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Cited by 491Sleep and related disordersMindfulness and Compassion InterventionsObstructive Sleep Apnea Research

Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances: A Randomized Clinical Trial

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Black, David S., O’Reilly, Gillian A., Olmstead, Richard, Breen, Elizabeth C., Irwin, Michael R.·2015·JAMA Internal Medicine
DOI 10.1001/jamainternmed.2014.8081PMC PMC4407465
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Abstract

IMPORTANCE: Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. OBJECTIVE: To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. DESIGN, SETTING, AND PARTICIPANTS: Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). INTERVENTIONS: A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. MAIN OUTCOMES AND MEASURES: The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB. RESULTS: Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05). CONCLUSIONS AND RELEVANCE: The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate 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. TRIAL REGISTRATION: clinicaltrials.gov Identifier: NCT01534338.

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Crossref · 10.1001/jamainternmed.2014.8081

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63 of 63 references verified0 citation errors · 0 not checkable

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  • The full cohort had mild baseline depression and anxiety symptoms and mild to moderate PTSD symptoms, which did not differ by group assignment.

    “The full cohort demonstrated mild baseline symptoms of depression and anxiety, as well as mild to moderate PTSD symptoms that did not differ by group assignment (Table 3; see also Online Supplement eTables 5 and 6).31”

    From Effects of mindfulness training programmes delivered by a self-directed mobile app and by telephone compared with an education programme for survivors of critical illness: A pilot randomised clinical trial (2019) · cites this paper as [31]

    The Results, “Participant Flow and Characteristics” (page unavailable), reports nonclinical baseline depression and anxiety scores and says baseline variables did not differ between treatment groups. It does not report PTSD symptoms or establish their severity or similarity across groups. (LLM, conf=0.88)

    Experimental — accuracy not yet measured

  • Most included studies focused on adult participants, with only two studies focusing on young people under 18 years old and three studies specifically focused on older adults (>65).

    “Most studies included adult participants, with only two studies focusing on young people under 18 years old (Blake et al., 2016; de Bruin et al., 2018) and three studies specifically focused on interventions with older adults (&gt;65) (Black et al., 2015; McCrae et al., 2018; Rybarczyk et al., 2005).”

    From Do non-pharmacological sleep interventions affect anxiety symptoms? A meta-analysis (2022) · cites this paper as Black et al., 2015

    The Methods (Setting and Participants; page unavailable) confirm that Black et al. studied an intervention for older adults with sleep disturbances. But eligibility began at age 55, not over 65; the Abstract reports a mean age of 66.3. This source therefore supports its identification as an older-adult intervention study, but not the stated >65 age cutoff. (LLM, conf=0.87)

    Experimental — accuracy not yet measured

  • Cognitive Behavioral Therapy for Insomnia (CBT-I) and mindfulness intervention approaches hold some promise.

    “Cognitive Behavioral Therapy for Insomnia (CBT-I) and mindfulness intervention approaches hold some promise (33–35).”

    From Nightly sleep duration predicts grade point average in the first year of college (2023) · cites this paper as [35]

  • Mindful awareness practices improve sleep quality in older adults with an effect size comparable to CBT-I.

    “we have evaluated the treatment efficacy of a mindful awareness practices (MAPs), on insomnia complaints, and found that MAPs can improve sleep quality in older adults with an ES comparable to CBT-I (Black et al, 2015)”

    From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Black et al, 2015

  • Mind-body interventions that do not include physical activity, such as mindfulness meditation, improve sleep.

    “Even mind-body interventions that do not incorporate components of physical activity, such as mindfulness meditation, have been found to improve sleep.”

    From Sleep health: Reciprocal regulation of sleep and innate immunity (2017) · cites this paper as Black et al, 2015

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Research works printed but not linked: 1

  1. [38]Smalley SL Winston D Fully Present: The Science, Art, Practice of Mindfulness 2010 Boston, MA Da Capo Press

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Authors
Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R.
Affiliations
  • University of Southern California (US)
  • University of California, Los Angeles (US)
Corresponding author
Black, David S.
ORCID
Venue
JAMA Internal Medicine
Publisher
American Medical Association (AMA)
Published
2015-04-01
Volume
175
Issue
4
Pages
494
ISSN
2168-6106 (ISSN-L)
DOI
10.1001/jamainternmed.2014.8081
PMC
PMC4407465
OpenAlex
W2106309035
Cited by
491
References
63
Citations by year
2026: 27 · 2025: 60 · 2024: 39 · 2023: 35 · 2022: 72 · 2021: 54 · 2020: 40 · 2019: 47 · 2018: 42 · 2017: 29 · 2016: 32 · 2015: 14
FWCI
58.93
Type
journal article
Language
en
Open access
Locations
  • JAMA Internal Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • National Institutes of Health (1ul1rr033176-01, UL1TR000124)
  • National Institute on Aging (R01AG026364, R01AG034588, P30AG028748)
  • National Heart, Lung, and Blood Institute (R01HL095799)
  • National Institute of Mental Health (5T32-MH019925, T32MH019925)
  • National Institute on Drug Abuse (R01DA032922)
  • National Cancer Institute (R01CA160245, R01CA119159)
  • National Center for Research Resources (UL1-RR-033176, 1UL1RR033176)
  • National Center for Advancing Translational Sciences
  • National Center for Complementary and Integrative Health (L30 AT008380)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
Keywords
mindfulness meditation, sleep disorders, older adults, sleep quality, daytime dysfunction, insomnia, sleep hygiene education, mind-body medicine, depression, fatigue, NF-κB, inflammation, community-based intervention, Pittsburgh Sleep Quality Index, stress and anxiety, aging and sleep, neurodegeneration risk, dementia risk, Alzheimer's disease risk, Parkinson's disease risk
MeSH terms
Aged, Aged, 80 and over, Fatigue, Female, Humans, Inflammation, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Quality of Life, Surveys and Questionnaires, Severity of Illness Index, Sleep, Los Angeles, Biomarkers, Treatment Outcome, Meditation, NF-kappa B p50 Subunit, Mindfulness

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