A randomized controlled trial to examine the feasibility and preliminary efficacy of a digital mindfulness-based therapy for improving insomnia symptoms
Open accessAbstract
Objectives Insomnia has widespread negative implications for health and well-being. Online delivery of mindfulness-based therapy for insomnia (MBTI) has not previously been evaluated. This study investigated the feasibility and preliminary efficacy of a digital MBTI program for improving insomnia symptoms. It was hypothesized that a 6-week digital MBTI program would reduce insomnia symptoms and pre-sleep arousal and improve mood, compared to a waitlist control condition.Methods Twenty-seven participants (M = 29.44, SD = 11.97 years) experiencing insomnia symptoms (insomnia severity index [ISI] ≥ 8) were randomized to either a 6-week intervention or waitlist condition. Participants completed the ISI, pre-sleep arousal scale (PSAS), and the positive and negative affect schedule at baseline, mid-, and post-study. Feasibility was assessed across four domains (acceptability, implementation, practicality, and preliminary efficacy) using self-reports, attrition, program completions, and module completions.Results Feasibility data for the intervention indicated that there was 22% attrition, and 79% of the modules were completed. There were significantly greater reductions in the severity of insomnia symptoms (p < .001) and both cognitive (p = .03) and somatic (p = .02) subscales of the PSAS, at post-intervention compared to the waitlist group. There were no significant group differences in mood.Conclusions This study provides preliminary evidence of the feasibility and efficacy of a digital MBTI, which may assist in the broader dissemination of insomnia treatment.Trial RegistrationAustralian and New Zealand Clinical Trials Registry: ACTRN12620000398909.
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Sleep effort and cognitive arousal are modifiable perpetuating factors that can be influenced by cognitive behavioral therapy and mindfulness-based therapy for insomnia treatments.
“Additionally, sleep effort and cognitive arousal are modifiable perpetuating factors that can be influenced by cognitive behavioral therapy and mindfulness-based therapy for insomnia treatments [56–60].”
From Insomnia is more likely to persist than remit after a time of stress and uncertainty: a longitudinal cohort study examining trajectories and predictors of insomnia symptoms (2024) · cites this paper as [58]
The Discussion (page unavailable) describes arousal as a mechanism maintaining insomnia and reports that digital mindfulness-based therapy reduced cognitive pre-sleep arousal. The paper also describes how cognitive behavioral therapy and mindfulness-based therapy address sleep-related thoughts. It does not establish that sleep effort is a modifiable perpetuating factor or that either treatment changes sleep effort. (LLM, conf=0.86)
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- Authors
- Kennett, L., Bei, B., & Jackson, M. L.
- Affiliations
- Monash University (AU)
- Corresponding author
- Jackson, Melinda L.
- Venue
- Mindfulness
- Published
- 2021-08-06
- Volume
- 12
- Issue
- 10
- Pages
- 2460-2472
- ISSN
- 1868-8527 (ISSN-L)
- 1868-8535
- PMC
- PMC8342656
- OpenAlex
- W3190088143
- Cited by
- 42
- References
- 47
- Citations by year
- 2026: 7 · 2025: 11 · 2024: 8 · 2023: 8 · 2022: 8
- FWCI
- 5.80
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Mindfulness (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and related disorders
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- insomnia, mindfulness-based interventions, digital interventions, online therapy, pre-sleep arousal, mood, feasibility, preliminary efficacy, insomnia severity, acceptability
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