Mindfulness-Based Stress Reduction Versus Pharmacotherapy for Chronic Primary Insomnia: A Randomized Controlled Clinical Trial
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Objective The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia.Design A randomized controlled trial was conducted.Setting The study was conducted at a university health center.Patients Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT).Interventions Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions.Main outcomes The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only).Results Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.
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MBSR is efficacious for improving stress, anxiety, depression, quality of life, physical functioning, chronic pain, sleep disturbance, and other health problems in a variety of populations.
“Results of several meta-analyses and systematic reviews of randomized controlled trials (RCTs) support the efficacy of MBSR for improving stress, anxiety, depression, quality of life, physical functioning, chronic pain, sleep disturbance, and other health problems in a variety of populations.16–21”
From Feasibility and Acceptability of a Community-Based Modified Mindfulness-Based Stress Reduction Program for the Under- and Unemployed (2020) · cites this paper as [18]
The Results (Standardized Sleep Scales and Quality of Life Measures; page unavailable) report significant improvements in sleep measures and reduced insomnia-related activity impairment after MBSR. This paper is a clinical trial, not a meta-analysis or systematic review. Its anxiety and depression changes were not statistically significant, and its findings do not establish efficacy for chronic pain, stress, or the full range of health problems across varied populations. (LLM, conf=0.88)
Experimental — accuracy not yet measuredA growing body of evidence supports the benefits of mindfulness as an effective treatment to improve mood and decrease symptoms of sleep disturbance and fatigue in cancer patients.
“A growing body of evidence supports the benefits of mindfulness as an effective treatment to improve mood and decrease symptoms of sleep disturbance and fatigue in cancer patients.12-19”
From Implementation Readiness and Initial Effects of a Brief Mindfulness Audio Intervention Compared With a Brief Music Control During Daily Radiation Therapy for Prostate Cancer: A Randomized Pilot Study. (2024) · cites this paper as [14]
The Introduction (‘MBSR and Sleep’; page not provided) reports significantly improved sleep-quality scores among patients with cancer after MBSR. The References list a study of sleep, mood, and fatigue in cancer outpatients, but this paper’s text does not report whether mood or fatigue improved in those patients. Its Discussion describes mood improvements in other populations, not specifically cancer patients. (LLM, conf=0.86)
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- Authors
- Gross, C. R., Kreitzer, M. J., Reilly-Spong, M., Wall, M., Winbush, N. Y., Patterson, R., Mahowald, M., & Cramer-Bornemann, M.
- Affiliations
- University of Minnesota (US)
- Hennepin County Medical Center (US)
- Corresponding author
- Gross, Cynthia R.
- Venue
- EXPLORE
- Publisher
- Elsevier BV
- Published
- 2011-03
- Volume
- 7
- Issue
- 2
- Pages
- 76-87
- ISSN
- 1550-8307 (ISSN-L)
- PMC
- PMC3077056
- OpenAlex
- W2140942529
- Cited by
- 249
- References
- 63
- Citations by year
- 2026: 2 · 2025: 5 · 2024: 12 · 2023: 18 · 2022: 18 · 2021: 21 · 2020: 20 · 2019: 12 · 2018: 19 · 2017: 18 · 2016: 17 · 2015: 29 · 2014: 23 · 2013: 17 · 2012: 16
- FWCI
- 23.68
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- EXPLORE (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Academic Health Center, University of Minnesota
- National Institutes of Health, National Center for Research Resources (M01 RR00400)
- 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-based stress reduction, chronic primary insomnia, eszopiclone, pharmacotherapy, mindfulness meditation, sleep latency, sleep efficiency, total sleep time, sleep quality, actigraphy, sleep hygiene
- MeSH terms
- Eszopiclone, Adult, Aged, Female, Humans, Hypnotics and Sedatives, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Patient Compliance, Piperazines, Sleep, Stress, Psychological, Treatment Outcome, Meditation, Azabicyclo Compounds, Young Adult, Actigraphy
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