Using Mindfulness for the Treatment of Insomnia
- 388 Downloads
Purpose of review
The goal of this review is to provide an update on the use of mindfulness meditation for the treatment of insomnia, including conceptual models and empirical evidence from randomized controlled trials.
A metacognitive model of insomnia has been proposed as a conceptual model to explain the application of mindfulness principles for reducing insomnia-related arousal. Furthermore, the evidence base for mindfulness-based therapies has grown with the results of several randomized controlled trials published in the past 3 years. Treatment effects appear to be strongest on self-report measures compared to objective measures of sleep.
Treatment programs featuring mindfulness meditation appear to be viable treatment options for people with insomnia. Further research is needed to determine who is likely to benefit from mindfulness-based therapies and how these interventions work. Additionally, further work is needed to resolve issues related to the delivery and implementation of mindfulness-based therapies.
KeywordsInsomnia Mindfulness Meditation Complementary and alternative medicine Metacognitions Cognitive therapy
Compliance with Ethical Standards
Conflict of Interest
Jason C. Ong receives royalties for a book published by the American Psychological Association. Christine E. Smith declares no conflict of interest.
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.
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
- 11.Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD. Clinical Guidelines Committee of the American College of P. Management of Chronic Insomnia Disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–33.CrossRefPubMedGoogle Scholar
- 18.Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness New York: Delacorte Press; 1990.Google Scholar
- 19.•• Ong JC, Manber R, Segal Z, Xia Y, Shapiro S, Wyatt JK. A Randomized controlled trial of mindfulness meditation for chronic insomnia. SLEEP. 2014. This three-arm RCT compared a mindfulness-based therapy developed specifically for insomnia (MBTI) to MBSR and an eight-week self-monitoring condition. Study results showed that MBTI had the highest rates of treatment remission and response at 6-month follow up, providing evidence for this treatment as a viable treatment option for adults with chronic insomnia. Google Scholar
- 28.Segal ZV, Williams JMG, Teasdale JD. Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse. New York: The Guilford Press; 2002.Google Scholar
- 35.•• Garland SN, Carlson LE, Stephens AJ, Antle MC, Samuels C, Campbell TS. Mindfulness-based stress reduction compared with cognitive behavioral therapy for the treatment of insomnia comorbid with cancer: a randomized, partially blinded, noninferiority trial. J Clin Oncol. 2014;32(5):449–57. This is a randomized controlled trial of MBSR versus CBT for insomnia showed that although both treatments resulted in clinically significant change in sleep and psychological outcomes, CBTI was associated with more rapid and durable improvements. The results of this study suggest that although mindfulness-based therapies like MBSR may be effective treatment options for insomnia, CBTI continues to be considered the preferred treatment for this sleep disorder. CrossRefPubMedGoogle Scholar
- 36.•• Black DS, O’Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med. 2015;175(4):494–501. This study compared a standardized mindfulness awareness practices (MAPs) intervention with sleep hygiene education in older adults and found that MAPs produced significant improvement in symptoms of insomnia, depression, and fatigue compared to sleep hygiene. This study showed that this mindfulness-based intervention was associated with improvements in daytime impairments as well as nighttime sleep, posing implications for quality of life. CrossRefPubMedPubMedCentralGoogle Scholar
- 37.• Zhang JX, Liu XH, Xie XH, Zhao D, Shan MS, Zhang XL, et al. Mindfulness-based stress reduction for chronic insomnia in adults older than 75 years: a randomized, controlled, single-blind clinical trial. Explore (NY). 2015;11(3):180–5. This is randomized controlled trial of MBSR in older adults with results showing that MBSR was superior to a wait-list control on the PSQI. CrossRefGoogle Scholar
- 38.Cullen M. Mindfulness-based interventions: An emerging phenomenon. 2011;2(3):186–193.Google Scholar