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Mindfulness training improves sleep of older adults, clinical trial shows

Posted 03.16.2015 | by AMRA

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About half of adults aged 55 and over report some difficulty falling and/or staying asleep. Moderate sleep disturbances are often accompanied by daytime fatigue and disturbances in mood, and may be precursors to clinical insomnia. Current treatments for sleep disturbances include medications which can have residual daytime effects and lead to dependency, and cognitive and behavioral treatments which can be costly and require access to skilled therapists. There is an ongoing need for novel treatments that are safe, effective, low cost, and accessible in the broader community.

In a randomized, controlled study, Black et al. [JAMA Internal Medicine] evaluated the Mindfulness Awareness Practices for Daily Living (MAPs) program as a treatment for moderate sleep disturbance in older adults. Prospective participants aged 55 and above were recruited through advertising and screened for the presence of moderate sleep disturbance and the absence of other diagnoses that could aversely affect sleep (e.g., sleep apnea, restless leg syndrome). Forty-nine predominantly Caucasian (84%), female (67%) participants (average age=66) were randomly assigned to either MAPS or to Sleep Hygiene Education (SHE), a widely accepted sleep intervention designed to match MAPS in format, participant involvement, and participant expectations for benefit.

The programs were delivered in six two-hour group sessions that included home practice or study. MAPs participants practiced sitting, walking, movement, eating, and loving-kindness meditations. SHE participants were instructed in sleep education and sleep self-monitoring, relaxation techniques, and sleep hygiene strategies. Pittsburgh Sleep Quality Index scores served as the primary outcome measure. Self-report measures of depression, anxiety, stress, fatigue, and mindfulness (the Five Factor Mindfulness Questionnaire, or FFMQ) were also included, as well as a blood drawn measure of NF-κB, […]

March 16th, 2015|News|

Insomnia relief from adapted mindfulness program

Posted: 09.19.2014 | by AMRA

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Insomnia affects up to 20% of the U.S. population, and sufferers present with difficulties in both falling asleep and staying asleep. Drugs used to treat insomnia often have undesirable side effects including substance dependency and memory impairment. Cognitive-behavioral therapy (CBT) can help, but less than half of all insomnia sufferers treated with CBT achieve full remission.

Ong et al. [Sleep] tailored a mindfulness-based therapy for insomnia (MBTI) modeled on MBSR. The program targets psychophysiological hyperarousal and includes behavioral strategies often used in CBT when applied to insomnia. Fifty-four patients meeting diagnostic criteria for chronic insomnia and reporting elevated pre-sleep arousal were randomly assigned to one of two mindfulness-based interventions (MBSR or MBTI) or an 8-week self-monitoring (SM) control.

All participants kept a sleep diary and rated the severity of their insomnia and pre-sleep arousal. Objective measures of sleep quality were also obtained through polysomnography (laboratory monitoring of brain rhythm, eye movement, and muscle tone) and wrist actigraphy (a measure of nighttime movement using a watch-like device worn on the wrist).

Both the MBSR and MBTI groups showed significant reductions in total self-reported awake time when compared with the control group. The combined meditation groups reduced self-reported time awake by 44 minutes per night, while the control group reported a reduction of only 1 minute per night. The combined groups also showed significantly greater reductions in self-rated pre-sleep arousal and significantly greater improvement in self-rated insomnia severity than the controls. Effect sizes were moderate to large.

Treatment response rates — as defined by at least a 7-point decline in self-rated insomnia severity — were 60% (MBTI), 39%(MBSR) and 0% (SM), respectively. MBTI response rates continued to […]

October 24th, 2014|News|

Mindfulness Meditation Superior to Sleep Hygiene for Cancer Survivors

Posted from archive: 02.07.2013 | by AMRA

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Nakamura et al [Journal of Cancer Survivorship] compared three interventions in 57 cancer survivors with self-reported problems sleeping. Participants were randomly assigned to sleep hygiene education (SHE), mindfulness meditation (MM), or mind, body bridging (MBB). All interventions were delivered in three 2-hour group sessions, with home practice left to the participants’ discretion.

MM was a shortened version of MBSR that included sitting and walking meditation, the body scan, and a forgiveness meditation. MBB shares features with MM (sensory awareness, non, judgmental attitude, decontextualization of thought) but doesn’t include formal meditation practice. It trains participants to “rest” their “identify systems” through sensory awareness, identify the irrational demands the system places on reality and on oneself, and disengage from those demands in a friendly manner, thus loosening an identification with a false sense of self, and getting in touch with an undamaged sense of wholeness.

All three interventions significantly improved self-reported sleep quality, with both MBB and MM proving superior to SHE. MBB participants also showed significant improvement on secondary measures of self-reported depression, mindfulness, and self-compassion when compared with the SHE control group, while MM participants showed a nonsignificant trend in the same direction of benefit.

Reference:

Nakamura, Y., Lipschitz, D. L., Kuhn, R., Kinney, A. Y., & Donaldson, G. W. (2013). Investigating efficacy of two brief mind-body intervention programs for managing sleep disturbance in cancer survivors: A pilot randomized controlled trial. Journal of Cancer Survivorship: Research and Practice, 7(2):165-82. [PMID: 23338490]

[Link to abstract]

December 26th, 2013|News|

Improved Short-Term Sleep Quality from MBSR in Breast Cancer Patients

Posted from archive: 02.01.2013 | by AMRA

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Andersen et al. [Acta Oncologica] studied a cohort of 336 breast cancer patients, randomly assigned to either MBSR or treatment as usual. Self-reported sleep quality improved for both conditions, with a significantly greater improvement noted for MBSR. The effect size was small, however, and the groups no longer differed at 6-, and 12-month follow-up, controls eventually catching up with MBSR participants.

The authors conclude MBSR has a small short-term effect on sleep. MBSR participants maintained their gains at long-term follow-up, suggesting maintenance of their initial improvement over time. Sleep problems were rare in this cohort, perhaps due to the patients being an average of 7-8 months past their diagnosis, placing a ceiling on the magnitude of change scores.

Reference:

Andersen, S. R., Würtzen, H., Steding-Jessen, M., Christensen, J., Andersen, K. K., Flyger, H., . . . Dalton, S. O. (2013). Effect of mindfulness-based stress reduction on sleep quality: Results of a randomized trial among Danish breast cancer patients. Acta Oncologica, 52(2), 336-44. [PMID: 23282113]

[Link to abstract]

December 25th, 2013|News|