Skip to main content

Advertisement

SpringerLink
Log in

A Narrative Review of the Effects of Mindfulness on Sleep and Hypertension

  • Sleep and Hypertension (SJ Thomas, Section Editor)
  • Published:
Current Hypertension Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The prevalence of both insomnia and hypertension in the general population is vast and the health implications to individuals and society are costly. The current pharmacological treatment options for insomnia and hypertension are limited and patients are becoming increasingly interested in non-pharmacological treatment options. Mindfulness, a disciplined mental training practice rooted in Eastern traditions, has become a widely popular treatment method for multiple chronic health problems. The aim of this paper was to review research on mindfulness-based intervention effects on sleep, insomnia, and hypertension from the past 3 years. Theoretical foundations of mindfulness are discussed. Empirical evidence and potential mechanisms of how mindfulness impacts sleep and hypertension are provided.

Recent Findings

Our findings suggest that mindfulness-based interventions are safe and effective for people with insomnia and hypertension. We saw consistent, albeit small to moderate, effects of mindfulness-based interventions on reducing insomnia symptoms, improving sleep quality, and lowering systolic and diastolic blood pressure readings.

Summary

While mindfulness interventions have shown to be effective for improving sleep and lowering hypertension, future research is needed to further evaluate their efficacy on larger samples of patient populations with long-term follow-up measures. These high-quality studies could help researchers and clinicians identify treatment response tendencies in patient populations which can lead to better tailoring of mindfulness-based interventions for specific health concerns.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

  1. Perlis ML, Pigeon WR, Grandner MA, Bishop TM, Riemann D, Ellis JG, et al. Why Treat Insomnia? J Prim Care Community Health. 2021.

  2. Chowdhury AI, Ghosh S, Hasan MDF, Khandakar KAS, Azad F. Prevalence of insomnia among university students in South Asian Region: a systematic review of studies. J Prev Med Hyg. 2021;61:E525–9.

    PubMed  PubMed Central  Google Scholar 

  3. Tzuang M, Owusu JT, Huang J, Sheehan OC, Rebok GW, Paudel ML, et al. Associations of insomnia symptoms with subsequent health services use among community-dwelling U.S. older adults. Sleep. 2021;44:zsaa251.

  4. Berkley AS, Carter PA, Yoder LH, Acton G, Holahan CK. The effects of insomnia on older adults’ quality of life and daily functioning: A mixed-methods study. Geriatr Nur (Lond). 2020;41:832–8.

    Article  Google Scholar 

  5. Whelton PK, Carey RM, Aronow WS, Casey DE, Collins KJ, Dennison Himmelfarb C, Wright JT. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. J Am Coll Cardiol. 2018;71:19:e127-e248.

  6. Mills KT, Stefanescu A, He J. The global epidemiology of hypertension. Nat Rev Nephrol. 2020;16:223–37.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  7. Brouwers S, Sudano I, Kokubo Y, Sulaica EM. Arterial hypertension. The Lancet. 2021;398:249–61.

    Article  CAS  Google Scholar 

  8. Wierzejska E, Giernaś B, Lipiak A, Karasiewicz M, Cofta M, Staszewski R. A global perspective on the costs of hypertension: a systematic review. Arch Med Sci. 2020;16:1078–91.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Zhang D, Lee EKP, Mak ECW, Ho CY, Wong SYS. Mindfulness-based interventions: an overall review. Br Med Bull. 2021;138:41–57.

    Article  CAS  PubMed  Google Scholar 

  10. Kabat-Zinn J. Wherever you go, there you are: mindfulness meditation in everyday life. Hachette UK: Hyperion. 1994.

  11. Luberto CM, Hall DL, Park ER, Haramati A, Cotton S. A perspective on the similarities and differences between mindfulness and relaxation. Glob Adv Health Med. 2020;9:216495612090559.

    Article  Google Scholar 

  12. Crowe M, Jordan J, Burrell B, Jones V, Gillon D, Harris S. Mindfulness-based stress reduction for long-term physical conditions: a systematic review. Aust N Z J Psychiatry. 2016;50:21–32.

    Article  PubMed  Google Scholar 

  13. Chen T-L, Chang S-C, Hsieh H-F, Huang C-Y, Chuang J-H, Wang H-H. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: a meta-analysis. J Psychosom Res. 2020;135: 110144.

    Article  PubMed  Google Scholar 

  14. Geiger C, Cramer H, Dobos G, Kohl-Heckl WK. A systematic review and meta-analysis of mindfulness-based stress reduction for arterial hypertension. J Hum Hypertens. 2023;37:161–9.

    Article  PubMed  Google Scholar 

  15. Lee EK, Yeung NC, Xu Z, Zhang D, Yu C-P, Wong SY. Effect and acceptability of mindfulness-based stress reduction program on patients with elevated blood pressure or hypertension: a meta-analysis of randomized controlled trials. Hypertension. 2020;76:1992–2001.

