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Victorson D, Mishra KK, Sauer J, Langford G, Maletich C, Horowitz B, Sauer C, Sejpal SV, Kalapurakal J. 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. GLOBAL ADVANCES IN INTEGRATIVE MEDICINE AND HEALTH 2024; 13:27536130241249140. [PMID: 38694593 PMCID: PMC11062214 DOI: 10.1177/27536130241249140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 05/04/2024]
Abstract
Background The most common and debilitating side effects of radiation therapy (RT) for prostate cancer (PC) are fatigue, sleep disturbance, anxiety, and depression. Previous research has reported palliative benefits from certain self-management approaches, such as mindfulness meditation. Objective To develop, pre-test, and evaluate the feasibility, acceptability and initial benefit of brief, audio-based mindfulness delivered during daily RT for PC compared to a relaxing music control. Methods Following intervention development, participants were randomized to either brief guided mindfulness audio recordings or a relaxing music control during daily RT. A pre-testing phase was first conducted to determine optimal program start time, length, and content most associated with retention. A final program (n = 26) was delivered daily, starting on day one of week 2 of RT and lasting 4 consecutive weeks. Feasibility was defined as ≥70% on enrollment rate, retention, and audio program adherence. Acceptability was measured with a 12-item post-study survey. A secondary focus compared between group changes on patient reported outcomes of fatigue, anxiety, depression, sleep disturbance, and related outcomes at baseline and follow up assessments. Descriptive statistics and general linear models were used. Results Overall, 76% (n = 38) of approached men enrolled. Pre-testing retention rates were <70% while the final program's retention rate was 89%. The majority of acceptability criteria were met in both conditions, with relatively higher ratings in the mindfulness arm. Compared to music controls, mindfulness participants demonstrated significantly less uncertainty intolerance at 4-weeks (P = .046, d = .95); and significantly lower fatigue scores (P = .049, d = 1.3) and lower sleep disturbance scores (P = .035, d = 1.1) at the 3 months follow up. Conclusion The final intervention met feasibility and acceptability criteria. Pre-testing refinements played a key role for optimal program delivery and retention. Audio-based mindfulness delivered during RT for PC hold potential to help decrease RT-related physical and emotional side effects.
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Affiliation(s)
- David Victorson
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Joseph Sauer
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- University of Illinois-Chicago Medical School, Chicago, IL, USA
| | - Grace Langford
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Carly Maletich
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Bruriah Horowitz
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Christina Sauer
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - John Kalapurakal
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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González-Martín AM, Aibar-Almazán A, Rivas-Campo Y, Marín-Gutiérrez A, Castellote-Caballero Y. Effects of mindfulness-based cognitive therapy on older adults with sleep disorders: a systematic review and meta-analysis. Front Public Health 2023; 11:1242868. [PMID: 38179560 PMCID: PMC10765593 DOI: 10.3389/fpubh.2023.1242868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Objective This systematic review and meta-analysis was conducted to analyze the effectiveness of a mindfulness-based program on sleep quality in healthy non-institutionalized older people. Methods This study was conducted following the PRISMA (Preferred Reporting Items For Systematic Reviews And Meta-Analyses) guidelines. The search was conducted during May and June 2023 using four databases: Pubmed, Scopus, Web of Science, and CINAHL. Different keywords combined with Boolean operators were used. Only 10 articles of the initial 177 were included. In the study, the standardized mean difference (SMD) was used along with a 95% confidence interval to measure the effect. Heterogeneity among the studies, assessed using Cochran's Q-test and the I2 statistic was found to be low, leading to the use of a fixed-effects model in the analysis. The effect size was expressed as Hedge'g. Furthermore, a subgroup analysis was conducted, taking into account the various tools used to assess sleep conditions. Results Mindfulness was found to reduce poor sleep quality in people with both long-term and short-term sleep disorders. Weighting effect model Hedge'g = -0.344 with a 95% confidence interval ranging from -0.425 to -0.263. In all cases, statistically significant results were observed, as well as moderate and negative effect sizes according to the Hedge's g index: -0.326 for Insomnia Severity Index (ISI), -0.343 for Pittsburgh Sleep Quality Index (PSQI), and -0.28 for Sleep Onset Latency (SOL). Conclusion This systematic review and meta-analysis found that mindfulness can be used to remedy poor sleep quality in older people, so it could be a viable treatment option for insomnia or other problems related to poor sleep quality in this population.
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Affiliation(s)
- Ana María González-Martín
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain
- Department of Psychology, Centro de Educación Superior de Enseñanza e Investigación Educativa, Madrid, Spain
| | - Agustín Aibar-Almazán
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, Jaén, Spain
| | - Yulieth Rivas-Campo
- Faculty of Human and Social Sciences, University of San Buenaventura-Cali, Santiago de Cali, Colombia
| | - Alejandro Marín-Gutiérrez
- Department of Education and Psychology, Faculty of Social Sciences, University of Atlántico Medio, Las Palmas de Gran Canaria, Spain
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Gallo GG, Curado DF, Machado MPA, Espíndola MI, Scattone VV, Noto AR. A randomized controlled trial of mindfulness: effects on university students' mental health. Int J Ment Health Syst 2023; 17:32. [PMID: 37833796 PMCID: PMC10571349 DOI: 10.1186/s13033-023-00604-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND The development of mental health disorders is common in the university population, and mindfulness-based interventions (MBIs) seem to be effective in addressing them in different contexts. Thus, this study investigated the impact of an 8-week MBI adapted to university students from the Mindfulness-Based Relapse Prevention (MBSR) on different symptoms related to mental health problems, specifically symptoms of anxiety, depression, stress and insomnia. METHODS University students (n = 136) were randomized into MBI group (n = 71) or wait-list group (n = 65). All participants completed self-administered questionnaires before and after the intervention, and the experimental group answered questionnaires weekly during intervention. Generalized mixed models were used to assess the effects of the intervention. RESULTS There were improvements in the symptoms of stress (B = 5.76, p < 0.001), depression (B = 1.55, p < 0.01) and insomnia (B = 1.35, p = 0.020) from the beginning of the intervention to the final assessment when it was compared to the control group. No effect was found in respect of trait anxiety. The MBI was found to be effective in reducing important symptoms related to university students' mental health, possibly grounding further research on the intervention's potential of preventing the development of mental disorders. TRIAL REGISTRATION The research was registered in the Brazilian Registry of Clinical Trials (ReBEC) - number RBR-63qsqx, approved at 09/16/2019.
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Affiliation(s)
- Giovana Gonçalves Gallo
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil.
| | - Daniela Fernandez Curado
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Mayra Pires Alves Machado
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Marília Ignácio Espíndola
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Vitor Villar Scattone
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
| | - Ana Regina Noto
- Departamento de Psicobiologia, NEPSIS - Núcleo de Pesquisa em Saúde de Uso de Substâncias - MBRP Brasil - Centro Brasileiro de Pesquisa e Formação em Prevenção de Recaídas Baseada em Mindfulness (MBRP), Universidade Federal de São Paulo, São Paulo, 04023-062, SP, Brazil
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Drager LF, Assis M, Bacelar AFR, Poyares DLR, Conway SG, Pires GN, de Azevedo AP, Carissimi A, Eckeli AL, Pentagna Á, Almeida CMO, Franco CMR, Sobreira EST, Stelzer FG, Mendes GM, Minhoto GR, Linares IMP, Sousa KMM, Gitaí LLG, Sukys-Claudino L, Sobreira-Neto MA, Zanini MA, Margis R, Martinez SCG. 2023 Guidelines on the Diagnosis and Treatment of Insomnia in Adults - Brazilian Sleep Association. Sleep Sci 2023; 16:507-549. [PMID: 38370879 PMCID: PMC10869237 DOI: 10.1055/s-0043-1776281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/20/2024] Open
Abstract
Chronic insomnia disorder (simplified in this document as insomnia) is an increasingly common clinical condition in society and a frequent complaint at the offices of different areas of health practice (particularly Medicine and Psychology). This scenario has been accompanied by a significant evolution in treatment, as well as challenges in approaching patients in an appropriately way. This clinical guideline, coordinated by the Brazilian Sleep Association and the Brazilian Association of Sleep Medicine and counting on the active participation of various specialists in the area, encompasses an update on the diagnosis and treatment of insomnia in adults. To this end, it followed a structured methodology. Topics of interest related to diagnosis were written based on theoretical framework, evidence in the literature, and professional experience. As for the topics related to the treatment of insomnia, a series of questions were developed based on the PICO acronym (P - Patient, problem, or population; I - Intervention; C - Comparison, control, or comparator; O - Outcome). The work groups defined the eligible options within each of these parameters. Regarding pharmacological interventions, only the ones currently available in Brazil or possibly becoming available in the upcoming years were considered eligible. Systematic reviews were conducted to help prepare the texts and define the level of evidence for each intervention. The final result is an objective and practical document providing recommendations with the best scientific support available to professionals involved in the management of insomnia.
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Affiliation(s)
- Luciano Ferreira Drager
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Unidades de HipertenSão, Instituto do Coração (InCor) e Disciplina de Nefrologia, Universidade de São Paulo, São Paulo, SP, Brazil.
| | - Márcia Assis
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Clínica do Sono de Curitiba, Hospital São Lucas, Curitiba, Brazil.
| | - Andrea Frota Rego Bacelar
- Associação Brasileira do Sono, São Paulo, SP, Brazil.
- Clínica Bacelar - Neuro e Sono, Rio de Janeiro, RJ, Brazil.
| | - Dalva Lucia Rollemberg Poyares
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- Instituto do Sono, São Paulo, SP, Brazil.
| | - Silvia Gonçalves Conway
- Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
- Departamento de Otoneurologia, Universidade de São Paulo, São Paulo, SP, Brazil.
- AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
| | - Gabriel Natan Pires
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- Instituto do Sono, São Paulo, SP, Brazil.
| | | | - Alicia Carissimi
- Faculdade Dom Bosco, Porto Alegre, RS, Brazil.
- Cronosul Clínica de Psicologia do Sono, Psicoterapia e Neuropsicologia, Porto Alegre, RS, Brazil.
| | - Allan Luiz Eckeli
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | - Álvaro Pentagna
- Hospital das Clínicas (HCFMUSP), Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
| | | | | | - Emmanuelle Silva Tavares Sobreira
- AkasA - Formação e Conhecimento, São Paulo, SP, Brazil.
- Universidade Federal do Ceará, Fortaleza, CE, Brazil.
- Clínica Sinapse Diagnóstico, Fortaleza, CE, Brazil.
| | - Fernando Gustavo Stelzer
- Departamento de Neurociências e Ciências do Comportamento, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil.
| | | | | | - Ila Marques Porto Linares
- Instituto de Psiquiatria (IPq), Universidade de São Paulo, São Paulo, SP, Brazil.
- Instituto da Criança, Faculdade de Medicina, Universidade de São Paulo (FMUSP), São Paulo, SP, Brazil.
| | - Ksdy Maiara Moura Sousa
- Departamento de Psicobiologia, Universidade Federal de São Paulo, São Paulo, Brazil.
- SleepUp Tecnologia e Saúde LTDA, São Paulo, SP, Brazil.
| | | | - Lucia Sukys-Claudino
- Disciplina de Neurologia, Universidade Federal de Santa Catarina (UFSC), Florianópolis, SC, Brazil.
| | | | - Marcio Andrei Zanini
- Instituto de Assistência Médica ao Servidor Público Estadual (IAMPSE), São Paulo, SP, Brazil.
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Wang S, Lan Y, Liu Z, Xu S, Wu X. Effects of different interventions on insomnia in adults: Systematic review and network meta-analysis. J Psychiatr Res 2023; 165:140-149. [PMID: 37499485 DOI: 10.1016/j.jpsychires.2023.07.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 05/04/2023] [Accepted: 07/06/2023] [Indexed: 07/29/2023]
Abstract
OBJECTIVE Insomnia is a common sleep disorder. There are many clinical-intervention methods for treating this condition, but thus far, the most effective method has not been determined. METHODS We conducted a network meta-analysis by including random evidence of insomnia improvement in people over 18 years old, without other physical diseases. From January 1, 1990 to June 15, 2022, we searched multiple electronic databases for randomized controlled trials of different insomnia-related, clinical-intervention methods. R software was used to analyze 10 indices, in order to evaluate the effect of sleep improvement. Primary outcomes comprised Pittsburgh sleep quality-index (PSQI) scores and insomnia severity-index (ISI) scores. RESULTS Finally, 122 randomized controlled trials were included in our study. For the PSQI scores, we found the sequence of intervention measures by effect to be as follows: electroacupuncture, acupuncture, repetitive transcranial magnetic stimulation (rTMS), essential oils, herbal medicine, traditional Western medicine, Tai Chi and Baduanjin, music, supplements, cognitive behavioral therapy for insomnia (CBT-I), and exercise. The results for ISI were similar to those for PSQI, but with slight differences. CONCLUSION Our research results indicate that various measures have a certain effect on improving sleep, among which the effect of instruments is more prominent. The curative effect of placebo groups was better than that of blank control groups. There is essentially no statistical difference in detailed classification within the same intervention category.
