Integrative body–mind–spirit intervention for concurrent sleep and mood disturbances: sleep‐specific daytime functioning mediates sleep and mood improvements

Abstract

Summary Sleep disturbances and depressive symptoms are associated closely with daytime dysfunctions, yet few studies have investigated their temporal relationship in a randomized controlled trial. We investigated the inter‐relationships among sleep, depressive symptoms and daytime functioning following an integrative body–mind–spirit (I‐BMS) intervention. One hundred and eighty‐five participants (mean age 55.28 years, 75.1% female) with co‐existing sleep and depressive symptoms were randomized to I‐BMS or waiting‐list. Daytime functioning variables included the daytime dysfunction items of the Pittsburg Sleep Quality Index (PSQI‐day), Somatic Symptom Inventory, Hospital Anxiety Depression Scale and Short Form Health Survey collected at baseline, post‐treatment and 3‐month follow‐up. Sleep and depressive symptoms were measured by the sleep items of the PSQI (PSQI‐night) and Center for Epidemiological Studies Depression Scale (excluding the sleep item) (CESD‐M). Regression and path analyses were used to understand the role of daytime functioning in sleep and depressive symptoms. We found significant group and time effects on almost all daytime variables and significant group × time interactions on PSQI‐day and somatic symptoms. The adjusted regression model showed that CESD‐M was associated with all daytime variables. However, PSQI‐night was associated only with PSQI‐day. Path analyses indicated that PSQI‐day bridged PSQI‐night and CESD‐M in a two‐way direction after the I‐BMS intervention. The conclusion was that, following I‐BMS intervention, improvement in daytime functioning was related predominantly to improvement in depressive symptoms. Night‐time sleep related only to daytime dysfunction that was specific to sleep disturbances. Therefore, ‘sleep‐specific daytime impairment’ could be regarded as a major link from night‐time sleep to depressive symptoms. More studies are required to understand the concept of ‘sleep‐specific daytime impairment’.

Study Protocol of Brief Daily Body-Mind-Spirit Practice for Sustainable Emotional Capacity and Work Engagement for Community Mental Health Workers: A Multi-Site Randomized Controlled Trial

“…Being more grounded, people may broaden their awareness and build a connection with the mind and spirit. Brief BMS practices have been evaluated and assessed with plenty of evidences in a wide range of clients, for instance, people with mood and sleep disturbances, chronic fatigue, and survivors of critical incidents ( Ng et al, 2006 ; Chan et al, 2016 , 2017 ; Ji et al, 2017 ). Given the emotional demanding nature of social services, we developed a brief daily BMS program and successfully piloted it with both professional and care workers at elderly service ( Ng, 2014 ).…”

A case of Melkersson‐Rosenthal syndrome with endocrine disorders: Extraordinary efficiency of hydroxychloroquine and mechanism hypothesis

“…The patient's negative emotions were eliminated, self‐confidence was fully restored, and she resumed college life. According to the principle of integrative body–mind–spirit [15], the patient's holistic health has been achieved, and the dual goals of clinical and psychological healing were established, which was our original goal.…”

Sleep Quality in Comorbid Generalized Anxiety Disorder and Major Depressive Disorder: Comparison with Healthy Controls

“…In the study by Huang, it was detected that depressed mothers in the early postpartum period showed more daytime dysfunction than non-depressive mothers 43 . In the study conducted by Ji, Daytime dysfunction was found to be related with changes in depressive symptoms rather than changes in nighttime sleep in patients with comorbid major depression and primary sleep disorder 44 . In a study conducted in the geriatric age group, it was found that geriatric depression scale scores were perfectly associated with daytime dysfunction 45 .…”