    Article  CAS  PubMed  Google Scholar 

  16. • Zhao Y, Liu J-E, Lewis FM, Nie Z-H, Qiu H, Han J, et al. Effects of mindfulness‐based cognitive therapy on breast cancer survivors with insomnia: a randomised controlled trial. Eur J Cancer Care (Engl). 2020;29:e13259. This randomized controlled trial (N = 136) explored the effects of mindfulness-based cognitive therapy for insomnia (MBCT-I) on breast cancer survivors. The MBCT-I group demonstrated significant improvements in insomnia severity and sleep quality compared to the control group at various follow-up points, endorsing MBCT-I as a potentially effective non-pharmacological intervention for insomnia in breast cancer survivors.

  17. • Camino M, Satorres E, Delhom I, Real E, Abella M, Melendez JC. Mindfulness-based cognitive therapy to improve sleep quality in older adults with insomnia. Psychosoc Interv. 2022;31:159–67. This study (N = 106) provides evidence for the effectiveness of Mindfulness-Based Cognitive Therapy in improving sleep quality in older adults with both subclinical and moderate insomnia. The significant reduction in insomnia symptoms observed in this study demonstrates the potential utility of non-pharmacological interventions such as mindfulness in treating sleep disorders, thereby reinforcing the argument for the therapeutic benefits of mindfulness in enhancing sleep quality.

  18. Alamout MM, Rahmanian M, Aghamohammadi V, Mohammadi E, Nasiri K. Effectiveness of mindfulness based cognitive therapy on weight loss, improvement of hypertension and attentional bias to eating cues in overweight people. Int J Nurs Sci. 2020;7:35–40.

    PubMed  Google Scholar 

  19. Perini F, Wong KF, Lin J, Hassirim Z, Ong JL, Lo J, et al. Mindfulness-based therapy for insomnia for older adults with sleep difficulties: a randomized clinical trial. Psychol Med. 2023;53:1038–48.

    Article  PubMed  Google Scholar 

  20. • Nardi WR, Harrison A, Saadeh FB, Webb J, Wentz AE, Loucks EB. Mindfulness and cardiovascular health: qualitative findings on mechanisms from the mindfulness-based blood pressure reduction (MB-BP) study. Dorjee D, editor. PLoS One. 2020;15:e0239533. This qualitative study conducted four focus group discussions (N = 19) on perceptions regarding the mechanisms through which the Mindfulness-Based Blood Pressure Reduction (MB-BP) program might influence cardiovascular health. Key themes of self-awareness, attention control, and emotion regulation emerged, all potentially crucial to improvements in cardiovascular health. The study’s findings provide important insights into how mindfulness practices can support self-regulation skills and promote healthier behaviors, thereby helping to lower the risk of cardiovascular diseases, including hypertension.

  21. Wang Y-Y, Wang F, Zheng W, Zhang L, Ng CH, Ungvari GS, et al. Mindfulness-based interventions for insomnia: a meta-analysis of randomized controlled trials. Behav Sleep Med. 2020;18:1–9.

    Article  PubMed  Google Scholar 

  22. • An E, Irwin MR, Doering LV, Brecht M-L, Watson KE, Corwin E, et al. Mindfulness effects on lifestyle behavior and blood pressure: a randomized controlled trial. Health Sci Rep. 2021;4:e296. This randomized controlled trial evaluated the impact of the Mindful Awareness Practices (MAP) program on blood pressure and lifestyle behaviors associated with hypertension. Notably, MAP outperformed the Health Promotion Program in reducing both systolic and diastolic blood pressure. Further, mediation analysis revealed that mindfulness practice influenced participants to initiate lifestyle behavior changes, partially explaining the program’s superior blood pressure reduction. These results bolster the case for employing mindfulness-based interventions in hypertension management.

  23. Intarakamhang U, Macaskill A, Prasittichok P. Mindfulness interventions reduce blood pressure in patients with non-communicable diseases: a systematic review and meta-analysis. Heliyon. 2020;6: e03834.

    Article  PubMed  PubMed Central  Google Scholar 

  24. • Dye L, Burke MG, Wolf C. Teaching mindfulness for the self-care and well-being of counselors-in-training. J Creat Ment Health. 2020;15:140–53. This mixed-methods study (N = 32) examined the effects of mindfulness on several aspects of wellbeing in a group of counselors-in-training. The current authors are clinical psychologists in training and therefore, may have experienced similar results as the participants in this study. One of the measures in this study was the Four-Dimensional Mood Scale, which includes scales of positive energy and tiredness. These scales are likely related to sleep quality and thus. This study found that mindfulness practice increased relaxation, awareness of the need for self-care, among others.

  25. Grasmann J, Almenräder F, Voracek M, Tran US. Only small effects of mindfulness-based interventions on biomarker levels of inflammation and stress: a preregistered systematic review and two three-level meta-analyses. Int J Mol Sci. 2023;24:4445.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  26. Park C, Youn I, Han S. Single-lead ECG based autonomic nervous system assessment for meditation monitoring. Sci Rep. 2022;12:22513.