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Affiliation(s)
- Shuwen Wang
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Yueyan Lan
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Zixiu Liu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China
| | - Shuang Xu
- Library of China Medical University, Shenyang, Liaoning Province, China
| | - Xiaomei Wu
- Department of Clinical Epidemiology and Center of Evidence Based Medicine, The First Hospital of China Medical University, Shenyang, Liaoning Province, China.
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de Entrambasaguas M, Díaz-Silveira C, Burgos-Julián FA, Santed MA. Can mindfulness-based interventions improve outcomes in cognitive-behavioural therapy for chronic insomnia disorder in the general population? Systematic review and meta-analysis. Clin Psychol Psychother 2023; 30:965-978. [PMID: 37271575 DOI: 10.1002/cpp.2874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 05/16/2023] [Accepted: 05/22/2023] [Indexed: 06/06/2023]
Abstract
Cognitive-behavioural therapy for insomnia (CBT-I) is the recommended first-line therapy for adults with chronic insomnia disorder (ID), which is characterized by hyperarousal. Mindfulness-based interventions (MBIs) are protocols aimed at stress reduction based on non-judgmental attention control in the present moment. However, MBIs have been increasingly used without a clear scientific basis. The objective of this analysis was to examine if MBIs could be useful as a component of the CBT-I therapeutic system through a systematic review and meta-analysis of randomized controlled trials (RCTs) and non-randomized studies (NRS) searched in PubMed, PsycINFO, Cochrane and WoS. The Insomnia Severity Index (ISI) was the primary outcome, while the Pittsburgh Sleep Quality Index (PSQI) and a composite sleep variable (CSV) were secondary outcomes. Thirteen articles corresponding to nine studies (three pragmatic RCTs, three explanatory RCTs and three NRS) were included. The omnibus test found that MBIs had a small to medium effect size on ISI nearing signification when comparing active control groups in the pretest-posttest period [Δ = 0.44, p = 0.07], a medium, non-significant, effect size on PSQI [Δ = 0.52, p = 0.18], and a significant though small effect size on CSV [Δ = 0.05, p < 0.01]. No heterogeneity was found. The analysis could not demonstrate that MBIs, combined with CBT-I components in some studies, positively affected ID in the general adult population. This was probably due to the lack of pragmatic designs and suitable measuring instruments. Recommendations are made for designing further studies to address these issues.
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Affiliation(s)
- Manuel de Entrambasaguas
- Sleep Unit, Clinical Neurophysiology, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Cintia Díaz-Silveira
- Department of Psychology, Health of Sciences Campus, Universidad Rey Juan Carlos, Alcorcón, Spain
| | | | - Miguel A Santed
- Faculty of Psychology, Universidad Nacional de Educación a Distancia (UNED), Madrid, Spain
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Imhoff-Smith TP, Grupe DW. The impact of mindfulness training on posttraumatic stress disorder symptoms, subjective sleep quality, and objective sleep outcomes in police officers. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023:2024-02812-001. [PMID: 37650805 PMCID: PMC10902185 DOI: 10.1037/tra0001566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
OBJECTIVE Sleep disturbances cooccur with posttraumatic stress disorder (PTSD) and are often correlated with PTSD severity. Previous research has shown that sleep problems mediate the relationship between PTSD and negative physical and mental health outcomes but has relied on self-reported sleep quality. We tested the effects of mindfulness training-previously shown to improve sleep quality and reduce PTSD symptoms-on subjective and objective sleep metrics and relationships with reduced PTSD symptoms. METHOD Following baseline data collection in 114 law enforcement officers, we randomly assigned participants to either an 8-week mindfulness training group or a waitlist control group. We repeated assessments immediately posttraining and at 3-month follow-up. Self-reported PTSD symptoms and subjective sleep quality were measured at each visit with the PTSD checklist and Pittsburgh Sleep Quality Index (PSQI), respectively. Participants also wore a Fitbit Charge 2 continuously over the course of a 4- to 6-day work week following each visit, from which we extracted two distinct objective sleep metrics: total minutes of sleep and sleep efficiency. RESULTS At baseline, PTSD symptoms were correlated with PSQI scores but not objective Fitbit metrics. Relative to waitlist, mindfulness training led to improved subjective sleep quality and reduced PTSD symptoms. Reduced PTSD symptoms mediated the improvement in subjective sleep quality following mindfulness training. Neither objective sleep metric demonstrated improvements following mindfulness training, nor did these metrics mediate reduced PTSD symptoms. CONCLUSIONS This study provides evidence linking improved subjective sleep quality, but not objective sleep markers, to reductions in PTSD symptoms following mindfulness training. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
| | - Daniel W Grupe
- Center for Healthy Minds, University of Wisconsin-Madison
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Guarnaccia JB, Njike VY, Dutton A, Ayettey RG, Treu JA, Comerford BP, Sinha R. A pilot, randomized, placebo-controlled study of mindfulness meditation in treating insomnia in multiple sclerosis. BMC Neurol 2023; 23:263. [PMID: 37434109 PMCID: PMC10334613 DOI: 10.1186/s12883-023-03309-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 06/27/2023] [Indexed: 07/13/2023] Open
Abstract
OBJECTIVE Mindfulness is an established approach to reduce distress and stress reactivity by improving awareness and tolerability of thoughts and emotions. This study compares mindfulness training to sleep hygiene in persons with multiple sclerosis (PWMS) who report chronic insomnia, examining sleep efficiency (SE), self-reported sleep quality and quality of life. METHODS Fifty-three PWMS were randomized (1:1) in a single-blinded, parallel group design to ten, two-hour weekly sessions of Mindfulness Based Stress Intervention for Insomnia (MBSI-I) over a span of ten weeks or a single, one hour sleep hygiene (SH) session over one day. The primary outcome measure was SE, measured by the Fitbit™ Charge 2 wrist device, at 10 and 16 weeks from the start of study interventions. Self-report outcomes included the Pittsburg Sleep Quality Rating Scale (PSQI), Insomnia Severity Index (ISI) and the Multiple Sclerosis Quality of Life Inventory (MSQLI). Nineteen participants in the MBSI-I group and 24 in the SH group completed the primary study. Subsequently, ten participants in the original SH group participated in the 10-week MSBI-I course and their data was added to the MBSI-I cohort (eMSBI-I). RESULTS While neither SE nor the PSQI showed significant differences between MBSI-I, eMBSI-I and SH groups, ISI improved in both the MSBI-I and eMBSI-I vs SH at 10 weeks (p = 0.0014 and p = 0.0275) but not 16 weeks. However, pre and post assessments within the MBSI-I and eMBSI-I cohorts did show significant improvement in the PSQI and ISI at 10 and 16 weeks, while SH was significant in the ISI only at 16 weeks. Several quality of life measurements, including fatigue, mental health and cognitive function favored the mindfulness cohorts. CONCLUSION This pilot study demonstrates beneficial effects of MBSR on insomnia, sleep quality and quality of life in PWMS. TRIAL REGISTRATION NCT03949296. 14 May 2019.
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Affiliation(s)
- Joseph B Guarnaccia
- Multiple Sclerosis Treatment Center, Griffin Hospital, 350 Seymour Ave., Suite 1C, Derby, Connecticut, 06418, USA.
| | - Valentine Y Njike
- Yale-Griffin Prevention Research Center, Griffin Hospital, 130 Division St., Derby, Connecticut, 06418, USA
| | - Anne Dutton
- Department of Psychiatry, Yale Stress Center, Yale University, New Haven, Connecticut, 06510, USA
| | - Rockiy G Ayettey
- Yale-Griffin Prevention Research Center, Griffin Hospital, 130 Division St., Derby, Connecticut, 06418, USA
| | - Judith A Treu
- Yale-Griffin Prevention Research Center, Griffin Hospital, 130 Division St., Derby, Connecticut, 06418, USA
| | - Beth P Comerford
- Yale-Griffin Prevention Research Center, Griffin Hospital, 130 Division St., Derby, Connecticut, 06418, USA
| | - Rajita Sinha
- Department of Psychiatry, Yale Stress Center, Yale University, New Haven, Connecticut, 06510, USA
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Kishimoto S, Watanabe N, Yamamoto Y, Imai T, Aida R, Germer C, Tamagawa-Mineoka R, Shimizu R, Hickman S, Nakayama Y, Etoh T, Sahker E, Carnie MB, Furukawa TA. Efficacy of Integrated Online Mindfulness and Self-compassion Training for Adults With Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol 2023; 159:628-636. [PMID: 37163257 PMCID: PMC10173097 DOI: 10.1001/jamadermatol.2023.0975] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 03/10/2023] [Indexed: 05/11/2023]
Abstract
Importance Quality of life (QOL) of patients with atopic dermatitis (AD) is reported to be the lowest among skin diseases. To our knowledge, mindfulness and self-compassion training has not been evaluated for adults with AD. Objective To evaluate the efficacy of mindfulness and self-compassion training in improving the QOL for adults with AD. Design, Setting, and Participants This randomized clinical trial conducted from March 2019 through October 2022 included adults with AD whose Dermatology Life Quality Index (DLQI) score, a skin disease-specific QOL measure, was greater than 6 (corresponding to moderate or greater impairment). Participants were recruited from multiple outpatient institutes in Japan and through the study's social media outlets and website. Interventions Participants were randomized 1:1 to receive eight 90-minute weekly group sessions of online mindfulness and self-compassion training or to a waiting list. Both groups were allowed to receive any dermatologic treatment except dupilumab. Main Outcomes and Measures The primary outcome was the change in the DLQI score from baseline to week 13. Secondary outcomes included eczema severity, itch- and scratching-related visual analog scales, self-compassion and all of its subscales, mindfulness, psychological symptoms, and participants' adherence to dermatologist-advised treatments. Results The study randomized 107 adults to the intervention group (n = 56) or the waiting list (n = 51). The overall participant mean (SD) age was 36.3 (10.5) years, 85 (79.4%) were women, and the mean (SD) AD duration was 26.6 (11.7) years. Among participants from the intervention group, 55 (98.2%) attended 6 or more of the 8 sessions, and 105 of all participants (98.1%) completed the assessment at 13 weeks. The intervention group demonstrated greater improvement in the DLQI score at 13 weeks (between-group difference estimate, -6.34; 95% CI, -8.27 to -4.41; P < .001). The standardized effect size (Cohen d) at 13 weeks was -1.06 (95% CI, -1.39 to -0.74). All secondary outcomes showed greater improvements in the intervention group than in the waiting list group. Conclusions and Relevance In this randomized clinical trial of adults with AD, integrated online mindfulness and self-compassion training in addition to usual care resulted in greater improvement in skin disease-specific QOL and other patient-reported outcomes, including eczema severity. These findings suggest that mindfulness and self-compassion training is an effective treatment option for adults with AD. Trial Registration https://umin.ac.jp/ctr Identifier: UMIN000036277.
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Affiliation(s)
- Sanae Kishimoto
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Norio Watanabe
- Department of Psychiatry, Soseikai General Hospital, Kyoto, Japan
| | - Yosuke Yamamoto
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Healthcare Epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takumi Imai
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Rei Aida
- Department of Medical Statistics, Graduate School of Medicine, Osaka Metropolitan University, Osaka, Japan
| | - Christopher Germer
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
- Center for Mindfulness and Compassion, Cambridge Health Alliance, Cambridge, Massachusetts
| | | | | | - Steven Hickman
- Center for Mindfulness, University of California San Diego
- Global Compassion Coalition, San Rafael, California
| | - Yujiro Nakayama
- Faculty of Medical Sciences, Shonan University of Medical Sciences, Yokohama, Kanagawa, Japan
| | | | - Ethan Sahker
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Population Health & Policy Research Unit, Medical Education Center, Kyoto University, Kyoto, Japan
| | - Martha B. Carnie
- Center for Patients and Families, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Toshi A. Furukawa
- Department of Health Promotion and Human Behavior, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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10
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Cognitive behavioral therapy and acceptance and commitment therapy for insomnia: Exploring the potential benefit of psychological flexibility and self-compassion combined with behavioral strategies. NEW IDEAS IN PSYCHOLOGY 2023. [DOI: 10.1016/j.newideapsych.2023.101013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023]
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11
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Korabelnikova EA, Akavov AN, Baranov ML. [Insomnia in neurological patients with disabilities]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:12-20. [PMID: 36843454 DOI: 10.17116/jnevro202312302112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
Sleep is the most important factor reflecting the level of psychophysical well-being of a person and influencing him/her to the same extent. The greater susceptibility to sleep disturbances in patients with disabilities is associated with numerous factors. In the existing literature, there are few studies of insomnia in people with neurological disabilities. This article presents a current view on sleep disorders in disabled people and methods for their treatment.
