A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia

Aug 22, 2014Sleep

Mindfulness meditation for long-term insomnia: a controlled trial

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Abstract

Participants receiving meditation-based interventions experienced a 43.75-minute reduction in total wake time compared to just 1.09 minutes in the self-monitoring group.

Mindfulness-based stress reduction (MBSR) and mindfulness-based therapy for insomnia (MBTI) led to significant reductions in total wake time, pre-sleep arousal, and insomnia severity compared to self-monitoring.
Both MBSR and MBTI showed sustained remission and response rates at a 6-month follow-up, with MBTI demonstrating higher rates of treatment remission (50%) and response (78.6%).
No significant differences were observed between MBSR and MBTI in outcomes from baseline to post-treatment.
MBTI exhibited greater reductions in insomnia severity scores than MBSR at the 6-month follow-up, with the largest difference noted at the 3-month follow-up.

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STUDY OBJECTIVES: To evaluate the efficacy of mindfulness meditation for the treatment of chronic insomnia.

DESIGN: Three-arm, single-site, randomized controlled trial.

SETTING: Academic medical center.

PARTICIPANTS: Fifty-four adults with chronic insomnia.

INTERVENTIONS: Participants were randomized to either mindfulness-based stress reduction (MBSR), mindfulness-based therapy for insomnia (MBTI), or an eight-week self-monitoring (SM) condition.

MEASUREMENTS AND RESULTS: Patient-reported outcome measures were total wake time (TWT) from sleep diaries, the pre-sleep arousal scale (PSAS), measuring a prominent waking correlate of insomnia, and the Insomnia Severity Index (ISI) to determine remission and response as clinical endpoints. Objective sleep measures were derived from laboratory polysomnography and wrist actigraphy. Linear mixed models showed that those receiving a meditation-based intervention (MBSR or MBTI) had significantly greater reductions on TWT minutes (43.75 vs 1.09), PSAS (7.13 vs 0.16), and ISI (4.56 vs 0.06) from baseline-to-post compared to SM. Post hoc analyses revealed that each intervention was superior to SM on each of the patient-reported measures, but no significant differences were found when comparing MBSR to MBTI from baseline-to-post. From baseline to 6-month follow-up, MBTI had greater reductions in ISI scores than MBSR (P < 0.05), with the largest difference occurring at the 3-month follow-up. Remission and response rates in MBTI and MBSR were sustained from post-treatment through follow-up, with MBTI showing the highest rates of treatment remission (50%) and response (78.6%) at the 6-month follow-up.

CONCLUSIONS: Mindfulness meditation appears to be a viable treatment option for adults with chronic insomnia and could provide an alternative to traditional treatments for insomnia.

TRIAL REGISTRATION: Mindfulness-Based Approaches to Insomnia: clinicaltrials.gov, identifier: NCT00768781.

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A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia

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