    Article  CAS  PubMed  PubMed Central  ADS  Google Scholar 

  27. van Loon AWG, Creemers HE, Okorn A, Vogelaar S, Miers AC, Saab N, et al. The effects of school-based interventions on physiological stress in adolescents: a meta-analysis. Stress Health. 2022;38:187–209.

    Article  PubMed  Google Scholar 

  28. Bagai K, Peltier AC, Malow BA, Diedrich A, Shibao CA, Black BK, et al. Objective sleep assessments in patients with postural tachycardia syndrome using overnight polysomnograms. J Clin Sleep Med JCSM Off Publ Am Acad Sleep Med. 2016;12:727–33.

    Google Scholar 

  29. Vitiello MV, Prinz PN, Halter JB. Sodium-restricted diet increases nighttime plasma norepinephrine and impairs sleep patterns in man. J Clin Endocrinol Metab. 1983;56:553–6.

    Article  CAS  PubMed  Google Scholar 

  30. • Lv Y, Jiang G, Tan X, Bao W, Chen L, Liu L. Association of sleep patterns and lifestyles with incident hypertension: evidence from a large population-based cohort study. Front Cardiovasc Med. 2022;9:847452. This research study used a large United Kingdom cohort sample (N=165,493) to track incident hypertension. A strength of this study is the size and diversity of its sample, increasing the generalizability of its results. Results indicated that individuals with poor sleep patterns are at higher risk for developing hypertension. This is one of many papers that highlights the association between sleep quality and blood pressure.

  31. Krizan Z, Hisler G, Boehm N. 0245 When do emotions impact sleep? A state of the evidence Sleep. 2022;45:A110–1.

    Google Scholar 

  32. Liu Y, Li H, Xu X, Li Y, Wang Z, Zhu H, et al. The relationship between insecure attachment to depression: mediating role of sleep and cognitive reappraisal. Neural Plast. 2020;2020:1–8.

    CAS  Google Scholar 

  33. Perez E, Sabet S, Soto P, Dzierzewski J. 0249 Sleeping in to avoid acting out: the association between sleep regularity and emotion regulation. Sleep. 2022;45:A112.

    Article  Google Scholar 

  34. Varma P, Burge M, Meaklim H, Junge M, Jackson ML. Poor sleep quality and its relationship with individual characteristics, personal experiences and mental health during the COVID-19 pandemic. Int J Environ Res Public Health. 2021;18:6030.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Harvey AG. A cognitive model of insomnia. Behav Res Ther. 2002;40:869–93.

    Article  CAS  PubMed  Google Scholar 

  36. Tutek J, Gunn HE, Lichstein KL. Worry and rumination have distinct associations with nighttime versus daytime sleep symptomology. Behav Sleep Med. 2021;19:192–207.

    Article  PubMed  Google Scholar 

  37. • Haliwa I, Lee J, Wilson J, Shook NJ. Mindfulness and engagement in COVID-19 preventive behavior. Prev Med Rep. 2020;20:101246. This study consisted of an online survey of American adults (N=353) at the beginning of the COVID-19 pandemic (April 2020). It included measures of both mindfulness and health behaviors, which were--and continue to be--especially key at that time. Mindfulness was found to be associated with social distancing even after controlling for demographics, health risk, and personality. This study is important because it highlights the individual factors that go into health behaviors (like behaviors that could prevent hypertension), and it identifies mindfulness as one of those individual factors.

  38. Szabó R, Börzsei D, Hoffmann A, Lesi ZN, Gesztelyi R, Juhász B, et al. Lifestyle-induced redox-sensitive alterations: cross-talk among the RAAS, antioxidant/inflammatory status, and hypertension. Lees S, editor. Oxid Med Cell Longev. 2021;2021:1–13.

  39. Valenzuela PL, Carrera-Bastos P, Gálvez BG, Ruiz-Hurtado G, Ordovas JM, Ruilope LM, et al. Lifestyle interventions for the prevention and treatment of hypertension. Nat Rev Cardiol. 2021;18:251–75.

    Article  CAS  PubMed  Google Scholar 

  40. Fountain JH, Kaur J, Lappin SL. Physiology, renin angiotensin system. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 [cited 2023 May 8]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK470410/.

Download references

Funding

None.

Author information

Authors and Affiliations

  1. Department of Psychology, University of Alabama at Birmingham, 1300 University Blvd Room 237G, Birmingham, AL, 35233, USA

    Daniel A. Kusko, Jason Blake & Rebecca Williams

Authors
  1. Daniel A. Kusko
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jason Blake
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rebecca Williams
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Daniel A. Kusko.

Ethics declarations

Conflict of Interest

The authors declare no competing interests.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kusko, D.A., Blake, J. & Williams, R. A Narrative Review of the Effects of Mindfulness on Sleep and Hypertension. Curr Hypertens Rep 26, 91–97 (2024). https://doi.org/10.1007/s11906-023-01279-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11906-023-01279-9

Keywords

Search

Navigation