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Affiliation(s)
- E A Korabelnikova
- Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
| | - A N Akavov
- Dagestan State Medical University, Makhachkala, Russia
| | - M L Baranov
- Main Military Clinical Hospital of the National Guard Forces, Moscow, Russia
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12
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Gao P, Mosazadeh H, Nazari N. The Buffering Role of Self-compassion in the Association Between Loneliness with Depressive Symptoms: A Cross-Sectional Survey Study Among Older Adults Living in Residential Care Homes During COVID-19. Int J Ment Health Addict 2023:1-21. [PMID: 36776917 PMCID: PMC9904273 DOI: 10.1007/s11469-023-01014-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/14/2023] [Indexed: 02/10/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic is an ongoing geriatric health emergency with a substantial increase in the prevalence of medical and mental health issues, particularly among older adults living in residential care homes. The knowledge of the risk and protective factors related to the psychological impact of the COVID-19 pandemic on older adults living in residential care homes is based on limited data. This study aimed to investigate whether loneliness mediates the effects of fear generated by a pandemic on depression. Additionally, we hypothesized that self-compassion moderates the effect of loneliness on depression. A sample comprised 323 older adults (females: n = 141, males: n = 182) with mean age = 74.98 years (standard deviation = 6.59, age 65-90) completed a survey comprising the Fear of COVID-19 Scale, De Jung Gierveld Loneliness Scale, the nine-item Patient Health Questionnaire, and the Self-compassion Scale. The results revealed that the total effect of fear on depression was statistically significant, with a medium effect size (Cohen's f 2 = .14) and this association was partially mediated by loneliness (β = .11, SE = .04, P < .001, t = 2.91, 95% CI 0.04-0.19). The self-compassion also moderated the loneliness effect on depression. The findings of this study support COVID-19 evidence, indicating that a greater level of fear generated by the pandemic is linked to depression and loneliness. The findings support the notion that self-compassion mitigates the adverse effects of stressful events in older adults. Customized self-compassion programs may be effective loneliness-mitigating interventions for older adults living in residential care homes. Supplementary Information The online version contains supplementary material available at 10.1007/s11469-023-01014-0.
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Affiliation(s)
- Pengfei Gao
- School of Public Administration, East China Normal University, Shanghai, 200062 China
| | - Hasan Mosazadeh
- Department of Psychology, Kazimierz Wielki University, Bydgoszcz, Poland
| | - Nabi Nazari
- Faculty of Human Sciences, Department of Psychology, Lorestan University, Khorramabad, Iran
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13
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Staples JK, Gibson C, Uddo M. Complementary and Integrative Health Interventions for Insomnia in Veterans and Military Populations. Psychol Rep 2023; 126:52-65. [PMID: 34855539 DOI: 10.1177/00332941211048473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Insomnia can be a serious problem diminishing quality of life for Veterans and military populations with and without posttraumatic stress disorder (PTSD). Sleep disturbances are one of the symptoms of PTSD but even after evidence-based PTSD treatments, insomnia symptoms often remain. The primary approaches for treating insomnia are cognitive behavioral therapy for insomnia (CBT-I) and pharmacotherapy. However, each of these treatments has drawbacks. Complementary and Integrative Health (CIH) approaches such as mindfulness meditation, mantram meditation, yoga, and tai chi may provide alternative treatments for insomnia in military populations. This paper provides a brief review of studies on CIH interventions for sleep disturbances in Veterans. It also proposes possible mechanisms by which CIH practices may be effective, including increasing hippocampal volume and gamma-aminobutyric acid acid (GABA). Finally, the acceptability of CIH approaches among Veterans is discussed.
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Affiliation(s)
- Julie K Staples
- Psychology Service, 20022Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA.,Biochemistry and Molecular & Cellular Biology, 12231Georgetown University Medical Center, Washington, DC, USA.,Awareness Technologies, Inc., Taos, NM, USA
| | - Courtney Gibson
- Psychology Service, 20022Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
| | - Madeline Uddo
- Psychology Service, 20022Southeast Louisiana Veterans Health Care System, New Orleans, LA, USA
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14
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Perini F, Wong KF, Lin J, Hassirim Z, Ong JL, Lo J, Ong JC, Doshi K, Lim J. Mindfulness-based therapy for insomnia for older adults with sleep difficulties: a randomized clinical trial. Psychol Med 2023; 53:1038-1048. [PMID: 34193328 PMCID: PMC9975962 DOI: 10.1017/s0033291721002476] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 04/16/2021] [Accepted: 06/02/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Poor sleep is a modifiable risk factor for multiple disorders. Frontline treatments (e.g. cognitive-behavioral therapy for insomnia) have limitations, prompting a search for alternative approaches. Here, we compare manualized Mindfulness-Based Therapy for Insomnia (MBTI) with a Sleep Hygiene, Education, and Exercise Program (SHEEP) in improving subjective and objective sleep outcomes in older adults. METHODS We conducted a single-site, parallel-arm trial, with blinded assessments collected at baseline, post-intervention and 6-months follow-up. We randomized 127 participants aged 50-80, with a Pittsburgh Sleep Quality Index (PSQI) score ⩾5, to either MBTI (n = 65) or SHEEP (n = 62), both 2 hr weekly group sessions lasting 8 weeks. Primary outcomes included PSQI and Insomnia Severity Index, and actigraphy- and polysomnography-measured sleep onset latency (SOL) and wake after sleep onset (WASO). RESULTS Intention-to-treat analysis showed reductions in insomnia severity in both groups [MBTI: Cohen's effect size d = -1.27, 95% confidence interval (CI) -1.61 to -0.89; SHEEP: d = -0.69, 95% CI -0.96 to -0.43], with significantly greater improvement in MBTI. Sleep quality improved equivalently in both groups (MBTI: d = -1.19; SHEEP: d = -1.02). No significant interaction effects were observed in objective sleep measures. However, only MBTI had reduced WASOactigraphy (MBTI: d = -0.30; SHEEP: d = 0.02), SOLactigraphy (MBTI: d = -0.25; SHEEP: d = -0.09), and WASOPSG (MBTI: d = -0.26; SHEEP (d = -0.18). There was no change in SOLPSG. No participants withdrew because of adverse effects. CONCLUSIONS MBTI is effective at improving subjective and objective sleep quality in older adults, and could be a valid alternative for persons who have failed or do not have access to standard frontline therapies.
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Affiliation(s)
- Francesca Perini
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Kian Foong Wong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jia Lin
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Zuriel Hassirim
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ju Lynn Ong
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - June Lo
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jason C. Ong
- Feinberg School of Medicine, Northwestern University, Evanston, IL 60208, USA
| | - Kinjal Doshi
- Department of Psychology, Singapore General Hospital, Singapore
| | - Julian Lim
- Centre for Sleep and Cognition, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Psychology, National University of Singapore, Singapore
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15
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Liguori C, Mombelli S, Fernandes M, Zucconi M, Plazzi G, Ferini-Strambi L, Logroscino G, Mercuri NB, Filardi M. The evolving role of quantitative actigraphy in clinical sleep medicine. Sleep Med Rev 2023; 68:101762. [PMID: 36773596 DOI: 10.1016/j.smrv.2023.101762] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 01/23/2023] [Accepted: 01/23/2023] [Indexed: 01/30/2023]
Abstract
Actigraphy has a consolidated role in Insomnia and Circadian Rhythm Sleep-Wake Disorders (CRSWD) and recent studies have highlighted the use of actigraphy for narcolepsy and REM sleep behaviour disorder (RBD). This review aims at summarising the results of studies published over the last decade regarding the use of actigraphy. Thirty-five studies proved eligible, and results were analysed separately for insomnia, narcolepsy and RBD. Actigraphy showed to consistently differentiate insomnia patients from healthy controls. Furthermore, the application of advanced analytical techniques has been shown to provide both unique insights into the physiology of insomnia and sleep misperception and to improve the specificity of actigraphy in detecting wakefulness within sleep periods. Regarding narcolepsy, several studies showed that actigraphy can detect peculiar sleep/wake disruption and the effects of pharmacological treatments. Finally, although the number of studies in RBD patients is still limited, the available evidence indicates a reduced amplitude of the activity pattern, sleep-wake rhythm dysregulation and daytime sleepiness. Therefore, the potential use of these markers as predictors of phenoconversion should be further explored. In conclusion, quantitative actigraphy presents a renewed interest when considering the possibility of using actigraphy in clinical sleep medicine to diagnose, monitor, and follow sleep disorders other than CRSWD.
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Affiliation(s)
- Claudio Liguori
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy.
| | - Samantha Mombelli
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | - Mariana Fernandes
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Marco Zucconi
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy
| | - Giuseppe Plazzi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; IRCCS Institute of Neurological Sciences, Bologna, Italy
| | - Luigi Ferini-Strambi
- IRCCS San Raffaele Scientific Institute, Department of Clinical Neurosciences, Neurology - Sleep Disorders Center, Milan, Italy; "Vita-Salute" San Raffaele University, Milan, Italy
| | - Giancarlo Logroscino
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy; Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro at Pia Fondazione "Card. G. Panico", Italy
| | - Nicola Biagio Mercuri
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Sleep Medicine Centre, Neurology Unit, University Hospital of Rome Tor Vergata, Rome, Italy
| | - Marco Filardi
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University of Bari Aldo Moro, Bari, Italy; Center for Neurodegenerative Diseases and the Aging Brain, University of Bari Aldo Moro at Pia Fondazione "Card. G. Panico", Italy
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16
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Li Z, Wang Q, Xu J, Song Q, Ling X, Gao Y, Lei J. Comparative efficacy and acceptability of interventions for insomnia in breast cancer patients: A protocol for systematic review and network meta-analysis. PLoS One 2023; 18:e0282614. [PMID: 36881596 PMCID: PMC9990914 DOI: 10.1371/journal.pone.0282614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 02/18/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Symptoms of insomnia are highly prevalent in patients with breast cancer. There are a large number of pharmacological and non-pharmacological interventions that can be used for the management of insomnia in breast cancer patients; however, their comparative effectiveness and acceptability remain uncertain. This review aims to evaluate the efficacy and acceptability of different interventions for insomnia in breast cancer patients using a Bayesian network meta-analysis (NMA). METHODS We will perform a comprehensive literature search in PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), Web of Science, and PsycINFO from inception to November 2022. We will include randomized controlled trials (RCTs) that compared the effects of different interventions on the management of insomnia in breast cancer patients. We will assess the risk of bias assessment using a modified Cochrane instrument. We will conduct a Bayesian random-effects framework NMA to estimate relative effects of interventional procedures. We will use Grading of Recommendations Assessment, Development and Evaluation to rate the certainty of evidence. DISCUSSION To our knowledge, this will be the first systematic review and network meta-analysis to compare the effectiveness and acceptability of all currently available interventions for insomnia in patients with breast cancer. The results of our review will help provide more evidence for the treatment of insomnia in breast cancer patients. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration number CRD42021282211.
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Affiliation(s)
- Zhifan Li
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Qian Wang
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Junxia Xu
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Qihua Song
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
| | - Xiaoling Ling
- Department of Oncology, The First Hospital of Lanzhou University, Lanzhou, China
| | - Ya Gao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, ON, Canada
- Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou, China
| | - Junqiang Lei
- The First Clinical Medical College of Lanzhou University, Lanzhou, China
- Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, China
- * E-mail:
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17
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Li Y, Nazari N, Sadeghi M. Internet delivered, non-inferiority, two-arm, assessor-blinded intervention comparing mindfulness-based stress reduction and cognitive-behavioral treatment for insomnia: a protocol study for a randomized controlled trial for nursing staff with insomnia. Trials 2022; 23:1020. [PMID: 36527137 PMCID: PMC9756716 DOI: 10.1186/s13063-022-06986-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 12/06/2022] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Insomnia and poor sleep quality are highly prevalent conditions related to coronavirus disease 2019 (COVID-19) complications among clinical nurses. Although cognitive behavioral therapy for insomnia (CBT-I) is a first-line treatment, CBT-I suffers from several major drawbacks. This study investigates whether the application of the internet-delivered mindfulness-based stress reduction (iMBSR) intervention will produce effects that are non-inferior to the internet-delivered CBT-I (iCBT-I) intervention in reducing the severity of insomnia in clinical nurses with insomnia at the end of the study. METHODS This study protocol presents an internet-delivered, parallel-groups, assessor-blinded, two-arm, non-inferiority randomized controlled trial. The primary outcome is sleep quality, assessed by the Insomnia Severity Index. Secondary outcomes include depression, dysfunctional beliefs, five facets of mindfulness, and client satisfaction. CONCLUSION It is expected that this study may address several gaps in the literature. The non-inferiority study design is a novel approach to evaluating whether a standardized, complementary treatment (i.e., MBSR) is as practical as a gold standard treatment rather than its potential benefits. This approach may lead to expanded evidence-based practice and improve patient access to effective treatments. TRIAL REGISTRATION Trial registration number: ISRCTN36198096 . Registered on 24th May 2022.
