Can Hypopressive Abdominal Gymnastics Improve Sleep? Evidence from a Pilot Study

Purpose Postpartum women and individuals with diastasis recti, pelvic floor disorders, or chronic lower back pain are always more and more encouraged to practise Hypopressive Abdominal Gymnastics (HAG). It is a postural method designed to engage core and pelvic floor muscles by combining specific breathing techniques with low-pressure exercises. HAG aims to reduce intra-abdominal pressure and support muscle function. Although its benefits are well explored, its potential impact on sleep quality remains unclear. This study aimed to explore whether HAG might influence subjective and objective sleep parameters in women with rectus abdominis diastasis. Methods Twenty-eight women (mean age 43.2 ± 7 years) with diastasis recti were assigned to either an intervention group (INT, n = 17) or a control group (CTRL, n = 11). The INT group participated in a supervised HAG program for two months (one session per week), while the CTRL group was advised to perform unsupervised home practice. Subjective sleep was evaluated using the Mini Sleep Questionnaire (MSQ), and objective sleep data were collected via actigraphy. Assessments were conducted one week before and after the intervention. ANCOVA (age AS COVARIATE) was used to analyse differences in pre-post delta values between groups. Results Although not statistically significant, delta MSQ total scores (INT: -2.67 ± 1.19 a.u.; CTRL: -0.94 ± 0.24 a.u.; p = 0.67) and subcomponents, i.e. sleep (INT: -1.7 ± 0.92 a.u.; CTRL: -0.99 ± 0.74 a.u., p = 0.82) and wake domains (INT: -0.97 ± 0.46 a.u.; CTRL: 0.05 ± 0.03 a.u., p = 0.63) showed slightly greater improvements in the INT group compared to CTRL. Actigraphy data also suggested a positive trend in the INT group for delta sleep time (INT: 0.62 ± 0.35 %; CTRL: -0.38 ± 0.22 %; p = 0.49) and immobility percentages (INT: 0.43 ± 0.14 %; CTRL: 0.32 ± 0.25 %; p = 0.23), while the CTRL group showed slight declines. Sleep efficiency remained stable across both groups (INT: 1.48 ± 1.02 %; CTRL: 2.01 ± 1.49 %). Conclusion This preliminary study suggests that a two-month HAG program may have a modest, positive effect on sleep quality, particularly in subjective assessments. However, results may not have reached statistical significance due to the small sample size and short duration. Future studies with larger cohorts and longer interventions are warranted better to understand HAG's potential role in sleep improvement.