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Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances: A Randomized Clinical Trial
Open accessAbstract
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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“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]
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“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 (>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
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“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]
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“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
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“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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Metadata
- 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.
- Venue
- JAMA Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2015-04-01
- Volume
- 175
- Issue
- 4
- Pages
- 494
- ISSN
- 2168-6106 (ISSN-L)
- 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
- green
- www.ncbi.nlm.nih.gov
- 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 (medical) › 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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