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Affiliation(s)
- Yaling Li
- grid.499351.30000 0004 6353 6136Mental Health Education and Counseling Center, Shenzhen Technology University, Shenzhen, 518118 Guangdong China
| | - Nabi Nazari
- grid.411406.60000 0004 1757 0173Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
| | - Masoud Sadeghi
- grid.411406.60000 0004 1757 0173Department of Psychology, Faculty of Human Sciences, Lorestan University, Khorramabad, Iran
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18
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Shabani F, Montazeri M, Abdolalipour S, Mirghafourvand M. The effect of mindfulness training on stress and sleep quality of postmenopausal women: A systematic review and meta-analysis. Post Reprod Health 2022; 28:223-236. [PMID: 36346199 DOI: 10.1177/20533691221140191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Mindfulness is an effective method for empowering women to cope with menopausal changes. This study aimed to determine the effect of mindfulness training on stress and sleep quality in postmenopausal women. MATERIALS AND METHODS English (PubMed, Cochrane Library, Google Scholar, Scopus, Web of Science, and CINHAL) and Persian (SID, Magiran) databases were searched until 25 June 2022, using the free and MeSH keywords included Mindfulness and Menopause. The quality of the published papers was evaluated using Cochrane Handbook for Systematic Reviews of Interventions version 5.2.0. The meta-analysis was conducted in RevMan 5.3 and the results were reported with mean difference (95% confidence interval). The quality of evidence was assessed using the GRADE approach. RESULTS A total of 1206 records were obtained. After removing duplicate and non-eligible records, finally five articles were included in the systematic review and meta-analysis. The results indicated that sleep quality score (SMD = -1.44; 95% CI = -2.44 to -0.46; p = 0.004) and perceived stress score (MD = -4.21; 95% CI = -6.41 to -2.00; p = 0.0002) were significantly reduced in the mindfulness training group compared to control group. CONCLUSION Mindfulness training is associated with improving sleep quality and perceived stress (with a low quality of evidence) in postmenopausal women. Mental health and quality of life in postmenopausal women impressively affect the community health. Given the low quality of evidence of the studies in this field, randomized controlled trials with better methodologies are suggested.
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Affiliation(s)
- Fatemeh Shabani
- Department of Midwifery, Student Research Committee, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Maryam Montazeri
- Midwifery Department, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Somayeh Abdolalipour
- Department of Midwifery, Student Research Committee, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Faculty of Nursing and Midwifery, 48432Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Family Health, Social Determinants of Health Research Center, Ardabil University of Medical Sciences, Ardabil, Iran
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19
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Kim SM, Park JM, Seo HJ, Kim J, Noh JW, Kim HL. Effects of mindfulness-based stress reduction on adults with sleep disturbance: an updated systematic review and meta-analysis. BMJ Open 2022; 12:e058032. [PMID: 36332952 PMCID: PMC9639069 DOI: 10.1136/bmjopen-2021-058032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE Mindfulness-based stress reduction (MBSR) is a meditation-based therapy originally recommended for stress management. However, it is currently used to alleviate sleep disturbances. Therefore, this contemporary systematic review aimed to elucidate the clinical effects of MBSR on sleep quality and sleep-related daytime impairment in adults with sleep disturbances, including chronic insomnia disorders. DESIGN Systematic review and meta-analysis of randomised controlled trials (RCTs). METHODS A comprehensive search was conducted using the following databases: Ovid MEDLINE, AMED, Ovidembase, PsycINFO, Cochrane Library, CINAHL, and four domestic databases: KoreaMed, KISS, KMbase and NDSL. The final search update was performed in June 2022. Two researchers independently selected relevant studies, assessed the risk of bias and extracted the data. RESULTS Of the 7516 records searched, 20 RCTs and 21 reports were included. In the subgroup analysis, MBSR did not improve objective or subjective sleep quality in chronic insomnia and cancers. However, MBSR versus waitlist control might have been effective in improving subjective sleep quality, but with substantial heterogeneity (standardised mean difference=-0.32; 95% CI: -0.56 to -0.08; I2=71%). In addition, MBSR compared with active control did not improve the sleep-related daytime impairments including depression, anxiety, stress, fatigue and quality of life. The overall risk of bias included in this review was a concern because of performance and detection bias. CONCLUSIONS MBSR might be ineffective for improving sleep quality in patients with chronic insomnia and cancers. In addition, more than half of the RCTs included in this review had small sample sizes and were vulnerable to performance and detection biases. Therefore, well-designed RCTs with larger sample sizes are required to confirm the clinical effects of MBSR in adults with sleep disturbances. PROSPERO REGISTRATION NUMBER CRD42015027963.
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Affiliation(s)
- Seong Min Kim
- Department of Nursing, Donggang University, Gwangju, Korea
| | | | - Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, Korea
| | - Jinhee Kim
- Department of Nursing, College of Medicine, Chosun University, Gwangju, Korea
| | - Jin-Won Noh
- Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University-Mirae Campus, Wonju-si, Gangwon-do, Korea
| | - Hyun Lye Kim
- Department of Nursing, College of Medicine, Chosun University, Gwangju, Korea
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20
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A Meta-Analysis of Mindfulness-Based Therapies for Insomnia and Sleep Disturbance Moving Toward Processes of Change. Sleep Med Clin 2022; 17:329-353. [PMID: 36150798 DOI: 10.1016/j.jsmc.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
MBTs are increasingly being investigated as a viable treatment of insomnia or sleep disturbance. To date, 13 trials published since 2010 suggest that MBTs are efficacious for improving symptoms of insomnia and sleep quality relative to psychological placebos and inactive control conditions with medium to large effects. Limited evidence suggests that these effects are sustained at 3-month follow-up. Despite this, limited data were collected evaluating the empirically supported mechanisms or processes of change. The authors propose a testable model in the psychological process model of sleep that they hope will advance the next generation of research into MBTs for insomnia.
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21
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Comparative efficacy and acceptability of psychotherapies, pharmacotherapies, and their combination for the treatment of adult insomnia: A systematic review and network meta-analysis. Sleep Med Rev 2022; 65:101687. [PMID: 36027795 DOI: 10.1016/j.smrv.2022.101687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 07/08/2022] [Accepted: 08/02/2022] [Indexed: 11/23/2022]
Abstract
This study aims to explore the comparative efficacy and acceptability of psychotherapies, pharmacotherapies, and their combinations for insomnia. MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, PsycINFO, CINAHL, and ClinicalTrials.gov were searched for randomized clinical trials (RCTs) examining the comparative efficacy in which a psychotherapy and a pharmacotherapy for insomnia were directly compared with each other, or in which a combination of psychotherapy and pharmacotherapy was compared with either alone. The analysis included data from 23 RCTs. In 18 of 23 studies, cognitive behavior therapy for insomnia (CBT-I) was the psychotherapy. At post-treatment, CBT-I showed higher subjective sleep efficiency (SE), and lower subjective wake time after sleep onset (WASO) and insomnia severity index (ISI) score. Compared with CBT-I plus pharmacotherapy, pharmacotherapy showed lower subjective SE, and higher subjective sleep latency (SL), PSG measured SL, subjective WASO, and ISI score. Overall, the findings derived from post-treatment data suggested that CBT-I is more beneficial in treating insomnia compared with pharmacotherapy. CBT-I combined with pharmacotherapy is beneficial in improving some sleep parameters (i.e., subjective SE, SL, WASO, and PSG measured SL) compared with pharmacotherapy alone. Daily clinical decisions should consider these findings on the relative efficacy of the principal approaches to insomnia treatment.
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22
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Camino M, Satorres E, Delhom I, Real E, Abella M, Meléndez JC. Mindfulness-based Cognitive Therapy to Improve Sleep Quality in Older Adults with Insomnia. INTERVENCION PSICOSOCIAL 2022; 31:159-167. [PMID: 37361010 PMCID: PMC10268553 DOI: 10.5093/pi2022a12] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 06/06/2022] [Indexed: 06/28/2023]
Abstract
There is a high prevalence of insomnia in older adults, which has negative consequences for their well-being and quality of life. The recommendation for first-line treatments is to administer non-pharmacological interventions. The objective of this research was to verify the effectiveness of Mindfulness-Based Cognitive Therapy in older adults with subclinical and moderate insomnia, studying its impact on sleep quality. One hundred and six older adults participated and were assigned to the subclinical insomnia (n = 50) or moderate insomnia (n = 56) groups; subsequently, they were randomly assigned to the control and intervention groups. Subjects were evaluated at two times with the Insomnia Severity Index and the Pittsburgh Sleep Quality Index. Significant results were obtained on both scales, with a reduction in insomnia symptoms in the subclinical and moderate intervention groups. The administration of a treatment that combines mindfulness and cognitive therapy is effective for treating insomnia in older adults.
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Affiliation(s)
- Manuel Camino
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
| | | | - Iraida Delhom
- Universidad Internacional de ValenciaValenciaSpainUniversidad Internacional de Valencia, Spain
| | - Elena Real
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
| | - Mireia Abella
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
| | - Juan C. Meléndez
- University of ValenciaValenciaSpainUniversity of Valencia, Spain;
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Hausswirth C, Nesi X, Dubois A, Duforez F, Rougier Y, Slattery K. Four Weeks of a Neuro-Meditation Program Improves Sleep Quality and Reduces Hypertension in Nursing Staff During the COVID-19 Pandemic: A Parallel Randomized Controlled Trial. Front Psychol 2022; 13:854474. [PMID: 35645851 PMCID: PMC9130829 DOI: 10.3389/fpsyg.2022.854474] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 04/07/2022] [Indexed: 11/13/2022] Open
Abstract
The purpose of this study was to examine the effectiveness of a neuro-meditation program to support nurses during the COVID-19 pandemic. Forty-five (10 men and 35 women) nurses were classified into three groups based on their systolic blood pressure: normotensive (G-nor; n = 16, 43.8 ± 11.0 year), hypertensive (G-hyp; n = 13, 45.2 ± 10.7 year) and control (G-con; n = 16, 44.9 ± 10.6 year). Using a parallel, randomly controlled design across a 4-week period, 10 × 30-min sessions using the Rebalance© Impulse were completed. Sleep was assessed by wrist actigraphy and subjective sleep questionnaires; perceived sleep quality, Ford Insomnia Response to Stress Test questionnaire and the Spiegel Sleep Quality questionnaire (SSQ). Blood pressure, resting heart rate, mean heart rate (HRmean), heart rate variability index (RMSSD), cortisol, and alpha-amylase were also measured. Statistical analysis was completed using factorial ANOVA. Sleep improved in the G-hyp group; SSQ (p < 0.01); perceived sleep quality (p < 0.01); sleep efficiency and fragmentation index (p < 0.05). In the G-nor group, sleep was improved to a lesser extent; perceived sleep quality (p < 0.01). A significant time-group interaction was reported in resting heart rate (p < 0.01), systolic blood pressure (p < 0.01), and diastolic blood pressure (p < 0.05) with these measures being significantly reduced in the G-hyp group. RMSSD increased in the G-nor group (p < 0.01). This initial evidence suggests that neuro-meditation reduces excessive sympathetic activity, promoting enhanced sleep quality and autonomic control during periods of increased work-related stress. Clinical Trial Registration The study was conducted at Bioesterel, Sophia-Antipolis, France as a clinical trial: Neuro-meditation improves sleep quality, https://www.drks.de/ui_data_web/DrksUI.html?locale=en, DRKS00025731.
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Affiliation(s)
- Christophe Hausswirth
- LAMHESS, University of Côte d'Azur, Nice, France.,BeScored Institute, Sophia Antipolis, France.,School of Sport, Exercise and Rehabilitation, University of Technology, Sydney, NSW, Australia
| | - Xavier Nesi
- BeScored Institute, Sophia Antipolis, France
| | - Alexandre Dubois
- Hotel-Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France
| | - François Duforez
- Hotel-Dieu de Paris, Centre du Sommeil et de la Vigilance, Paris, France
| | | | - Katie Slattery
- School of Sport, Exercise and Rehabilitation, University of Technology, Sydney, NSW, Australia
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Tokdemir G. Software professionals during the COVID-19 pandemic in Turkey: Factors affecting their mental well-being and work engagement in the home-based work setting. THE JOURNAL OF SYSTEMS AND SOFTWARE 2022; 188:111286. [PMID: 35250124 PMCID: PMC8885087 DOI: 10.1016/j.jss.2022.111286] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Revised: 02/09/2022] [Accepted: 02/22/2022] [Indexed: 06/14/2023]
Abstract
With the COVID-19 pandemic, strict measures have been taken to slow down the spread of the virus, and consequently, software professionals have been forced to work from home. However, home-based working entails many challenges, as the home environment is shared by the whole family simultaneously under pandemic conditions. The aim of this study is to explore software professionals' mental well-being and work engagement and the relationships of these variables with job strain and resource-related factors in the forced home-based work setting during the COVID-19 pandemic. An online cross-sectional survey based on primarily well-known, validated scales was conducted with software professionals in Turkey. The analysis of the results was performed through hierarchical multivariate regression. The results suggest that despite the negative effect of job strain, the resource-related protective factors, namely, sleep quality, decision latitude, work-life balance, exercise predict mental well-being. Additionally, work engagement is predicted by job strain, sleep quality, and decision latitude. The results of the study will provide valuable insights to management of the software companies and professionals about the precautions that can be taken to have a better home-based working experience such as allowing greater autonomy and enhancing the quality of sleep and hence mitigating the negative effects of pandemic emergency situations on software professionals' mental well-being and work engagement.
