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How does yoga reduce stress? A systematic review of mechanisms of change and guide to future inquiry
Abstract
Yoga is increasingly used in clinical settings for a variety of mental and physical health issues, particularly stress-related illnesses and concerns, and has demonstrated promising efficacy. Yet the ways in which yoga reduces stress remain poorly understood. To examine the empirical evidence regarding the mechanisms through which yoga reduces stress, we conducted a systematic review of the literature, including any yoga intervention that measured stress as a primary dependent variable and tested a mechanism of the relationship with mediation. Our electronic database search yielded 926 abstracts, of which 71 were chosen for further inspection and 5 were selected for the final systematic review. These five studies examined three psychological mechanisms (positive affect, mindfulness and self-compassion) and four biological mechanisms (posterior hypothalamus, interleukin-6, C-reactive protein and cortisol). Positive affect, self-compassion, inhibition of the posterior hypothalamus and salivary cortisol were all shown to mediate the relationship between yoga and stress. It is striking that the literature describing potential mechanisms is growing rapidly, yet only seven mechanisms have been empirically examined; more research is necessary. Also, future research ought to include more rigorous methodology, including sufficient power, study randomisation and appropriate control groups.
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From Embodied Cognition in Meditation, Yoga, and Ethics—An Experimental Single-Case Study on the Differential Effects of Four Mind–Body Treatments (2022) · cites this paper as [25]
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“Although there are many mechanisms by which yoga may decrease stress or depression (Riley & Park, 2015; Uebelacker et al., 2010), two that we highlight are increased self-compassion (Gard et al., 2012) and a “decentered” or mindful perspective on one’s experiences (Teasdale et al., 2002).”
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“In summary, one can postulate a structural effect of Yoga on brain areas that are related to learning, attention, emotional regulation and stress response [43-48].”
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“Fittingly, increased mindfulness has been proposed as a central mechanism of yoga’s effectiveness on stress and general health [85,86].”
BackgroundThe impact of yoga on occupational stress and wellbeing: exploring practitioners’ experiences
Hagen, I., & Hagen, Ø. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1352197 · Cited by 13
Bhargav, H., Raghavan, V., Rao, N. P., Gulati, K., Binumon, K. V., Anu, K. N., Ravi, S., Jasti, N., Holla, B., Varambally, S. S., et al. (2024) · Frontiers in Psychology · doi:10.3389/fpsyg.2024.1436691 · Cited by 13
“Its psychological mediators are positive affect, self-compassion, mindfulness and sense of connectedness (Riley and Park, 2015).”
Cognitive and psychosocial effects of an acute sun salutation intervention among adults with stress
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“The systematic nature of the AY practice can provide a higher consistency and uniformity across practitioners compared to other styles of yoga, thus addressing some methodological issues raised in previous yoga research (Riley and Park, 2015).”
Scientific yoga module for hypothyroidism: A study protocol for tele-yoga RCT
Nilkantham, S., Majumdar, V., & Singh, A. (2023) · Contemporary Clinical Trials Communications · doi:10.1016/j.conctc.2023.101157 · Cited by 15
“2 experimental and clinical studies [9] as they demonstrate the positive effect in preventing and managing a variety of endocrinal diseases without any side effects [10].”
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Pacanowski, C. R., Diers, L., Crosby, R., MacKenzie, M. J., & Neumark‐Sztainer, D. (2020) · Eating Disorders · doi:10.1080/10640266.2020.1763110 · Cited by 11
Dyadic Yoga for Head and Neck Cancer Patients Undergoing Chemoradiation and their Family Caregivers
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“Yoga helps alleviate emotional tension in the body and experience the healing that comes with it (Riley & Park, 2015).”
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“…is thought to reduce stress by correcting parasympathetic underactivity (91) and modulating immune responses (92), as well as via psychophysiological mechanisms such as impacting positive affect, self-compassion, and inhibition of the posterior hypothalamus and reduction of salivary cortisol (93).”
Yoga and Cardiovascular Diseases – A Mechanistic Review
Murugesan, P. (2024) · International Journal of Yoga · doi:10.4103/ijoy.ijoy_55_24 · Cited by 12
“[97,98] Yoga and relaxation techniques have been shown to reduce the expression of inflammatory genes by directly inhibiting them.”
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“In line with the previously observed psychological effects of yoga (3), the following dimensions were sampled: affect (21), mindfulness (22–24), stress (2, 22), worrying (22), self-compassion (23), and interoceptive awareness (25).”
