Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial

Jun 26, 2017Psychotherapy and psychosomatics

Mindfulness Therapy, Sleep Education, and Exercise Compared for Chronic Insomnia

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Abstract

The Insomnia Severity Index score decreased significantly in the MBCT group compared to the PEEC group at 2 months (p = 0.023).

Mindfulness-based cognitive therapy for insomnia (MBCT-I) showed a short-term reduction in insomnia severity compared to the sleep psycho-education with exercise control (PEEC).
Wake time after sleep onset was less in the MBCT-I group at both 2 and 5 months.
At 8 months, both groups exhibited improvements in insomnia severity, sleep onset latency, wake time after sleep onset, sleep efficiency, and total sleep time, but no significant differences were found between the groups.
Treatment response and remission rates based on insomnia severity were not significantly different between MBCT-I and PEEC.

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BACKGROUND: Mindfulness-based cognitive therapy (MBCT) is a potential treatment for chronic insomnia. We evaluated the efficacy of MBCT for insomnia (MBCT-I) by comparing it with a sleep psycho-education with exercise control (PEEC) group.

METHODS: Adults with chronic primary insomnia (n = 216) were randomly allocated to the MBCT-I or PEEC group. The MBCT-I included mindfulness and psycho-education with cognitive and behavioural components under cognitive behavioural therapy for insomnia. PEEC included psycho-education of sleep hygiene and stimulus control, and exercises. Any change in insomnia severity was measured by the Insomnia Severity Index (ISI). Secondary outcomes included sleep parameters measured by a sleep diary, health service utilisation, absence from work and mindfulness measured by the Five Facet Mindfulness Questionnaire.

RESULTS: The ISI score significantly decreased in the MBCT-I group compared with the PEEC group at 2 months (i.e., post-intervention) (p = 0.023, effect size [95% CI] -0.360 [-0.675, -0.046]) but not at 5 or 8 months. Treatment response rates and remission rates based on the ISI cut-off scores were not significantly different between groups. Wake time after sleep onset (WASO) was less in the MBCT-I group at 2 and 5 months. At 8 months, both groups showed a reduced ISI score, sleep onset latency and WASO, and increased sleep efficiency and total sleep time; however, no group differences were seen. Other outcome measures did not significantly improve in either group.

CONCLUSIONS: Long-term benefits were not seen in MBCT-I when compared with PEEC, although short-term benefits were seen.

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Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial

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