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Affiliation(s)
- Gul Tokdemir
- Cankaya University, Computer Engineering Department, Eskisehir Yolu 29.km. Mimar Sinan Cad. No:4, 06790, Ankara, Turkey
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25
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Li AC, Wong KK, Chio FH, Mak WW, Poon LW. Delivering Mindfulness-Based Interventions for Insomnia, Pain, and Dysfunctional Eating Through a Text Messaging App: Three Randomized Controlled Trials Investigating the Effectiveness and Mediating Mechanisms. J Med Internet Res 2022; 24:e30073. [PMID: 35503653 PMCID: PMC9115660 DOI: 10.2196/30073] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 02/09/2022] [Accepted: 02/24/2022] [Indexed: 01/16/2023] Open
Abstract
Background Although text messaging has the potential to be the core intervention modality, it is often used as an adjunct only. To improve health and alleviate the distress related to insomnia, pain, and dysregulated eating of people living in urban areas, text messaging–based mindfulness-based interventions were designed and evaluated in 3 randomized controlled trials. Objective This study investigated the effectiveness and mediating mechanisms of text messaging–based mindfulness-based interventions for people with distress related to insomnia, pain, or dysregulated eating. Methods In these trials, 333, 235, and 351 participants were recruited online and randomized to intervention and wait-list control conditions for insomnia, pain, and dysregulated eating, respectively. Participants experienced 21 days of intervention through WhatsApp Messenger. Participants completed pre-, post-, 1-month follow-up, and 3-month follow-up self-report questionnaires online. The retention rates at postmeasurements were 83.2% (139/167), 77.1% (91/118), and 72.9% (129/177) for intervention groups of insomnia, pain, and dysregulated eating, respectively. Participants’ queries were answered by a study technician. Primary outcomes included insomnia severity, presleep arousal, pain intensity, pain acceptance, and eating behaviors. Secondary outcomes included mindfulness, depression, anxiety, mental well-being, and functional impairments. Mindfulness, dysfunctional beliefs and attitudes about sleep, pain catastrophizing, and reactivity to food cues were hypothesized to mediate the relationship between the intervention and outcomes. Results For all 3 studies, the intervention groups showed significant improvement on most outcomes at 1-month follow-up compared to their respective wait-list control groups; some primary outcomes (eg, insomnia, pain, dysregulated eating indicators) and secondary outcomes (eg, depression, anxiety symptoms) were sustained at 3-month follow-up. Medium-to-large effect sizes were found at postassessments in most outcomes in all studies. In the intervention for insomnia, mediation analyses showed that dysfunctional beliefs and attitudes about sleep mediated the effect of the intervention on all primary outcomes and most secondary outcomes at both 1-month and 3-month follow-ups, whereas mindfulness mediated the intervention effect on presleep arousal at 1-month and 3-month follow-ups. In the intervention for pain, pain catastrophizing mediated the effect of intervention on pain intensity and functioning at both 1-month and 3-month follow-ups, whereas mindfulness only mediated the effect of intervention on anxiety and depressive symptoms. In the intervention for dysregulated eating, power of food mediated the effect of intervention on both uncontrolled and emotional eating at both 1-month and 3-month follow-ups and mindfulness was found to mediate the effect on depressive symptoms at both 1-month and 3-month follow-ups. Conclusions These 3 studies converged and provided empirical evidence that mindfulness-based interventions delivered through text messaging are effective in improving distress related to sleep, pain, and dysregulated eating. Text messaging has the potential to be a core intervention modality to improve various common health outcomes for people living a fast-paced lifestyle. Trial Registration Clinical Research and Biostatistics Clinical Trials Registry CUHK_CCRB00559; https://tinyurl.com/24rkwarz
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Affiliation(s)
- Amanda Cm Li
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Keith Kl Wong
- Clinical Psychological Services, New Life Psychiatric Rehabilitation Association, Hong Kong, Hong Kong
| | - Floria Hn Chio
- Department of Counselling and Psychology, Hong Kong Shue Yan University, Hong Kong, Hong Kong
| | - Winnie Ws Mak
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong, Hong Kong
| | - Loretta Wh Poon
- newlife.330, New Life Psychiatric Rehabilitation Association, Hong Kong, Hong Kong
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Feasibility and the effects of an online mindfulness-based health promotion program on college students' sleep, circadian rhythms, and well-being: protocol for a randomized trial [CIRCAMIND study]. Eur J Integr Med 2022. [DOI: 10.1016/j.eujim.2022.102127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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27
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Pan C, Tie B, Yuwen W, Su X, Deng Y, Ma X, Wu Y, Liao Y, Kong L, Zhang Y, Li Z, Pan Q, Tang Q. 'Mindfulness Living with Insomnia': an mHealth intervention for individuals with insomnia in China: a study protocol of a randomised controlled trial. BMJ Open 2022; 12:e053501. [PMID: 35168972 PMCID: PMC8852731 DOI: 10.1136/bmjopen-2021-053501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Insomnia has a remarkably negative effect on the work, quality of life and psychosomatic health of individuals, and imposes a substantial economic burden on society. Mindfulness-based interventions (MBIs) have proven beneficial in the treatment of insomnia. However, the effect of mobile or online-based (mHealth) MBIs requires further verification. This study will evaluate the effectiveness of an mHealth MBI, 'Mindful Living with Insomnia' (MLWI), relative to that of mHealth cognitive behavioural therapy for insomnia (CBT-I). METHODS AND ANALYSIS The study is an mHealth, randomised controlled trial. Two hundred and fifty participants will be allocated randomly and equally to either the MLWI or CBT-I group. The intervention will involve 12 sessions over a 6-week course, with 2, 30 min sessions per week. The primary outcomes are sleep quality, severity of insomnia symptoms and sleep activity, according to the Pittsburgh Sleep Quality Index, Insomnia Severity Index and sleep tracker Mi Smart Band, respectively. The secondary outcomes are perceived stress, anxiety, depression and mindfulness. Outcomes will be evaluated at the baseline, end of the intervention period and at the 3-month follow-up. Data analyses will include covariance, regression analysis, χ2, t-test and Pearson's correlations. Participants will be recruited from January to June 2022, or until the recruitment process is complete. The follow-up will be completed in December 2022. All trial results should be available by the end of December 2022. ETHICS AND DISSEMINATION Full approval for this study has been obtained from the Ethics Committee at The Third Xiangya Hospital, Central South University, Changsha, China (21010). Study results will be disseminated via social media and peer-reviewed publications. TRIAL REGISTRATION NUMBER NCT04806009.
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Affiliation(s)
- Chen Pan
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Bingyu Tie
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Weichao Yuwen
- School of Nursing and Healthcare Leadership, University of Washington Tacoma, Tacoma, Washington, USA
| | - Xiaoyou Su
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Yunlong Deng
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xin Ma
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yan Wu
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Luya Kong
- Psychology of Teaching and Research Section, Ideological and Political Department, Heze Professional College on Household, Heze, Shandong, China
| | - Yutao Zhang
- Department of Student Affairs, Hunan University of Chinese Medicine, Changsha, Hunan, China
| | - Ziwan Li
- Department of Psychology, Hunan Normal University, Changsha, Hunan, China
| | - Qinghua Pan
- Department of Ophthalmology and Otorhinolaryngology, The Second People's Hospital of Xiangtan City, Xiangtan, Hunan, China
| | - Qiuping Tang
- Department of Clinical Psychology, The Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Effectiveness of a Mindfulness-Based Group Intervention for Chinese University Students with Sleep Problems. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020755. [PMID: 35055577 PMCID: PMC8775412 DOI: 10.3390/ijerph19020755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/29/2021] [Accepted: 01/06/2022] [Indexed: 11/17/2022]
Abstract
The increasing prevalence of sleep disorders among university students should be taken seriously. Group counseling involving a mindfulness-based strategy may help prevent students from developing insomnia and subsequent mental health disorders. This study aimed to evaluate the ameliorating effects of a mindfulness-based group intervention on sleep problems and emotional symptoms in university students in China. Twenty-one university students (16 females, 22.71 ± 4.28 years) who were not on medication were recruited and assigned to the intervention group based on the criterion of high levels of sleep problems. Additionally, twenty-four university students (19 females, 24.50 ± 0.93 years) were included as a nonrandomized control group. Individuals in the intervention group participated in a two-hour group intervention once a week for eight sessions. All participants completed self-reported questionnaire baseline tests, postintervention tests, and one-month follow-ups on mindfulness, sleep quality, anxiety and depressive symptoms. Repeated-measures ANOVA was performed. The results revealed significant intervention effects, with significant differences observed between the two groups in mindfulness and sleep quality. However, there was no significant effect of the intervention on anxiety and depressive symptoms. This study contributes to a better understanding of the effectiveness of mindfulness-based intervention in addressing sleep problems in university students.
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Mindfulness-Based Strategies for Improving Sleep in People with Psychiatric Disorders. Curr Psychiatry Rep 2022; 24:645-660. [PMID: 36227451 PMCID: PMC9633492 DOI: 10.1007/s11920-022-01370-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 01/29/2023]
Abstract
PURPOSE OF THE REVIEW To review the recent literature on mindfulness-based strategies for improving self-report and objective measures of sleep, in individuals with psychiatric disorders. RECENT FINDINGS Currently, research provides some support for the use of mindfulness-based interventions to improve sleep amongst individuals with psychiatric comorbidities. The strongest evidence was for the use of standardized programs, particularly for improving sleep in anxiety and depressive disorders. There is a paucity of well-controlled studies using validated subjective or objective measures of sleep. As these interventions were not specifically designed to target sleep, observed improvements may be an indirect consequence of reduced psychiatric symptoms. There is insufficient research into the application of mindfulness-based strategies to improve sleep or treat sleep disorders in people with psychiatric disorders. Well-controlled studies using standardized, mindfulness-based interventions developed to target sleep, such as mindfulness-based therapy for insomnia, may optimize the potential benefits of mindfulness for sleep in psychiatric populations.
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Using Actigraphy and Heart Rate Variability (HRV) to Assess Sleep Quality and Sleep Arousal of Three App-Based Interventions: Sleep Music, Sleepcasts, and Guided Mindfulness. JOURNAL OF COGNITIVE ENHANCEMENT 2021. [DOI: 10.1007/s41465-021-00233-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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31
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Schuman-Olivier Z, Trombka M, Lovas DA, Brewer JA, Vago DR, Gawande R, Dunne JP, Lazar SW, Loucks EB, Fulwiler C. Mindfulness and Behavior Change. Harv Rev Psychiatry 2021; 28:371-394. [PMID: 33156156 PMCID: PMC7647439 DOI: 10.1097/hrp.0000000000000277] [Citation(s) in RCA: 82] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/22/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023]
Abstract
Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.
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3-Doors Compassion Project: Examining the longitudinal effects of a nine-month Tibetan mind-body meditation program. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-02292-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
AbstractAbundant research supports the benefits of participating in mindfulness meditation training programs including Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy. However, these well researched programs include a narrow range of meditation practices and research to date has minimally examined how home practice associates with favorable outcomes. The present study evaluated the 3 Doors Compassion Project (3DCP), a structured 9-months meditation program that teaches Tibetan Mind-Body practices and examined how frequency and duration of home practice associated with favorable outcomes. Twenty-seven medical and mental healthcare professionals completed assessments prior to, during, and following participation in the 3DCP program and recorded daily meditation practices. Study aims were to test general effectiveness of the 3DCP program and to test the hypotheses that frequency and duration of meditation home-practice would associate with improvements on mindfulness, stress, and depression. General linear mixed modeling demonstrated significant improvements throughout the duration of the 3DCP program for mindfulness, depression (p < .001) and stress (p < .05), with each variable evidencing incremental monthly improvements. Frequency of meditation (i.e., days practiced per month), but not time (i.e., minutes per month) was significantly associated with improvements throughout the 3DCP program. Results provide support for the benefits of the 3DCP while offering clinically useful information that can inform current guidelines for meditation home practice. As predicted, the 3DCP was associated with significant improvements on all outcomes. Favorable outcomes were linked to frequency, but not total time of meditation practice, which suggests that consistent meditation may be more helpful than extended meditation.
