Disclosures: The authors report no relevant financial disclosures.
July 22, 2021
2 min read

Mindfulness-based therapy effective alternative insomnia treatment

Disclosures: The authors report no relevant financial disclosures.
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Mindfulness-Based Therapy for Insomnia effectively improved subjective and objective sleep quality among older adults, according to results from a randomized clinical trial published in Psychological Medicine.

Julian Lim

“Current treatment options such as cognitive behavioral therapy for people with insomnia disorder and other sleep problems can be ineffective and are in limited supply in some health care systems,” Julian Lim, PhD, assistant professor in the department of medicine at the National University of Singapore’s Yong Loo Lin School of Medicine, told Healio Neurology. “Preliminary research has suggested that mindfulness-based treatments might be an effective alternative, and we wanted to advance our knowledge by conducting a pre-registered, high-quality trial to test the effectiveness of one such program.”

Lim and colleagues conducted a single-site, parallel-arm trial that incorporated blinded assessments obtained at baseline, after the intervention and at 6 months follow-up. They randomly assigned 127 individuals aged 50 years to 80 years who had a Pittsburgh Sleep Quality Index (PSQI) score of five or greater to either Mindfulness-Based Therapy for Insomnia (MBTI; n = 65) or to a Sleep Hygiene, Education and Exercise Program (SHEEP; n = 62), both of which consisted of 2-hour weekly group sessions that lasted 8 weeks. PSQI and Insomnia Severity Index, as well as actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO), served as primary outcomes.

Both groups exhibited reductions in insomnia severity (MBTI Cohen d = 1.27; 95% CI, 1.61 to 0.89; SHEEP Cohen d = 0.69; 95% CI, 0.96 to 0.43), with the MBTI resulting in significantly greater improvement, according to results of intention-to-treat analysis. The researchers noted equivalent sleep quality improvement among both groups (MBTI Cohen d = 1.19; SHEEP Cohen d = 1.02). They observed no significant interaction effects in objective sleep measures. Only MBTI exhibited reductions in WASO actigraphy (MBTI Cohen d = 0.3; SHEEP Cohen d = 0.02), SOL actigraphy (MBTI Cohen d = 0.25; SHEEP Cohen d = 0.09) and WASO polysomnography (MBTI Cohen d = 0.26; SHEEP Cohen d = 0.18). SOL polysomnography did not change. No participants withdrew due to adverse effects, according to the researchers.

“The effects of mindfulness on sleep quality and insomnia symptoms were large and were sustained at 6-month follow-up,” Lim said. “Because of that, the study increases our confidence that Mindfulness-Based Therapy for Insomnia could be an effective alternative to current frontline treatments, such as cognitive behavioral therapy. However, more work needs to be done to compare these treatments head-to-head and discover the characteristics of people who benefit more from each type of therapy.”