Sleep disturbance is a huge problem. A recent study published in JAMA Internal Medicine in 2015 by David Black and colleagues from University of Southern California examined the effect of mindfulness meditation on sleep quality in adults with moderate sleep disturbance. People who attended a mindfulness program had greater improvement in their sleep than those who attended a sleep hygiene program.
About 50% of adults aged 55 years or older have some form of sleep disturbance, including falling asleep and staying asleep. This then leads to adverse effects in daytime functioning and on mental health. Current treatment options are far from satisfactory. Pharmacotherapy using sleep medications provide temporary benefit with potential side effects and dependence. Non-medication treatments such as sleep hygiene education are helpful as people go onto modify their behaviour e.g. not consuming caffeine containing drinks at night.
The authors decided to test Mindfulness practice as an intervention, since there is some report that of mindfulness being helpful for sleep problems. People aged 55 and over were recruited by adverts and screened to see if they met the study entry criteria. Then they were allocated to one of two groups by randomization, ensuring that each study participant has an equal chance of being allocated to the mindfulness intervention group or the control sleep hygiene program group.
The mindfulness intervention consisted of 2 hour weekly sessions for 6 weeks. Mindfulness practice home work began with 5 minutes daily and progressed to 20 minutes daily by the final session. The sleep hygiene group was also 2 hours, weekly for 6 sessions.
49 people were randomized with 24 in the mindfulness group and 25 in the sleep hygiene group. The main outcome measure was the Pittsburgh Sleep Quality Index, which is a self-rated measure of sleep quality. The mindfulness group improved their score by 2.8, the sleep hygiene group by 1.1. Thus there was greater improvement in the mindfulness group, this was statistically significant. The authors reported that the mindfulness group showed significant improvement relative to the sleep hygiene group also on the secondary outcome measures of depression and fatigue scores. The authors concluded that mindfulness interventions have clinical importance by remediating 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. The study does involve small numbers of participants, however such studies are difficult to conduct due to conduct due to difficulties in obtaining funding. The authors have conducted a well-designed study using the gold standard of a randomized controlled study.