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Diachenko M, Smith KK, Fjorback L, Hansen NV, Linkenkaer-Hansen K, Pallesen KJ. Pre-retirement Employees Experience Lasting Improvements in Resilience and Well-Being After Mindfulness-Based Stress Reduction. Front Psychol 2021; 12:699088. [PMID: 34335417 PMCID: PMC8321239 DOI: 10.3389/fpsyg.2021.699088] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 06/17/2021] [Indexed: 01/07/2023] Open
Abstract
The socio-economic benefits of interventions to prevent stress and related mental health problems are enormous. In the labor market, it is becoming desirable to keep employees for as long as possible. Since aging implies additional stressors such as increased risk of illness, and added pressure by professional tasks such as transferring knowledge, or learning new technologies, it is of particular relevance to offer stress-reduction to pre-retirement employees. Here, we report the effects of an eight-week Mindfulness-Based Stress Reduction (MBSR) intervention on mental well-being in 60-65-year-old work-active Danish employees, compared to a waiting-list control group. We observed improvements in resilience (Brief Resilience Scale) and mental well-being (WHO-5) not only at the end of the intervention, but also at the 12-month follow-up measurement that was preceded by monthly booster sessions. Interestingly, whereas well-being usually refers to experiences in the past weeks or months, we observed increasing Comfort in the MBSR-intervention group during a 5-minute eyes-closed rest session suggesting that this therapeutic effect of MBSR is measurable in how we feel even during short periods of time. We argue that MBSR is a cost-effective intervention suited for pre-retirement employees to cultivate resilience to prevent stress, feel more comfortable with themselves, maintain a healthy work-life in the last years before retirement, and, potentially, stay in their work-life a few more years than originally planned.
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Affiliation(s)
- Marina Diachenko
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, (CNCR), Amsterdam, Neuroscience, VU Amsterdam, Amsterdam, Netherlands
| | - Kristina K Smith
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, (CNCR), Amsterdam, Neuroscience, VU Amsterdam, Amsterdam, Netherlands
| | - Lone Fjorback
- Danish Center for Mindfulness, Department of Clinical Medicine, Aarhus University, Brabrand, Denmark
| | - Niels Viggo Hansen
- Danish Center for Mindfulness, Department of Clinical Medicine, Aarhus University, Brabrand, Denmark
| | - Klaus Linkenkaer-Hansen
- Department of Integrative Neurophysiology, Center for Neurogenomics and Cognitive Research, (CNCR), Amsterdam, Neuroscience, VU Amsterdam, Amsterdam, Netherlands
| | - Karen Johanne Pallesen
- Danish Center for Mindfulness, Department of Clinical Medicine, Aarhus University, Brabrand, Denmark
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Mathews G, Anderson C. The Lived Experience of Learning Mindfulness as Perceived by People Living With Long-Term Conditions: A Community-Based, Longitudinal, Phenomenological Study. QUALITATIVE HEALTH RESEARCH 2021; 31:1209-1221. [PMID: 33739175 PMCID: PMC8182297 DOI: 10.1177/1049732321997130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
While a considerable research base demonstrates the positive effects of 8-week secular mindfulness courses, it remains unclear to what degree their participants continue to engage with mindfulness practices; and there is a dearth of published reports on longer-term mindfulness interventions. Studies have also tended to focus on clinical "effectiveness," with less attention given to participants' own construal and expectations of mindfulness. To address these gaps, the study reported here implemented a year-long mindfulness program for a group of 20 individuals with long-standing health conditions who gradually transitioned to self-guiding. Their experiences, expectations, and understanding of mindfulness were investigated through the lens of descriptive phenomenology. The findings revealed that mindfulness practice did bring therapeutic improvement but that it was a multi-faceted process where an individual's intentionality toward practice was key, with a clear division between those pursuing an "embodied integrated" mindfulness and those viewing it as a stress management tool.
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Tai Y, Obayashi K, Yamagami Y, Yoshimoto K, Kurumatani N, Nishio K, Saeki K. Hot-water bathing before bedtime and shorter sleep onset latency are accompanied by a higher distal-proximal skin temperature gradient in older adults. J Clin Sleep Med 2021; 17:1257-1266. [PMID: 33645499 DOI: 10.5664/jcsm.9180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES Passive body heating in controlled settings could shorten sleep onset latency (SOL). The hypothesized mechanism is vasodilation-induced heat loss before bedtime. However, this evidence is based on small sample-sized studies in specific populations. Thus, we analyzed the association of hot-water bathing and its before-bedtime timing with SOL and heat loss in a large study population of older adults. METHODS We conducted a longitudinal analysis using repeated measurements of hot-water bathing and sleep among 1,094 older adults (mean age, 72.0 years). SOL was recorded using actigraphy and self-reported sleep estimates and was categorized into conditions (intervals of 1-60, 61-120, 121-180, and > 181 minutes between hot bath and bedtime) and compared with the control condition of no bathing. The heat-loss indicator, distal-proximal skin temperature gradient, was examined in the same categorization. RESULTS Mixed-effects linear regression models suggested that the bathing conditions of 61-120 minutes and 121-180 minutes showed significantly shorter log-transformed actigraphic SOL by 0.23 log-minutes (95% confidence interval (CI), 0.03-0.42) and 0.32 log-minutes (95% CI, 0.09-0.56), shorter self-reported SOL by 0.16 log-minutes (95% CI, 0.02-0.30) and 0.18 log-minutes (95% CI, 0.01-0.35), and higher distal-proximal skin temperature gradient for 30 minutes before bedtime by 0.49°C (95% CI, 0.22-0.75) and 0.51°C (95% CI, 0.20-0.83), respectively, independent of potential confounders. CONCLUSIONS Hot-water bathing before bedtime is significantly associated with shorter SOL and higher distal-proximal skin temperature gradient among the large-scale older population. This finding could enhance the generalizability of hot-water bathing habits for ameliorating sleep initiation difficulty.
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Affiliation(s)
- Yoshiaki Tai
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan.,Department of General Medicine, Nara Medical University School of Medicine, Nara, Japan
| | - Kenji Obayashi
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Yuki Yamagami
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kiyomi Yoshimoto
- Department of General Medicine, Nara Medical University School of Medicine, Nara, Japan
| | - Norio Kurumatani
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
| | - Kenji Nishio
- Department of General Medicine, Nara Medical University School of Medicine, Nara, Japan
| | - Keigo Saeki
- Department of Epidemiology, Nara Medical University School of Medicine, Nara, Japan
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Singleterry LR, Caulfield SL. Holistic Approaches to Support Sleep in the Intensive Care Unit Patient. Crit Care Nurs Clin North Am 2021; 33:131-144. [PMID: 34023081 DOI: 10.1016/j.cnc.2021.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Sleep disruption in intensive care unit patients has internal, interpersonal, behavioral, and environmental factors to consider when developing sleep promotion protocols. Holistic approaches are integrative practices that go beyond modifying environmental factors. This article presents 3 holistic approaches that are cost-effective, easy to use, and independent nursing actions that are integrative in nature. Aromatherapy, guided imagery, and mindfulness show promising effects in the literature to improve comfort, anxiety and stress, which are thought to improve sleep.
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Affiliation(s)
- Lisa R Singleterry
- Bronson School of Nursing, Western Michigan University, 1903 W. Michigan Avenue, Kalamazoo, MI 49008, USA.
| | - Susan L Caulfield
- School of Interdisciplinary Health Programs, Western Michigan University, 1903 W. Michigan Avenue, Kalamazoo, MI 49008, USA
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Di Leone A, Terribile D, Magno S, Sanchez AM, Scardina L, Mason EJ, D’Archi S, Maggiore C, Rossi C, Di Micco A, Carnevale S, Paris I, Marazzi F, Masiello V, Orlandi A, Palazzo A, Fabi A, Masetti R, Franceschini G. Neoadjuvant Chemotherapy in Breast Cancer: An Advanced Personalized Multidisciplinary Prehabilitation Model (APMP-M) to Optimize Outcomes. J Pers Med 2021; 11:324. [PMID: 33919061 PMCID: PMC8143137 DOI: 10.3390/jpm11050324] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/12/2021] [Indexed: 01/01/2023] Open
Abstract
Neoadjuvant chemotherapy is increasingly being employed in the management of breast cancer patients. Efforts and resources have been devoted over the years to the search for an optimal strategy that can improve outcomes in the neoadjuvant setting. Today, a multidisciplinary approach with the application of evidence-based medicine is considered the gold standard for the improvement of oncological results and patient satisfaction. However, several clinical complications and psychological issues due to various factors can arise during neoadjuvant therapy and undermine outcomes. To ensure that health care needs are adequately addressed, clinicians must consider that women with breast cancer have a high risk of developing "unmet needs" during treatment, and often require a clinical intervention or additional care resources to limit possible complications and psychological issues that can occur during neoadjuvant treatment. This work describes a multidisciplinary model developed at "Fondazione Policlinico Universitario Agostino Gemelli" (FPG) in Rome in an effort to optimize treatment, ease the application of evidence-based medicine, and improve patient quality of life in the neoadjuvant setting. In developing our model, our main goal was to adequately meet patient needs while preventing high levels of distress.
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Affiliation(s)
- Alba Di Leone
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Daniela Terribile
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Stefano Magno
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Alejandro Martin Sanchez
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Lorenzo Scardina
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Elena Jane Mason
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Sabatino D’Archi
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Claudia Maggiore
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Cristina Rossi
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Annalisa Di Micco
- Centre of Integrative Oncology—Multidisciplinary Breast Centre—Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (C.M.); (C.R.); (A.D.M.)
| | - Stefania Carnevale
- UOS Psicologia Clinica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Ida Paris
- Department of Woman and Child Health and Public Health, Woman Health Area, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy;
| | - Fabio Marazzi
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (F.M.); (V.M.)
| | - Valeria Masiello
- UOC di Radioterapia Oncologica, Dipartimento di Diagnostica per Immagini, Radioterapia Oncologica ed Ematologia, Fondazione Policlinico Universitario A. Gemelli I RCCS, 00168 Rome, Italy; (F.M.); (V.M.)
| | - Armando Orlandi
- Comprehensive Cancer Center, Multidisciplinary Breast Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.O.); (A.P.)
| | - Antonella Palazzo
- Comprehensive Cancer Center, Multidisciplinary Breast Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli, 8, 00168 Rome, Italy; (A.O.); (A.P.)
| | - Alessandra Fabi
- Medicina di Precisione in Senologia, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy;
| | - Riccardo Masetti
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
| | - Gianluca Franceschini
- Multidisciplinary Breast Centre, Dipartimento Scienze della Salute della Donna e del Bambino e di Sanità Pubblica, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00168 Rome, Italy; (D.T.); (S.M.); (A.M.S.); (L.S.); (E.J.M.); (S.D.); (R.M.); (G.F.)
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Kim HG. Effects and mechanisms of a mindfulness-based intervention on insomnia. Yeungnam Univ J Med 2021; 38:282-288. [PMID: 33440465 PMCID: PMC8688792 DOI: 10.12701/yujm.2020.00850] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 01/07/2023] Open
Abstract
Medication alone is not sufficient to treat insomnia. In addition, the side effects of sleep medications themselves cannot be ignored during treatment. Insomnia begins with poor sleep quality and discomfort, but as it continues, patients fall into a vicious circle of insomnia with negative thoughts and dysfunctional and distorted perceptions related to sleep. Mindfulness-based intervention for insomnia corrects these sequential cognitive and behavioral processes. The mindfulness technique basically recognizes all the thoughts, feelings, and experiences that occur to us as they are, nonjudgmentally, and then trains them to return to the senses of our body. In this way, while noticing all the processes of the sequential vicious cycle and training them to return to our bodies (e.g., breathing), mindfulness determines whether we are really sleepy or just fatigued. This mindfulness-based intervention can be a useful nonpharmaceutical intervention for insomnia, and its stability and efficacy has been proven by many studies.
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Affiliation(s)
- Hye-Geum Kim
- Department of Psychiatry, Yeungnam University College of Medicine, Daegu, Korea
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Chan NY, Chan JWY, Li SX, Wing YK. Non-pharmacological Approaches for Management of Insomnia. Neurotherapeutics 2021; 18:32-43. [PMID: 33821446 PMCID: PMC8116473 DOI: 10.1007/s13311-021-01029-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 02/06/2023] Open
Abstract
Insomnia is a prevalent sleep problem associated with a constellation of negative health-related outcomes and significant socioeconomic burden. It commonly co-occurs with psychiatric and medical conditions, which may further exacerbate these comorbid conditions and hinder treatment response. There is much empirical evidence to support the clinical efficacy of non-pharmacological treatment for insomnia, especially cognitive behavioral therapy for insomnia (CBT-I), in managing insomnia in a wide range of populations. This article reviews the research on the efficacy of CBT-I for primary insomnia and insomnia comorbid with other psychiatric and medical conditions, the empirical evidence regarding different CBT-I treatment modalities, the implementation of CBT-I across different age groups, and some initial evidence on the sequential combination of insomnia treatments. A brief overview of other non-pharmacological treatment with regard to complementary alternative medicine is also provided.