BackgroundRole of yoga in managing the consequences of work stress—a review
Harini, K. N., & Nilkantham, S. (2022) · Health Promotion International · doi:10.1093/heapro/daac038 · Cited by 9
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An Intervention to Improve Mental and Physical Health of Undergraduate Nursing Students
Ciezar-Andersen, S. D., Campbell, T. S., White, D., & King‐Shier, K. M. (2024) · Canadian Journal of Nursing Research · doi:10.1177/08445621241248308 · Cited by 8
“Yoga practice has improved mental and physical health in a variety of groups including healthcare professionals and students (Chong et al., 2011; Ciezar-Andersen et al., 2021; Field, 2016; Gaskins et al., 2014; Pascoe et al., 2017; Pascoe & Bauer, 2015; Riley & Park, 2015; Yi et al., 2021).”
Đorđević, D., Garnier, J., van Mackelenbergh, T., Seitz, S., & Mundhenke, C. (2024) · Archives of Gynecology and Obstetrics · doi:10.1007/s00404-024-07563-6 · Cited by 8
“These markers are known to be altered in depression, it is assumed that yoga can improve mood and well-being through a regulation of inflammation and neurotransmission [23].”
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Gebe Kadınların Gebelikte Yoganın Faydaları Hakkındaki Bilgi ve Görüşleri
Yurtsal, Z. B., & Eroğlu, V. (2019) · Uludağ Üniversitesi Tıp Fakültesi Dergisi · doi:10.32708/uutfd.622187 · Cited by 8
Wong, S. S. S., Liu, T. W., & Ng, S. S. M. (2024) · Heliyon · doi:10.1016/j.heliyon.2024.e35883 · Cited by 8
“In addition, the combination of relaxation elements with guided meditative practice in yoga helps practitioners to restore body homeostasis, including disrupted circadian rhythms, which is associated with sleep problems [20,21].”
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Karri, R. R., Bhavanani, A. B., Ramanathan, M., & Mopidevi, V. G. (2023) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry.indianjpsychiatry_464_22 · Cited by 8
“[9] Key outcomes vary, including mental status, physical health, global state, wellness index, quality of life, social functioning, adverse effects, and care costs.”
Sun, C., Li, H., Wang, X., Shao, Y., Huang, X., Qi, H., Zhang, Z., & Su, G. (2024) · Scientific Reports · doi:10.1038/s41598-024-70884-8 · Cited by 12
Balkrishna, A., Gupta, A., Ghosh, S., Om, R., & Arya, V. (2024) · Journal of Evidence-Based Integrative Medicine · doi:10.1177/2515690x241284280 · Cited by 9
“40,41 Yagna as a therapy for psychological ailments provides pulmonary inhalation of medicinal smoke of multiple herbs (generated through oblation in fi re along with chanting of Vedic hymns), which has the potential for therapeutic results.”
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“Multiple studies, through different yoga approaches and durations, propose that the common biological mechanisms for yoga practice reduced the stress level by decreasing the sympathetic activity and activating the parasympathetic activity (12,33,34), and the increased cortisol levelmitigates through yoga practice in t…”
BackgroundThe Africa Yoga Project and Well‐Being: A Concept Map of Students’ Perceptions
Giambrone, C. A., Cook‐Cottone, C. P., & Klein, J. E. (2018) · Applied Psychology Health and Well-Being · doi:10.1111/aphw.12124 · Cited by 8
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Gangadhar, B. N. (2023) · Indian Journal of Psychiatry · doi:10.4103/indianjpsychiatry.indianjpsychiatry_813_22 · Cited by 8
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Fogawat, K., Keswani, J., Sharma, H., Tewani, G. R., Kodali, P. B., & Nair, P. M. K. (2024) · Journal of Education and Health Promotion · doi:10.4103/jehp.jehp_541_23 · Cited by 7
School-based yoga intervention for internet resilience and holistic well-being of adolescents
Reshu, Kumar, S., & Rathi, A. (2024) · Brain Behavior and Immunity Integrative · doi:10.1016/j.bbii.2024.100102 · Cited by 6
Pandya, S. P. (2018) · Child & Youth Care Forum · doi:10.1007/s10566-018-9468-8 · Cited by 6
Thayabaranathan, T., Immink, M. A., Stevens, P. J., Hillier, S., Thrift, A. G., Brodtmann, A. G., Carey, L. M., Kilkenny, M. F., & Cadilhac, D. A.-M. (2018) · Future Neurology · doi:10.2217/fnl-2018-0005 · Cited by 6
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Single-arm Pilot Trial of Hatha Yoga for Adolescents with Depression
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“There are many hypotheses about mechanisms by which yoga may be helpful for stress or depression (Riley & Park, 2015; Uebelacker et al., 2010).”
