinite support; Dr. Erich Ottem, who planted the seed of science about human physiology and endocrinology; and Dr. Scott Drum, for motivation, direction, and encouragement along the way. Other professors I would like to acknowledge are as follows: Dr. Randall Jensen and Dr. Alan Rebertus for help with the statisitics portion of this project and Dr. Paul Mann for guidance in the Clinical Sciences Lab. Deep bows of gratitude to Karina A. Mirsky, my yoga teacher, who has encouraged me to seek my passion of connecting the ancient wisdom of the Eastern yogic philosophies to the Western science world. I have an infinite amount of appreciation for the financial support received from my parents, Carol and Jeff Hennekens; Northern Michigan University; Superior Health Foundation; Rohana Yoga & Wellness; and Northstar Investment Management. Without these amazing people and thoughtful organizations, this project would not have been possible. Last, but definitely not the least, I am extremely grateful for the subjects who participated within the study. Without you, there wouldn’t be an experiment to write about. iv PREFACE The cost of the research covered in this project was underwritten by grants from two organizations: (A) Excellence in Education Award of $1,500.00 from Northern Michigan University & the Fall 2017 Grant of $276.82 from the Superior Health Foundation. This thesis document follows the format prescribed by the Office of Graduate Education and Research and of the School of Health and Human Performance at Northern Michigan University. Chapter I is written in journal-ready format for the Journal of Holistic Nursing (JHN) and uses the American Psychological Association (APA) citation format. Review the JHN submission guidelines here. v Contents ABSTRACT ..................................................................................................................... i DEDICATION ............................................................................................................... iii ACKNOWLEDGMENTS .............................................................................................. iv PREFACE ....................................................................................................................... v LIST OF FIGURES ...................................................................................................... viii LIST OF TABLES ......................................................................................................... ix LIST OF DEFINITIONS ................................................................................................. x CHAPTER I: RESEARCH EXPERIMENT ................................................................... 1 BACKGROUND & PURPOSE ...................................................................................... 1 Stress & Nursing Students ........................................................................................... 1 Cortisol & Stress .......................................................................................................... 2 Complexity of Measuring Cortisol .............................................................................. 5 Cortisol Response to Exercise ..................................................................................... 6 Yoga as Exercise .......................................................................................................... 8 Cortisol Response to Yoga Interventions .................................................................... 9 Theory of Yoga Class Design to Reduce Cortisol ..................................................... 10 Purpose of the Study .................................................................................................. 14 METHODS .................................................................................................................... 15 Subjects ...................................................................................................................... 15 Protocol ...................................................................................................................... 15 Design of Yoga Sessions ........................................................................................... 17 Health History & Questionnaires ............................................................................... 20 Salivary Samples ........................................................................................................ 20 Statistical Analysis ..................................................................................................... 22 RESULTS ...................................................................................................................... 23 DISCUSSION ............................................................................................................... 31 LIMITATIONS & FUTURE RECOMMENDATIONS ............................................... 35 SIGNIFICANCE OF STUDY ....................................................................................... 39 CHAPTER II – REVIEW OF LITERATURE .............................................................. 40 STRESS & NURSING STUDENTS ......................................................................... 40 Stress: Basic Overview .............................................................................................. 40 vi Stress in Nursing Students ......................................................................................... 40 CORTISOL & STRESS-RELATED DISEASE ..........................................................