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Affiliation(s)
- Ngan Yin Chan
- Li Chiu Kong Family Sleep Assessment Unit, Departments of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Joey Wing Yan Chan
- Li Chiu Kong Family Sleep Assessment Unit, Departments of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Shirley Xin Li
- Department of Psychology, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pokfulam, Hong Kong SAR, China.
| | - Yun Kwok Wing
- Li Chiu Kong Family Sleep Assessment Unit, Departments of Psychiatry, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China.
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Rossi C, Maggiore C, Rossi MM, Filippone A, Guarino D, Di Micco A, Forcina L, Magno S. A Model of an Integrative Approach to Breast Cancer Patients. Integr Cancer Ther 2021; 20:15347354211040826. [PMID: 34670415 PMCID: PMC8543635 DOI: 10.1177/15347354211040826] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 07/09/2021] [Accepted: 08/03/2021] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Breast cancer (BC) survivors have physical and psychological needs that require convincing responses by health care providers. The quality of life issue and clinical unmet needs are among the main reasons pushing a number of patients toward "natural" therapies that are often misleading and alternative to mainstream cancer care. Integrative Oncology (IO) tries to respond to many of those needs, by combining lifestyle counseling, body-mind activities, and complementary evidence-informed therapies with anticancer standard treatments. METHODS In our model at Fondazione Policlinico Gemelli (FPG), every woman diagnosed with a BC waiting for surgery or candidate to neoadjuvant chemotherapy undergoes a preliminary psycho-oncological distress evaluation and a brief lifestyle interview. Anthropometric measurements, body composition analysis, and individual levels of physical activity are recorded. Patients are given evidence based recommendations about the advisable diet and physical activity in a prehabilitation setting. A physician provides patients with information about integrative care plans to treat symptoms related to the disease or its treatments. Therapeutic approaches include acupuncture, mindfulness-based protocols, qigong, massage therapy, and classes of music/art therapy. RESULTS Between September 2018 and February 2020, the Center for Integrative Oncology at FPG has carried out 1249 lifestyle counseling sessions, 1780 acupuncture treatments, 1340 physiotherapy sessions, 3261 psycho-oncological consultations, 218 herbal medicine counseling sessions. Moreover, 90 BC patients completed the mindfulness based stress reduction (MBSR) protocol and 970 patients participated in qigong, art therapy, and music therapy classes. CONCLUSIONS Our integrative approach aims to achieve a person-centered medicine by improving symptoms management, adherence to oncological protocols, and eventually overall quality of life.
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Affiliation(s)
- Cristina Rossi
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Claudia Maggiore
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maria Maddalena Rossi
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Alessio Filippone
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Donatella Guarino
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Annalisa Di Micco
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Luana Forcina
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Stefano Magno
- Center for Integrative Oncology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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El Rafihi-Ferreira R, Morin CM, Toscanini AC, Lotufo Neto F, Brasil IS, Gallinaro JG, Borges DS, Conway SG, Hasan R. Acceptance and commitment therapy-based behavioral intervention for insomnia: a pilot randomized controlled trial. ACTA ACUST UNITED AC 2020; 43:504-509. [PMID: 33331495 PMCID: PMC8555642 DOI: 10.1590/1516-4446-2020-0947] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 10/08/2020] [Indexed: 11/21/2022]
Abstract
Objective: To evaluate a protocol for acceptance and commitment therapy-based behavioral intervention for insomnia (ACT-BBI-I) in adults compared to cognitive behavioral therapy for insomnia (CBT-I). Methods: Forty-five adults with chronic insomnia were randomized to ACT-BBI-I or CBT-I. Both interventions were performed in six weekly group sessions. The common treatment elements in both protocols included stimulus control and sleep restriction. CBT-I is focused on the cognitive restructuring of maladaptive beliefs about sleep and the daytime effects of insomnia. ACT-BBI-I focuses on therapeutic processes of acceptance, availability, values, defusion, and commitment. The results were evaluated through the following instruments: a sleep diary, the Insomnia Severity Index, the Epworth Sleepiness Scale, the Hospital Anxiety and Depression Scale, the Acceptance and Action Questionnaire-II, and the Dysfunctional Beliefs and Attitudes about Sleep scale. Results: Both interventions had a significant positive impact on sleep patterns, insomnia, anxiety, beliefs about sleep, and psychological flexibility. All improvement was maintained at the 6-month follow-up. Conclusion: The results suggest that integrating principles of ACT with behavioral techniques may be useful for treating insomnia. Further research should identify whether the principles of ACT result in added effectiveness compared to behavioral components alone. Clinical trial registration: RBR-7nc5wq
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Affiliation(s)
- Renatha El Rafihi-Ferreira
- Ambulatório de Sono, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Charles M Morin
- École de Psychologie, Université Laval, Sainte-Foy, Québec, Canada
| | - Andrea C Toscanini
- Ambulatório de Sono, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Francisco Lotufo Neto
- Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, USP, São Paulo, SP, Brazil
| | - Israel S Brasil
- Ambulatório de Sono, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - João G Gallinaro
- Ambulatório de Sono, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Daniel Suzuki Borges
- Ambulatório de Sono, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Silvia G Conway
- Ambulatório de Sono, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
| | - Rosa Hasan
- Ambulatório de Sono, Instituto de Psiquiatria, Hospital das Clínicas, Faculdade de Medicina, Universidade de São Paulo (USP), São Paulo, SP, Brazil
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Kirk U, Axelsen JL. Heart rate variability is enhanced during mindfulness practice: A randomized controlled trial involving a 10-day online-based mindfulness intervention. PLoS One 2020; 15:e0243488. [PMID: 33332403 PMCID: PMC7746169 DOI: 10.1371/journal.pone.0243488] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 11/23/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES The goal of the present study was to probe the effects of mindfulness practice in a naturalistic setting as opposed to a lab-based environment in the presence of continuous heart rate variability (HRV) measurements. The specific experimental goals were to examine the effects of a brief 10-day online-based mindfulness intervention on both chronic and acute HRV responses. METHOD We conducted a fully randomized 10-day longitudinal trial of mindfulness practice, explicitly controlling for practice effects with an active-control group (music listening) and a non-intervention control group. To assess chronic cardiovascular effects, we asked participants in the 3 groups to complete 2-day HRV pre- and post-intervention measurement sessions. Using this experimental setup enabled us to address training effects arising from mindfulness practice to assess physiological impact on daytime as well as nighttime (i.e. assessing sleep quality) on the underlying HRV response. To assess acute cardiovascular effects, we measured HRV in the 2 active intervention groups during each of the 10 daily mindfulness or music sessions. This allowed us to track the development of purported training effects arising from mindfulness practice relative to the active-control intervention in terms of changes in the HRV slope over the 10-day time-course. RESULTS Firstly, for the acute phase we found increased HRV during the daily practice sessions in both the mindfulness and active-control group indicating that both interventions were effective in decreasing acute physiological stress. Secondly, for the chronic phase we found increased HRV in both the day- and nighttime indicating increased sleep quality, specifically in the mindfulness group. CONCLUSION These results suggest causal effects in both chronic and acute phases of mindfulness practice in formerly naïve subjects and provides support for the argument that brief online-based mindfulness interventions exert positive impact on HRV.
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Affiliation(s)
- Ulrich Kirk
- Department of Psychology, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Johanne L. Axelsen
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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Mindfulness and Behaviour Therapy for Insomnia: An Assessment of Treatment Effect in a Sleep Disorders Clinic Population with Insomnia. BEHAVIOUR CHANGE 2020. [DOI: 10.1017/bec.2020.18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractInsomnia is a common major health concern, which causes significant distress and disruption in a person's life. The objective of this paper was to evaluate a 6-week version of Mindfulness-Based Therapy for Insomnia (MBTI) in a sample of people attending a sleep disorders clinic with insomnia, including those with comorbidities. Thirty participants who met the DSM-IV-TR diagnosis of insomnia participated in a 6-week group intervention. Outcome measures were a daily sleep diary and actigraphy during pre-treatment and follow-up, along with subjective sleep outcomes collected at baseline, end-of-treatment, and 3-month follow-up. Trend analyses showed that MBTI was associated with a large decrease in insomnia severity (p < .001), with indications of maintenance of treatment effect. There were significant improvements in objective sleep parameters, including sleep onset latency (p = .005), sleep efficiency (p = .033), and wake after sleep onset (p = .018). Significant improvements in subjective sleep parameters were also observed for sleep efficiency (p = .005) and wake after sleep onset (p < .001). Overall, this study indicated that MBTI can be successfully delivered in a sleep disorders clinic environment, with evidence of treatment effect for both objective and subjective measures of sleep.
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Wasson RS, Luberto CM, Murthi M, McDonald SB, Pallerla H, Novak BK, Cotton S. Feasibility and Acceptability of a Community-Based Modified Mindfulness-Based Stress Reduction Program for the Under- and Unemployed. Glob Adv Health Med 2020; 9:2164956120973636. [PMID: 33224634 PMCID: PMC7656859 DOI: 10.1177/2164956120973636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 09/28/2020] [Accepted: 10/22/2020] [Indexed: 11/16/2022] Open
Abstract
Background Mindfulness-Based Stress Reduction (MBSR) often improves health outcomes, though literature primarily focuses on middle-class, employed individuals. With an estimated average of six million unemployed over the past year, and the recent uptick in unemployment due to the COVID-19 pandemic, it is important to identify methods to mitigate and reduce the negative health outcomes often associated with under- and unemployment. Objectives We aimed to 1) outline the process of partnering with a community organization to implement a modified MBSR program for under- and unemployed individuals, and 2) present pilot data on preliminary results. Methods The modified MBSR program was implemented in two phases within a job training program for under- and unemployed individuals. In Phase I, group one received an eight-week program. Based on feedback, the MBSR program was reduced to six weeks and implemented for groups two and three (Phase II). Feasibility and acceptability were evaluated utilizing a mixed-methods approach. Changes in mindfulness, perceived stress, pain interference, anxiety, depression, and sleep disturbance were assessed pre-post the modified MBSR program. Results Thirty-three participants completed the program with twenty-nine post-survey responses. The modified MBSR program was feasible and acceptable as evidenced by the enrollment rate (96%), retention rate (72%), and qualitative feedback. Fifty-percent of participants self-reported weekly home practice compliance. Perceived stress and mindfulness demonstrated significant moderate improvements (d = .69, p = .005; d = .46, p = .001). Depression, anxiety, and pain interference results suggested small non-significant effect size improvements (d = .27, p = .19; d = .23, p = .31; d = .25, p = .07). Effects on fatigue and sleep disturbance were negligible. Conclusion The modified MBSR program was feasible and acceptable to the organization and participants. Small to moderate improvements in mental health and pain interference outcomes were observed. Research using larger sample sizes and randomized designs is warranted.
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Affiliation(s)
- Rachel S Wasson
- Department of Psychology, Bowling Green State University, Bowling Green, Ohio
| | - Christina M Luberto
- Department of Psychiatry, Health Policy Research Center, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Meera Murthi
- Center for Integrative Health and Wellness, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Susan Blocksom McDonald
- Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Harini Pallerla
- Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Brenna K Novak
- Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sian Cotton
- Center for Integrative Health and Wellness, University of Cincinnati College of Medicine, Cincinnati, Ohio.,Department of Family and Community Medicine, Division of Integrative Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio
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Farias M, Maraldi E, Wallenkampf KC, Lucchetti G. Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatr Scand 2020; 142:374-393. [PMID: 32820538 DOI: 10.1111/acps.13225] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/07/2020] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Meditation techniques are widely used as therapy and wellbeing practices, but there are growing concerns about its potential for harm. The aim of the present study is to systematically review meditation adverse events (MAEs), investigating its major clinical categories and its prevalence. METHOD We searched PubMed, PsycINFO, Scopus, Embase and AMED up to October 2019. Eligible studies included original reports of meditation practices (excluding related physical practices such as Yoga postures) with adult samples across experimental, observational and case studies. We identified a total of 6742 citations, 83 of which met the inclusion criteria for MAEs with a total of 6703 participants who undertook meditation practice. RESULTS Of the 83 studies analysed, 55 (65%) included reports of at least one type of MAE. The total prevalence of adverse events was 8.3% (95% CI 0.05-0.12), though this varied considerably across types of studies - 3.7% (95% CI 0.02-0.05) for experimental and 33.2% (95% CI 0.25-0.41) for observational studies. The most common AEs were anxiety (33%, 18), depression (27%, 15) and cognitive anomalies (25%, 14); gastrointestinal problems and suicidal behaviours (both 11%, 6) were the least frequent. CONCLUSION We found that the occurrence of AEs during or after meditation practices is not uncommon, and may occur in individuals with no previous history of mental health problems. These results are relevant both for practitioners and clinicians, and contribute to a balanced perspective of meditation as a practice that may lead to both positive and negative outcomes.
