A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia

Ong, Jason C.; Manber, Rachel; Segal, Zindel; Xia, Yinglin; Shapiro, Shauna; Wyatt, James K.

doi:10.5665/sleep.4010

Cited by 332Sleep and related disordersMindfulness and Compassion InterventionsObstructive Sleep Apnea Research

A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia

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Ong, Jason C., Manber, Rachel, Segal, Zindel, Xia, Yinglin, Shapiro, Shauna, Wyatt, James K.·2014·Sleep

DOI 10.5665/sleep.4010PMC PMC4153063

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Abstract

STUDY OBJECTIVES: To evaluate the efficacy of mindfulness meditation for the treatment of chronic insomnia. DESIGN: Three-arm, single-site, randomized controlled trial. SETTING: Academic medical center. PARTICIPANTS: Fifty-four adults with chronic insomnia. INTERVENTIONS: Participants were randomized to either mindfulness-based stress reduction (MBSR), mindfulness-based therapy for insomnia (MBTI), or an eight-week self-monitoring (SM) condition. MEASUREMENTS AND RESULTS: Patient-reported outcome measures were total wake time (TWT) from sleep diaries, the pre-sleep arousal scale (PSAS), measuring a prominent waking correlate of insomnia, and the Insomnia Severity Index (ISI) to determine remission and response as clinical endpoints. Objective sleep measures were derived from laboratory polysomnography and wrist actigraphy. Linear mixed models showed that those receiving a meditation-based intervention (MBSR or MBTI) had significantly greater reductions on TWT minutes (43.75 vs 1.09), PSAS (7.13 vs 0.16), and ISI (4.56 vs 0.06) from baseline-to-post compared to SM. Post hoc analyses revealed that each intervention was superior to SM on each of the patient-reported measures, but no significant differences were found when comparing MBSR to MBTI from baseline-to-post. From baseline to 6-month follow-up, MBTI had greater reductions in ISI scores than MBSR (P < 0.05), with the largest difference occurring at the 3-month follow-up. Remission and response rates in MBTI and MBSR were sustained from post-treatment through follow-up, with MBTI showing the highest rates of treatment remission (50%) and response (78.6%) at the 6-month follow-up. CONCLUSIONS: Mindfulness meditation appears to be a viable treatment option for adults with chronic insomnia and could provide an alternative to traditional treatments for insomnia. TRIAL REGISTRATION: Mindfulness-Based Approaches to Insomnia: clinicaltrials.gov, identifier: NCT00768781.

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Mindfulness-based interventions improve sleep quality and reduce the incidence of insomnia and sleep disorders.
“several studies showed that mindfulness-based interventions improve the quality of sleep (typical index of well-being) and reduce the incidence of insomnia and sleep disorders20–22.”
From Mindfulness-based online intervention increases well-being and decreases stress after Covid-19 lockdown (2022) · cites this paper as [21]
An awareness of sleepiness that is cultivated by mindfulness approaches can also be integrated into strategies to increase sleep efficiency by going to bed and staying in bed only during a state of sleepiness.
“An awareness of sleepiness that is cultivated by mindfulness approaches can also be integrated into strategies to increase sleep efficiency by going to bed and staying in bed only during a state of sleepiness [16].”
From Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial (2020) · cites this paper as [16]
Limited research suggests that MBIs can be effective in treating insomnia, although such interventions have not been tested in pregnancy.
“Limited research suggests that MBIs can be effective in treating insomnia [16] although such interventions have not been tested in pregnancy.”
From Online prenatal trial in mindfulness sleep management (OPTIMISM): Protocol for a pilot randomized controlled trial (2020) · cites this paper as [16]

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Changes in psychological inflexibility as a potential mediator of longitudinal links between college students’ sleep problems and depressive symptoms
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Biobehavioral utility of mindfulness-based art therapy: Neurobiological underpinnings and mental health impacts
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A randomized controlled trial to examine the feasibility and preliminary efficacy of a digital mindfulness-based therapy for improving insomnia symptoms
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Changes in dietary inflammatory potential predict changes in sleep quality metrics, but not sleep duration
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Heart rate variability during mindful breathing meditation
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How Modifiable Are Modifiable Dementia Risk Factors? A Framework for Considering the Modifiability of Dementia Risk Factors
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Mindfulness-based therapy improves brain functional network reconfiguration efficiency
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The mediating role of sleep-related metacognitive processes in trait and pre-sleep state hyperarousal in insomnia disorder
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Yoga Nidra: An innovative approach for management of chronic insomnia- A case report
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Reductions in perceived stress following Transcendental Meditation practice are associated with increased brain regional connectivity at rest
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Being kind to self is being kind to sleep? A structural equation modelling approach evaluating the direct and indirect associations of self-compassion with sleep quality, emotional distress and mental well-being
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Effects of Web-Based Group Mindfulness Training on Stress and Sleep Quality in Singapore During the COVID-19 Pandemic: Retrospective Equivalence Analysis (Preprint)
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A prospective, longitudinal study of sleep disturbance and comorbidity in opiate dependence (the ANRS Methaville study)
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Effects of mindfulness in patients with mild cognitive impairment with insomnia: A double-blind randomized controlled trial
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Treating subclinical and clinical symptoms of insomnia with a mindfulness-based smartphone application: a pilot study
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“The improvements in cognitive pre-sleep arousal are consistent with theoretical models of insomnia and previous intervention research (Ong et al., 2014; Ong et al., 2008; Ong et al., 2009).”
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0385 Heartfulness Meditation: an Effective Treatment Option For Chronic Insomnia
Yommer, D., Thimmapuram, J., & Tudor, L. (2018) · SLEEP · doi:10.1093/sleep/zsy061.384 · Cited by 1 · see citing works
Mindfulness Based Stress Reduction as a treatment for Chronic Insomnia in Traumatic Brain Injury Patients (P3.6-023)
Werner, J. K. (2019) · Neurology · doi:10.1212/wnl.92.15_supplement.p3.6-023

Authors: Ong, J. C., Manber, R., Segal, Z., Xia, Y., Shapiro, S., & Wyatt, J. K.
Affiliations: Rush University Medical Center (US)
Stanford Medicine (US)
University of Toronto (CA)
University of Rochester Medicine (US)
Santa Clara University (US)
ORCID: Ong, Jason C.
Manber, Rachel
Segal, Zindel
Xia, Yinglin
Wyatt, James K.
Venue: Sleep
Publisher: Oxford University Press (OUP)
Published: 2014-09-01
Volume: 37
Issue: 9
Pages: 1553-1563
ISSN: 0161-8105 (ISSN-L)
1550-9109
DOI: 10.5665/sleep.4010
PMC: PMC4153063
OpenAlex: W2049451047
Cited by: 332
References: 60
Citations by year: 2026: 19 · 2025: 33 · 2024: 19 · 2023: 26 · 2022: 43 · 2021: 28 · 2020: 35 · 2019: 26 · 2018: 25 · 2017: 28 · 2016: 25 · 2015: 22 · 2014: 2
FWCI: 35.71
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Locations: SLEEP (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
Funders: National Center for Complementary and Integrative Health (K23AT003678)
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, chronic insomnia, mindfulness-based stress reduction, self-monitoring, pre-sleep arousal, Insomnia Severity Index, treatment remission
MeSH terms: Adult, Arousal, Chronic Disease, Female, Humans, Sleep Initiation and Maintenance Disorders, Male, Middle Aged, Sleep, Stress, Psychological, Treatment Outcome, Meditation, Actigraphy, Self Report, Mindfulness

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A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia

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