Mindfulness therapy more effective in improving sleep quality

Researchers from the Centre for Sleep and Cognition at the Yong Loo Lin School of Medicine found mindfulness-based therapy to be more effective than an active sleep hygiene program in improving sleep quality, according to a new study published in the journal Psychological Medicine.

For the study, researchers looked towards mindfulness-based treatment. Mindfulness is the awareness of moment-to-moment thoughts, feelings, and bodily sensations, and the practice of accepting these experiences without judging or reacting to them. Backed by scientific evidence, practicing mindfulness is becoming increasingly popular to reduce stress, treat mental health problems, and improve general wellbeing.

The randomized controlled study compared a Mindfulness-Based Therapy for Insomnia (MBTI) with an active Sleep Hygiene, Education, and Exercise Programme (SHEEP) to see if the former could improve sleep outcomes in older adults with sleep complaints. A total of 127 participants, aged 50-80, were randomized and allocated between the two programs, 65 received MBTI while 62 went through SHEEP. Both interventions consisted of eight weekly sessions which were of two hours duration each.

The MBTI course included formal mindfulness exercises such as mindful eating, sitting meditation, mindful movement, and body scans. This was followed by a group discussion of their experiences during the past week, as well as the application of practices and principles of mindfulness which directly addressed their sleep difficulties. In addition, participants were taught good sleep habits and behavioral strategies that they could use to improve their sleep.

On the other hand, the SHEEP course provided participants with information about sleep biology, self-monitoring of sleep behavior and taught changes to make in their habits and environment that could improve sleep quality. Participants also learned and practiced sleep-promoting exercises such as diaphragmatic breathing, morning and evening stretching movements, and progressive muscle relaxation.

Although sleep quality improved across the board, the study found MBTI to be more effective in reducing insomnia symptoms than SHEEP. Additionally, MBTI led to observable improvements when sleep was measured objectively using wrist-worn activity monitors, and by recording electrical brain activity while participants slept at home. These objective measurements showed that MBTI participants took less time to fall asleep, and spent less time awake during the night, while this was not seen among SHEEP participants.

Sleep problems are common in the general population with up to half of Singaporean adults reporting insufficient or unsatisfying sleep. Sleep quality tends to worsen with age and poor sleep is a modifiable risk factor for multiple disorders, including cardiovascular disease and cognitive impairment.

Currently, insomnia is treated with either medication or psychological interventions. However, even frontline treatments such as cognitive-behavioral therapy have limitations, the researchers said, with up to 40 percent of patients do not get relief from their insomnia symptoms after undergoing this treatment. Furthermore, the waiting time to receive such treatment is often long as it is typically delivered as individual therapy and there are limited available local providers.