Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial.
|Title||Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial.|
|Publication Type||Journal Article|
|Year of Publication||2015|
|Authors||Black DS, O'Reilly GA, Olmstead R, Breen EC, Irwin MR|
|Journal||JAMA Intern Med|
|Date Published||2015 Apr|
|Keywords||Aged, Aged, 80 and over, Biomarkers, Fatigue, Female, Humans, Inflammation, Los Angeles, Male, Meditation, Middle Aged, Mindfulness, NF-kappa B p50 Subunit, Quality of Life, Severity of Illness Index, Sleep, Sleep Initiation and Maintenance Disorders, Surveys and Questionnaires, Treatment Outcome|
IMPORTANCE: Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep.
OBJECTIVE: To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances.
DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5).
INTERVENTIONS: A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework.
MAIN OUTCOMES AND MEASURES: The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB.
RESULTS: Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05).
CONCLUSIONS AND RELEVANCE: The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life.
TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01534338.
|Alternate Journal||JAMA Intern Med|
|PubMed Central ID||PMC4407465|
|Grant List||1UL1RR033176 / RR / NCRR NIH HHS / United States |
5T32-MH019925 / MH / NIMH NIH HHS / United States
L30 AT008380 / AT / NCCIH NIH HHS / United States
P30 AG028748 / AG / NIA NIH HHS / United States
P30-AG028748 / AG / NIA NIH HHS / United States
R01 AG026364 / AG / NIA NIH HHS / United States
R01-AG026364 / AG / NIA NIH HHS / United States
R01-AG034588 / AG / NIA NIH HHS / United States
R01-CA119159 / CA / NCI NIH HHS / United States
R01-CA160245 / CA / NCI NIH HHS / United States
R01-CA160245-01 / CA / NCI NIH HHS / United States
R01-DA032922 / DA / NIDA NIH HHS / United States
R01-DA032922-01 / DA / NIDA NIH HHS / United States
R01-HL095799 / HL / NHLBI NIH HHS / United States
T32 MH019925 / MH / NIMH NIH HHS / United States
UL1TR000124 / TR / NCATS NIH HHS / United States