Mindfulness-Based Treatments for Chronic Insomnia: Concepts and Results from a Randomized Controlled Trial
Speaker: Jason Ong, PhD
Format: Audio & Slides

Objective: The purpose of this study was to evaluate the efficacy of mindfulness meditation as a treatment for chronic insomnia using mindfulness-based stress reduction (MBSR) and mindfulness-based therapy for insomnia (MBTI), a unique meditation-based therapy combined with traditional behavior therapy (BT) for insomnia.

Methods: Fifty-four adults with chronic insomnia participated in a three-arm, single-site, randomized controlled trial. Treatment consisted of 8 weeks of (1) MBSR, (2) MBTI, or (3) traditional BT for insomnia that began after 8-weeks of self-monitoring (SM). Patient-reported outcome measures were total wake time (TWT) derived from sleep diaries and the pre-sleep arousal scale (PSAS), measuring a prominent waking correlate of insomnia. Sleep was assessed objectively using laboratory polysomnography and wrist actigraphy. The clinical endpoints were remission and response defined by validated criteria based on the Insomnia Severity Index (ISI).

Results: Linear mixed models showed significantly greater reduction on TWT and PSAS scores in the combined study arms that received meditation treatment (MBTI and MBSR) compared to the SM arm from baseline to post-treatment and from baseline to six months follow-up. The mean reduction in TWT from baseline was 43.75 minutes at post-treatment and 49.63 minutes at 6-month follow-up, showing durability of treatment effects. The combined meditation arms also had an average baseline-to-post reduction in PSAS score of 7.13 points compared to a 0.16 point decrease in SM, showing differential reduction in sleep-related arousal. Remission and response rates in MBTI and MBSR were comparable to BT, with MBTI showing the highest rates of treatment response (78.6%) at the 6 month follow-up.

Conclusions: Mindfulness meditation appears to be a viable treatment option for adults with chronic sleep disturbance and could provide an alternative to traditional pharmacological and behavioral treatments for insomnia.