BackgroundTesting psychosocial mediators of a mind–body resiliency intervention for cancer survivors
Finkelstein‐Fox, L., Rasmussen, A. W., Hall, D. L., Perez, G. K., Comander, A. H., Peppercorn, J. M., Anctil, R., Wang, C., & Park, E. R. (2022) · Supportive Care in Cancer · doi:10.1007/s00520-022-07022-5 · Cited by 6
“Building upon this framework, there is a need to optimize [18] mind–body interventions such as the SMART-3RP to most efficiently promote resiliency in cancer survivorship and understand treatment mechanisms or “active ingredients” of mind–body programs [19, 20].”
BackgroundMore than a feeling: Perceptions of wellbeing in regular Ashtanga Yoga practitioners
Ramirez-Duran, D., Kern, M. L., & Stokes, H. (2022) · International Journal of Wellbeing · doi:10.5502/ijw.v12i2.2027 · Cited by 6
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“This intervention, along with many others described in the literature (Riley and Park 2015; Pascoe et al. 2017a, b; Park et al. 2021), can therefore help to create healthy, productive, and supportive work environments.”
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“36 Furthermore, the unique circumstances of working from home during the COVID-19 outbreak might have amplified its stress-reducing effects.”
Sohl, S. J., Strahley, A. E., Tooze, J. A., Levine, B. J., Kelly, M., Wheeler, A. E., Evans, S., & Danhauer, S. C. (2023) · Journal of Psychosocial Oncology · doi:10.1080/07347332.2023.2236083 · Cited by 6
“42,43 The AC group also reported improvements related to enhanced reflection, which could be assessed with the observing facet of mindfulness.”
BackgroundRole of Yoga as Adjunctive Therapy for Migraines: A Narrative Review of the Literature
Kachhadia, M. P., Khalil, Z. M., Shah, S. C., Fawad, M., Sajjad, H., Yadav, K. P., Kanthala, N. R., Patel, T., Egbujo, U. C., & Basant, K. (2023) · Cureus · doi:10.7759/cureus.48434 · Cited by 5
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“International Journal of Yoga | Volume 15 | Issue 1 | January-April 2022 13 and there have been scientific reports of its utility in the reduction of stress,[12,13] anxiety,[14,15] and depression,[15,16] resulting an enhanced quality of life[17] as well as better pain management in chronic disease.”
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Rhoads, M. C., Barber, M. E., Grevstad, N., Kirkland, R. A., Myers, S., Gruidel, K. A., & Greenwood, E. (2024) · Health Psychology Review · doi:10.1080/17437199.2024.2420974 · Cited by 7
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Yoga For Musculoskeletal Disorders: A Review of Prospective Clinical Studies
Gandolfi, M. G., Zamparini, F., Spinelli, A., Saper, R. B., & Prati, C. (2025) · Global Advances in Integrative Medicine and Health · doi:10.1177/27536130251388385 · Cited by 6
The Lotus in the Mud: A Conceptual Model of Livestream Yoga Service Experience
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“On the wellness spectrum, yoga aligns with a salutogenic approach towards health, focused on prevention (e.g., stress reduction) (Riley and Park 2015) and attaining optimal wellbeing that encompass eudemonic pursuits (finding meaning in life) which helps human flourish (Ivtzan and Papantoniou 2014;…”
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“Despite an array of coping strategies, yoga practices are found to reduce perceived stress,[2,3,4,5] anxiety,[4,6,7,8] markers of stress such as cortisol,[9] improved general health and well-being,[5,10,11] physical and physiological health,[6,12,13] improve cognition[14] as well as cultivation of positive emotions[2,…”
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“Yoga is one well-known MBI that is being explored as a method of stress reduction [120] and as a potential treatment for endocrine disorders [121].”
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“Empirical evidence shows that yoga reduces stress through increases in positive affect and self-compassion as well as inhibition of the posterior hypothalamus and decreases in cortisol [20].”
