Mindfulness training versus sleep hygiene for insomnia symptoms in older adults: A randomized controlled comparison trial
Speaker: David Black, PhD, MPH
Format: Audio & Slides

Objective: Adequate sleep is vital to our survival, yet sleep problems grow common with age. About 50% of people aged 55+ years experience insomnia weekly. Given that sleep problems often go untreated in older adults, and untreated sleep problems increase the risk for morbidity and all-cause mortality, effective treatments for sleep problems are a priority to improve the health of our aging population.

Methods: This randomized controlled comparison trial examined the relative efficacy of two 6-week interventions (mindfulness meditation training, MT vs. sleep hygiene, SH) on sleep, inflammatory markers, and brain morphology. Participants (N=49) were ages 55-90 (M=66.27, SD=7.43). Inclusion criteria: currently active insomnia symptoms, age in years > 55, and agreeing to randomization. Exclusion criteria: current inflammatory disorder, illness, or infection, current practice of mediation, depression, cognitive impairment, class II or greater obesity, current sleep apnea diagnosis, inability to speak English, and current smoking and/or substance dependence. The UCLA IRB approved study procedures. Measures included self-reported sleep, fatigue, and peripheral blood mononuclear cell levels of Nuclear Factor-kappa B. Brain images were acquired on a 1.5T Siemens Sonata scanner using an 8-channel head coil and a T1-weighted MPRAGE sequence.

Results: Forty-three (88%) participants completed the trial. ITT analyses showed that both groups reported improved sleep and NF-kB levels post- intervention. Sleep improvements in the MT condition were significantly greater than SH (p<.02). Fatigue symptoms improved only in the MT group (p<.01). Significant increases in brain gray matter density were observed in the MT group in the posterior cingulate cortex (p<.05).

Conclusions: Findings have implications for broadening treatment options for older adults with insomnia symptoms, and novel neuroimmune mechanisms are elucidated.