Mindfulness meditation practices resulted in improved sleep quality for older adults with moderate sleep disturbance in a clinical trial comparing meditation to a more structured program focusing on changing poor sleep habits and establishing a bedtime routine, according to an article published online by JAMA Internal Medicine.
Sleep disturbances are a medical and public health concern for our nation's aging population. An estimated 50 percent of individuals 55 years and older have some sort of sleep problem. Moderate sleep disturbances in older adults are associated with higher levels of fatigue, disturbed mood, such as depressive symptoms, and a reduced quality of life, according to the study background.
David S. Black, Ph.D., M.P.H., of the University of Southern California, Los Angeles, and coauthors conducted the small clinical trial in Los Angeles in 2012 and their analysis included 49 individuals (average age 66). The trial included 24 individuals who took part in a standardized mindful awareness practices (MAPs) intervention and 25 individuals who participated in a sleep hygiene education (SHE) intervention. Differences between the groups were measured using the Pittsburgh Sleep Quality Index (PSQI), a widely used self-reported questionnaire of sleep disturbances.
Participants in the MAPs group showed improvement relative to those in the SHE group. The MAPs group had average PSQI scores of 10.2 at baseline and 7.4 after the intervention. The SHE group had average PSQIs of 10.2 at baseline and 9.1 after the intervention, study results show. The MAPs group also showed improvement relative to the SHE group on secondary measures of insomnia symptoms, depression symptoms, fatigue interference and fatigue severity. However, differences between the groups were not seen for anxiety, stress or inflammatory signaling, a measure of which declined in both groups over time.
"According to our findings, mindfulness meditation appears to have a role in addressing the prevalent burden of sleep problems among older adults by remediating their moderate sleep disturbances and deficits in daytime functioning, with short-term effect sizes commensurate with the status quo of clinical treatment approaches for sleep problems. ... Given that standardized mindfulness programs are readily delivered in many communities, dissemination efforts do not serve as a barrier in this instance. ... Pending future replication of these findings, structured mindfulness mediation training appears to have at least some clinical usefulness to remediate moderate sleep problems and sleep-related daytime impairment in older adults," the study concludes.
Commentary: Being Mindful of Later-Life Sleep Quality
In a related commentary, Adam P. Spira, Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, writes: "As the authors explain, effective nonpharmacological interventions that are both 'scalable' and 'community accessible' are needed to improve disturbed sleep and prevent clinical levels of insomnia. This is imperative given links between insomnia and poor health outcomes, risks of sleep medication use and the limited availability of health care professionals trained in effective nondrug treatments such as behavior therapy and cognitive behavioral therapy for insomnia. This context makes the positive results of this RCT [randomized clinical trial] compelling."
"This excellent study raises some questions that need to be answered in future research," Spira continues.
"In summary, Black et al are to be applauded for their intriguing study. Other community-based nonpharmacological interventions are needed that improve sleep and perhaps prevent insomnia among older adults. Such interventions may have a key role in safely reducing the morbidity associated with disturbed sleep in later life," Spira concludes.
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