Exercise and Stress in At-Risk Women during Pregnancy and Postpartum
Guo, Y., Kehoe, P., Pimentel, P. S., Rousseau, J., Axelin, A., Rahmani, A. M., & Dutt, N. D. (2021) · MCN The American Journal of Maternal/Child Nursing · doi:10.1097/nmc.0000000000000722 · Cited by 4
Efficacy of Yoga in Tobacco Cessation: A Systematic Review and Meta-Analysis
Singh, S., Dhanlika, D., Haldar, P., & Sharma, G. (2025) · Nicotine & Tobacco Research · doi:10.1093/ntr/ntaf236 · Cited by 3
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“First, cortisol, recognized as an important stress hormone linked to the hypothalamic–pituitary–adrenal axis (HPA), has robustly been shown to decrease as a result of both singing 25,26 and yoga 19,27 .”
Denninger, J. W., Joss, D., Romero, P. M., Khalsa, S. B. S., Hoge, E. A., Bhasin, M., Lazar, S. W., Dusek, J. A., Macklin, E. A., Libermann, T. A., et al. (2025) · Frontiers in Psychology · doi:10.3389/fpsyg.2025.1653242 · Cited by 4
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Cardiometabolic Syndrome and Effects of Yoga
Chatterjee, S., & Bhattacharya, P. (2022) · Springer eBooks · doi:10.1007/978-981-16-6913-2_15 · Cited by 4
Effect of Yoga on Periodontal Health - A Systematic Review and Meta-Analysis
Kalburgi, V., & Harsha, N. S. S. (2021) · Journal of dental research and reviews · doi:10.4103/jdrr.jdrr_139_21 · Cited by 3
“[13] Oxygen plays a vital role in inflammation, as it was observed in the previous studies that the oxygen saturation is relatively low in the inflamed gingiva than the normal gingiva.”
Cavour-Więcławek, N., & Rogowska, A. M. (2024) · Behavioral Sciences · doi:10.3390/bs14090772 · Cited by 5
“The proposed mechanisms of yoga on stress, physical health, and emotional well-being comprise increasing psychological resources, such as mindfulness, positive affect, self-compassion, body consciousness, self-transcendence, spiritual peace, and social connectedness [43,44].”
BackgroundCoping in Conflict Zones: A Model Integrating Mindfulness, Yoga, and Support Groups
Litvak‐Hirsch, T., & Ben-Arie, D. K. (2025) · Journal of Loss and Trauma · doi:10.1080/15325024.2025.2499871 · Cited by 3
“The practice of yoga promotes relaxation (Riley & Park, 2015), improves physical health (Kuntsevich et al., 2010), and enhances overall well-being and quality of life (Woodyard, 2011), making it a valuable tool for managing stress (Riley & Park, 2015).”
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“For example, numerous biological processes, including the autonomic nervous system (ANS), hypothalamic–pituitary–adrenal (HPA) axis, limbic system activity, and peripheral nervous system, have suggested that yoga may alleviate stress [186].”
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“The findings indicate that positive affect, self-compassion, inhibition of the posterior hypothalamus, and salivary cortisol levels may mediate the relationship between yoga and stress (Riley and Park, 2015).”
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Metadata
- Authors
- Riley, K. E., & Park, C. L.
- Affiliations
- University of Connecticut (US)
- Corresponding author
- Riley, Kristen E.
- Venue
- Health Psychology Review
- Publisher
- Informa UK Limited
- Published
- 2015-04-15
- Volume
- 9
- Issue
- 3
- Pages
- 379-396
- ISSN
- 1743-7199 (ISSN-L)
- 1743-7202
- OpenAlex
- W1971363556
- Cited by
- 287
- References
- 65
- Citations by year
- 2026: 26 · 2025: 36 · 2024: 38 · 2023: 31 · 2022: 24 · 2021: 39 · 2020: 31 · 2019: 15 · 2018: 18 · 2017: 18 · 2016: 8 · 2015: 3
- FWCI
- 2.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Health Psychology Review (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Life Sciences › Neuroscience › Behavioral Neuroscience › Stress Responses and Cortisol
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Physical Activity and Health
- Keywords
- yoga, stress reduction, mechanisms of change, mediation, positive affect, mindfulness, self-compassion, posterior hypothalamus, interleukin-6, C-reactive protein, salivary cortisol, stress-related disorders
- MeSH terms
- C-Reactive Protein, Humans, Hydrocortisone, Stress, Psychological, Yoga, Interleukin-6, Treatment Outcome, Meditation
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