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Affiliation(s)
- M Farias
- Brain, Belief, & Behaviour Lab, CTPSR, Coventry University, Coventry, UK
| | - E Maraldi
- Pontifical Catholic University of São Paulo, São Paulo, Brazil
| | - K C Wallenkampf
- School of Medicine, Loma Linda University, Loma Linda, CA, USA
| | - G Lucchetti
- School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil
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Jones BJ, Kaur S, Miller M, Spencer RMC. Mindfulness-Based Stress Reduction Benefits Psychological Well-Being, Sleep Quality, and Athletic Performance in Female Collegiate Rowers. Front Psychol 2020; 11:572980. [PMID: 33071908 PMCID: PMC7531189 DOI: 10.3389/fpsyg.2020.572980] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 08/21/2020] [Indexed: 12/30/2022] Open
Abstract
Factors such as psychological well-being, sleep quality, and athletic coping skills can influence athletic performance. Mindfulness-based interventions, including mindfulness-based stress reduction (MBSR), have been shown to benefit these factors, suggesting they may, at least indirectly, benefit athletic performance. Moreover, while mindfulness training has been linked to better accuracy in some high-precision sports, whether it can improve non-precision elements of athletic performance is unclear. The objective of this study was to investigate the influence of MBSR on psychological well-being, sleep, athletic coping skills, and rowing performance in collegiate rowers in a controlled experimental design. Members of a Division I NCAA Women's Rowing team completed either an 8-week MBSR course along with their regular athletic training program (Intervention group) or the athletic training program alone (Control group). Measurements of interest were taken at baseline and again either during or shortly following the intervention. In contrast to the Control group, the Intervention group showed improvements in psychological well-being, subjective and objective sleep quality, athletic coping skills, and rowing performance as measured by a 6,000-m ergometer test. Improvements in athletic coping skills, psychological well-being, and subjective sleep quality were all correlated with increases in mindfulness in the Intervention group. These results suggest that mindfulness training may benefit non-precision aspects of athletic performance. Incorporating mindfulness training into athletic training programs may benefit quality of life and performance in student athletes.
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Affiliation(s)
- Bethany J Jones
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, United States.,Neuroscience and Behavior Program, University of Massachusetts, Amherst, MA, United States
| | - Sukhmanjit Kaur
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, United States.,Commonwealth Honors College, University of Massachusetts, Amherst, MA, United States
| | | | - Rebecca M C Spencer
- Department of Psychological and Brain Sciences, University of Massachusetts, Amherst, MA, United States.,Neuroscience and Behavior Program, University of Massachusetts, Amherst, MA, United States
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Low T, Conduit R, Varma P, Meaklim H, Jackson ML. Treating subclinical and clinical symptoms of insomnia with a mindfulness-based smartphone application: A pilot study. Internet Interv 2020; 21:100335. [PMID: 32939342 PMCID: PMC7479350 DOI: 10.1016/j.invent.2020.100335] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 06/08/2020] [Accepted: 06/08/2020] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND/OBJECTIVES Emerging research suggests that face-to-face group mindfulness-based therapies are an effective intervention for insomnia. This pilot study examined the effectiveness of a mindfulness-based smartphone application for improving objectively-measured sleep, self-reported sleep, insomnia severity, pre-sleep arousal and daytime mood. METHOD A community sample of 23 adults with subclinical to moderately severe symptoms of insomnia were randomized to either a mindfulness or progressive muscle relaxation (PMR) smartphone application for 40 or 60 days. Objective sleep outcomes assessed using actigraphy, and self-report measures of total wake time, cognitive and somatic pre-sleep arousal, and daytime positive and negative affect were assessed for 14 nights at baseline and post-intervention. Insomnia severity was recorded at baseline and post-intervention. RESULTS A greater reduction in sleep onset latency was observed in the mindfulness group over time, relative to the PMR group. The mindfulness group also reported medium effect size improvements for sleep efficiency. No significant interaction effects were found for self-reported sleep measures, however, main effects of time were found for both groups for total wake time, insomnia severity, cognitive pre-sleep arousal, and daytime positive and negative affect. CONCLUSIONS These preliminary findings suggest that both mindfulness and PMR smartphone applications have the potential to improve symptoms of insomnia. In particular, this mindfulness-based smartphone application may improve sleep onset latency and reduce the duration of night-awakenings. Further research exploring digital therapeutics as a self-help option for those with insomnia is needed.
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Key Words
- ANOVA, analysis of variance
- ISI, Insomnia Severity Index
- MBSR, mindfulness-based stress reduction
- Mindfulness
- NA, negative affect
- PA, positive affect
- PMR, progressive muscle relaxation
- PSAS (Cog), cognitive subscale of Pre-Sleep Arousal Scale
- PSAS (Som), somatic subscale of Pre-Sleep Arousal Scale
- PSAS, Pre-Sleep Arousal Scale
- Pre-sleep arousal
- Progressive muscle relaxation
- SFI, sleep fragmentation index
- SOL, sleep onset latency
- Sleep
- Smartphone applications
- TIB, time in bed
- TST, total sleep time
- TWT, total wake time
- WASO, wake after sleep onset
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Affiliation(s)
- Tiffany Low
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Russell Conduit
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
| | - Prerna Varma
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Hailey Meaklim
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Melinda L. Jackson
- School of Health and Biomedical Sciences, RMIT University, Melbourne, Australia
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
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48
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Chen TL, Chang SC, Hsieh HF, Huang CY, Chuang JH, Wang HH. Effects of mindfulness-based stress reduction on sleep quality and mental health for insomnia patients: A meta-analysis. J Psychosom Res 2020; 135:110144. [PMID: 32590218 DOI: 10.1016/j.jpsychores.2020.110144] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 05/14/2020] [Accepted: 05/15/2020] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Mindfulness-based stress reduction (MBSR) is a potentially effective supplement for the treatment of insomnia; however, there is no comprehensive review of its mental health effects among insomnia patients. This study aimed to synthesize relevant quantitative evidence and evaluate MBSR application and effectiveness for insomnia patients' sleep quality and mental health. METHODS A systematic search through eight databases from the earliest available dates until August 2019 was conducted. Randomized controlled trials assessing the effects of MBSR on sleep quality, anxiety, and depression as outcome measures among insomnia patients comprising patients aged above 18 years were included in this meta-analysis. Each study's quality was assessed using the modified Jadad quality scale. The Review Manager 5.3 software was used to calculate the standardized mean differences (SMD) with 95% confidence intervals (CIs) for the data analyses. RESULTS In total, data for 497 patients in seven randomized controlled trials were analyzed. The results revealed that compared to the control group, the MBSR group significantly improved in sleep quality (SMD = -0.69, 95% CI: -1.12~ - 0.26, Z = 3.16, p = .002), depression (SMD = -1.83, 95% CI: -2.81-0.84, Z = 3.63, p < .001), and anxiety (SMD = -1.74, 95% CI: -2.90-0.59, Z = 2.96, p = .003). A sensitivity analysis was undertaken. After carefully reviewing included trials, we can reasonably conclude that these heterogeneities did not impair the overall effect size of MBSR in the results. CONCLUSIONS MBSR significantly improved sleep quality and mental health. Future research is needed using standardized methods examining the long-term effects of MBSR on the mental health of individuals with insomnia.
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Affiliation(s)
- Tsai-Ling Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Chen Chang
- Department of Nursing, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsiu-Fen Hsieh
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Chin-Yi Huang
- Research Department, Changhua Christian Hospital, Changhua, Taiwan
| | - Jui-Hsiang Chuang
- Department of Psychiatry, Luckang Christian Hospital, Changhua, Taiwan
| | - Hsiu-Hung Wang
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
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49
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Baglioni C, Bostanova Z, Bacaro V, Benz F, Hertenstein E, Spiegelhalder K, Rücker G, Frase L, Riemann D, Feige B. A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials Evaluating the Evidence Base of Melatonin, Light Exposure, Exercise, and Complementary and Alternative Medicine for Patients with Insomnia Disorder. J Clin Med 2020; 9:E1949. [PMID: 32580450 PMCID: PMC7356922 DOI: 10.3390/jcm9061949] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 06/09/2020] [Accepted: 06/11/2020] [Indexed: 12/15/2022] Open
Abstract
Insomnia is a prevalent disorder and it leads to relevant impairment in health-related quality of life. Recent clinical guidelines pointed out that Cognitive-Behavior Therapy for Insomnia (CBT-I) should be considered as first-line intervention. Nevertheless, many other interventions are commonly used by patients or have been proposed as effective for insomnia. These include melatonin, light exposure, exercise, and complementary and alternative medicine. Evaluation of comparable effectiveness of these interventions with first-line intervention for insomnia is however still lacking. We conducted a systematic review and network meta-analysis on the effects of these interventions. PubMed, PsycInfo, PsycArticles, MEDLINE, and CINAHL were systematically searched and 40 studies were included in the systematic review, while 36 were entered into the meta-analysis. Eight network meta-analyses were conducted. Findings support effectiveness of melatonin in improving sleep-onset difficulties and of meditative movement therapies for self-report sleep efficiency and severity of the insomnia disorder. Some support was observed for exercise, hypnotherapy, and transcranial magnetic resonance, but the number of studies for these interventions is still too small. None of the considered interventions received superior evidence to CBT-I, which should be more widely disseminated in primary care.
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Affiliation(s)
- Chiara Baglioni
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
- Department of Human Sciences, Guglielmo Marconi University, 00193 Rome, Italy;
| | - Zarina Bostanova
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Valeria Bacaro
- Department of Human Sciences, Guglielmo Marconi University, 00193 Rome, Italy;
| | - Fee Benz
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Elisabeth Hertenstein
- University Hospital of Psychiatry and Psychotherapy, University of Bern, 3012 Bern, Switzerland;
| | - Kai Spiegelhalder
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Gerta Rücker
- Institute of Medical Biometry and Statistics, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany;
| | - Lukas Frase
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Dieter Riemann
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
| | - Bernd Feige
- Department of Psychiatry and Psychotherapy, Medical Center, Faculty of Medicine, University of Freiburg, 79104 Freiburg, Germany; (Z.B.); (F.B.); (K.S.); (L.F.); (D.R.); (B.F.)
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50
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Zhao Y, Liu JE, Lewis FM, Nie ZH, Qiu H, Han J, Su YL, Yang SS. Effects of mindfulness-based cognitive therapy on breast cancer survivors with insomnia: A randomised controlled trial. Eur J Cancer Care (Engl) 2020; 29:e13259. [PMID: 32424878 DOI: 10.1111/ecc.13259] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 01/14/2020] [Accepted: 04/16/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE We investigated the effects of mindfulness-based cognitive therapy on insomnia (MBCT-I) in breast cancer survivors. METHODS In total, 136 participants were allocated randomly to a MBCT-I group or a waitlist control (WLC) group. Indicators of insomnia and mindfulness were evaluated using the Insomnia Severity Index, actigraphy and the Five Facet Mindfulness Questionnaire. Data were collected at baseline (T1), post-intervention (T2), 3-month follow-up (T3) and 6-month follow-up (T4) time points. RESULTS Insomnia severity decreased significantly in the MBCT-I group, compared with the WLC group, at T2, T3 and T4 (all p < .001). We found that 59.6% of the MBCT-I group with moderate and severe insomnia improved to no insomnia and subclinical insomnia at T4 relative to T1, accounting for 7.9% and 55.3%, respectively. Compared with the WLC group, the MBCT-I group improved on actigraphy measures of sleep; they exhibited a pattern of decreased sleep onset latency and waking after sleep onset, as well as increased total sleep time and sleep efficiency. Mindfulness also increased more in the MBCT-I group than in the WLC group at T2, T3 and T4 (all p < .001). CONCLUSIONS MBCT-I may be an efficacious non-pharmacologic intervention to improve sleep quality in breast cancer survivors.
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Affiliation(s)
- Yue Zhao
- School of Nursing, Capital Medical University, Beijing, China
| | - Jun-E Liu
- School of Nursing, Capital Medical University, Beijing, China
| | | | - Zhi-Hong Nie
- School of Nursing, Capital Medical University, Beijing, China
| | - Hui Qiu
- School of Nursing, Capital Medical University, Beijing, China
| | - Jing Han
- School of Nursing, Capital Medical University, Beijing, China
| | - Ya-Li Su
- Breast center, Breast Cancer Center, Beijing Tiantan Hospital affiliated to Capital Medical University, Beijing, China
| | - Shen-Shen Yang
- School of Nursing, Capital Medical University, Beijing, China
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