Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults with Sleep Disturbances

Mi Jin Kim, Mercer University College of Pharmacy 2015

The National Sleep Foundation reports that older adults may experience sleep problems, which affect their quality of life. About two thirds of the elderly experience some form of sleep problem.1 Sleep Hygiene Education (SHE), a cognitive behavioral intervention, aims for the modification of behavioral and environmental factors.2 It can be used as a successful treatment for insomnia, but it is suggested to require highly trained therapists. Mindfulness medication sleep, known as Mindful Awareness Practices (MAP), can be a useful technique for improving sleep.3 A recently published study compared MAP with SHE in improvement in sleep quality among older adults with sleep disturbances.4

Title: Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances
Design Randomized, parallel groups, single site study; 49 patients
Objective

(Primary)

Determine the efficacy of a mindfulness meditation intervention to promote sleep quality in older adults with moderate sleep disturbances
Study Groups A mindful awareness practice (MAP) group vs. a sleep hygiene education (SHE) group
Methods Participants randomly received a MAP intervention (n= 24) or a SHE intervention (n= 25). Both groups received a 6-week intervention with assigned homework.
Duration From January 1 to December 2012
Primary outcome measure Difference between the groups in moderate sleep disturbance measured via the Pittsburgh Sleep Quality Index (PSQI) at post-intervention
Baseline Characteristics MAP group: age 66.5, female 67%, white 88%, BMI 25

SHE group: age 66.1, female 68%, white 80%, BMI 25

Results The mean difference between groups was 1.8 (95% confidence interval [CI] 0.6-2.9; p < 0.05), with an effect size of 0.89.
Adverse Events Common Adverse Effects: Not reported
Serious Adverse Events: Not reported
Percentage that Discontinued due to Adverse Events: Not reported
Study Author Conclusions The use of a community-accessible MAP intervention resulted in improvements in sleep quality at immediate post-intervention, which was superior to a highly structured SHE intervention.

This study investigated the effect of MAP on sleep disturbances among older adults. The results of this study showed that MAP led to better outcomes and improvement in sleep quality compared to SHE program. Mindfulness meditations, the core work of MAP, led to positive effects on not only sleep quality but also on daytime fatigue and depression, two conditions often caused by poor sleep. This study was meaningful since it was the first randomized clinical trial to examine the effect of MAP solely in elderly patients. This population was considered among the highest prevalence of sleep problems. However, the population size in this trial was small and further research is needed to confirm this finding with larger population sizes.

References

1. National Sleep Foundation. 2003 sleep and aging. http://sleepfoundation.org/sites/default/files/2003SleepPollExecSumm.pdf.Accessed April 7, 2015

2. Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA, Lichstein KL. Psychological and behavioral treatment of insomnia: update of the recent evidence (1998-2004). Sleep. 2006;29(11):1398-414.

3. Cine J. Mindful sleep. Psychology today. 2014. https://www.psychologytoday.com/blog/sleepless-in-america/201401/mindful-sleep. Accessed April 13, 2015.

4. 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.

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