A randomized controlled trial of mindfulness meditation for chronic insomnia.

Author: Ong JC1, Manber R2, Segal Z3, Xia Y4, Shapiro S5, Wyatt JK1.
Affiliation: 1Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL. 2Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Palo Alto, CA. 3Department of Psychiatry, University of Toronto, Toronto, ON, Canada. 4Department of Biostatistics and Computational Biology, University of Rochester Medical Center, Rochester, NY. 5Department of Counseling Psychology, Santa Clara University, Santa Clara, CA.
Conference/Journal: Sleep
Date published: 2014 Sep
Other: Volume ID: 37 , Issue ID: 9 , Pages: 1553-63 , Special Notes: doi: 10.5665/sleep.4010 , Word Count: 292


STUDY OBJECTIVES:
To evaluate the efficacy of mindfulness meditation for the treatment of chronic insomnia.
DESIGN:
Three-arm, single-site, randomized controlled trial.
SETTING:
Academic medical center.
PARTICIPANTS:
Fifty-four adults with chronic insomnia.
INTERVENTIONS:
Participants were randomized to either mindfulness-based stress reduction (MBSR), mindfulness-based therapy for insomnia (MBTI), or an eight-week self-monitoring (SM) condition.
MEASUREMENTS AND RESULTS:
Patient-reported outcome measures were total wake time (TWT) from sleep diaries, the pre-sleep arousal scale (PSAS), measuring a prominent waking correlate of insomnia, and the Insomnia Severity Index (ISI) to determine remission and response as clinical endpoints. Objective sleep measures were derived from laboratory polysomnography and wrist actigraphy. Linear mixed models showed that those receiving a meditation-based intervention (MBSR or MBTI) had significantly greater reductions on TWT minutes (43.75 vs 1.09), PSAS (7.13 vs 0.16), and ISI (4.56 vs 0.06) from baseline-to-post compared to SM. Post hoc analyses revealed that each intervention was superior to SM on each of the patient-reported measures, but no significant differences were found when comparing MBSR to MBTI from baseline-to-post. From baseline to 6-month follow-up, MBTI had greater reductions in ISI scores than MBSR (P < 0.05), with the largest difference occurring at the 3-month follow-up. Remission and response rates in MBTI and MBSR were sustained from post-treatment through follow-up, with MBTI showing the highest rates of treatment remission (50%) and response (78.6%) at the 6-month follow-up.
CONCLUSIONS:
Mindfulness meditation appears to be a viable treatment option for adults with chronic insomnia and could provide an alternative to traditional treatments for insomnia.
TRIAL REGISTRATION:
Mindfulness-Based Approaches to Insomnia: clinicaltrials.gov, identifier: NCT00768781.
CITATION:
Ong JC, Manber R, Segal Z, Xia Y, Shapiro S, Wyatt JK. A randomized controlled trial of mindfulness meditation for chronic insomnia. SLEEP 2014;37(9):1553-1563.
KEYWORDS:
behavior therapy; clinical trial; complementary and alternative medicine; insomnia; meditation; mindfulness; sleep

PMID: 25214695