Mindfulness-Based Stress Reduction Versus Pharmacotherapy for Chronic Primary Insomnia: A Randomized Controlled Clinical Trial

Abstract

Objective To investigate the potential of Mindfulness-Based Stress Reduction (MBSR) as a treatment for chronic primary insomnia. Design Randomized controlled trial. Setting University health center. Patients 30 adults with primary chronic insomnia based on DSM-IV-TR criteria were randomized 2:1 to MBSR or pharmacotherapy (PCT). Interventions MBSR, a program of mindfulness meditation training consisting of 8 weekly 2.5 hour classes and a day-long retreat, with ongoing home meditation practice expectations during 3 month follow-up; PCT, consisting of 3 mg of eszopiclone (LUNESTA™) nightly for 8 weeks, followed by 3 months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions. Main Outcomes The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries and wrist actigraphy collected pre-treatment, post-treatment (8 weeks), and at 5 months (self-reports only). Results Between baseline and 8-weeks, sleep onset latency measured by actigraphy decreased 8.9 minutes in the MBSR arm (P<.05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, sleep onset latency and sleep efficiency (Ps<.01, all) from baseline to 5 month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. 27 out of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by: sleep diary, actigraphy, well-validated sleep scales and measures of remission and clinical recovery.

The SENSE study: Post intervention effects of a randomized controlled trial of a cognitive–behavioral and mindfulness-based group sleep improvement intervention among at-risk adolescents.

“…For example, participants selected for the interventions were characterized by longer SOL, but not lower TST, compared with those not selected for the interventions. These results are also consistent with emerging empirical evidence showing that children and adolescents with anxious and depressive symptoms have particular difficulties with wakefulness in bed (Lovato & Gradisar, 2014), especially sleep initiation (Alfano et al, 2013;Forbes et al, 2008), and with the results of other sleep interventions that have found SOL among the most improved variables (Bei et al, 2013;Bootzin & Stevens, 2005;Clarke et al, 2015;de Bruin et al, 2015de Bruin et al, , 2014Garland et al, 2014;Gradisar, Dohnt, et al, 2011;Gross et al, 2011;Koffel et al, 2015;Schlarb et al, 2011;Trauer et al, 2015).…”

Use of Relaxation Techniques and Complementary and Alternative Medicine by American Adults with Insomnia Symptoms: Results from a National Survey

“…For example, despite popularized claims of the therapeutic benefit for meditation for sleep, data from randomized trials evaluating mindfulness meditation for sleep disturbances are mixed. [28][29][30][31][32][33] Conversely, three recent randomized controlled studies evaluating the benefit of Tai Chi for sleep have demonstrated improvement in subjective sleep parameters (i.e., Pittsburgh Sleep Quality Index [PSQI]). [14][15][16] However, larger randomized controlled trials with objective outcome measures are needed to improve our understanding of the efficacy of alternative mind-body therapies, with particular attention given to important methodological issues that are related to behavioral interventions, such as difficulty with blinding.…”

Validity evidence of the brazilian version of the five facet mindfulness questionnaire (FFMQ)

“…In addition to their influence on the subjective well-being, mindfulness-based interventions have shown great efficacy for different types of mental disorders and chronic diseases, including chronic pain (Morone, Lynch, Greco, Tindle, & Weiner, 2008) and primary insomnia (Gross et al, 2011). They have also proved effective in improving the quality of life of cancer patients (Carlson, Speca, Patel, & Goodey, 2004), reducing anxiety in patients with heart conditions (Tácon, McComb, Caldera, & Randolph, 2003), and reducing mood disorders (Williams, 2008).…”