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Pickett SM, Kozak AT, Lanni DJ, Warnke AS, Gaillard P, Jarrett NL. The comparison of brief, online mindfulness and relaxation interventions to reduce stress and improve sleep-related outcomes in college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:1085-1093. [PMID: 35709245 DOI: 10.1080/07448481.2022.2066979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 02/24/2022] [Accepted: 04/10/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The current study aimed to examine whether brief online stress reduction exercises supplemented with sleep improvement strategies would reduce stress, arousal, and sleep difficulties in college students who were not required to use the sleep improvement strategies for participation. PARTICIPANTS A sample of 114 college student participants were enrolled because they were experiencing stress and/or wanted to improve their sleep. METHODS Participants were randomized into an abbreviated progressive muscle relaxation, a mindful breathing, or a self-monitoring control condition for the 4-week intervention. Measures of physical relaxation, mindfulness, perceived stress, pre-sleep arousal, and insomnia symptom severity were collected. RESULTS The APMR group improved on five of the six dependent measures and was significantly different than the SM group at posttest, but not different than the MB group. CONCLUSION The results suggests promise for brief, online, scaled back stress reduction interventions to reduce stress, arousal, and sleep difficulties in college students.
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Affiliation(s)
- Scott M Pickett
- Department of Behavioral Sciences and Social Medicine, College of Medicine, Florida State University, Tallahassee, Florida, USA
| | - Andrea T Kozak
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Daniel J Lanni
- Department of Psychology, Georgia State University, Atlanta, Georgia, USA
| | - Andrew S Warnke
- Department of Psychology, Oakland University, Rochester, Michigan, USA
| | - Philippe Gaillard
- Office of Clinical Research Advancement, Florida State University, Tallahassee, Florida, USA
| | - Nicole L Jarrett
- Department of Psychology, Oakland University, Rochester, Michigan, USA
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2
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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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3
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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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4
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Wang Y, Chen C, Gu L, Zhai Y, Sun Y, Gao G, Xu Y, Pang L, Xu L. Effect of short-term mindfulness-based stress reduction on sleep quality in male patients with alcohol use disorder. Front Psychiatry 2023; 14:928940. [PMID: 36998624 PMCID: PMC10043304 DOI: 10.3389/fpsyt.2023.928940] [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: 04/26/2022] [Accepted: 02/17/2023] [Indexed: 03/15/2023] Open
Abstract
Background Sleep disturbance is one of the most prominent complaints of patients with alcohol use disorder (AUD), with more than 70% of patients with AUD reporting an inability to resolve sleep problems during abstinence. Mindfulness-based stress reduction (MBSR) has been shown to improve sleep quality and as an alternative therapy to hypnotics for sleep disorders. Objective The aim of the present study was to evaluate the effect of short-term MBSR on sleep quality in male patients with AUD after withdrawal. Methods A total of 91 male patients with AUD after 2 weeks of routine withdrawal therapy were randomly divided into two groups using a coin toss: the treatment group (n = 50) and the control group (n = 41). The control group was received supportive therapy, and the intervention group added with MBSR for 2 weeks on the basis of supportive therapy. Objective sleep quality was measured at baseline and 2 weeks after treatment using the cardiopulmonary coupling (CPC). Indicators related to sleep quality include total sleep time, stable sleep time, unstable sleep time, rapid eye movement (REM) sleep time, wake-up time, stable sleep latency, sleep efficiency, and apnea index. These indicators were compared by an analysis of covariance (ANCOVA) between the two groups, controlling for individual differences in the respective measures at baseline. Results The results showed that there were no significant differences in the age [t (89) = -0.541, P = 0.590), BMI [t (89) = -0.925, P = 0.357], educational status [t (89) = 1.802, P = 0.076], years of drinking [t (89) = -0.472, P = 0.638), daily intake [t (89) = 0.892, P = 0.376], types of alcohol [χ2 (1) = 0.071, P = 0.789], scores of CIWA-AR [t (89) = 0.595, P = 0.554], scores of SDS [t (89) = -1.151, P = 0.253), or scores of SAS [t (89) = -1.209, P = 0.230] between the two groups. Moreover, compared with the control group, the total sleep time [F (1.88) = 4.788, P = 0.031) and stable sleep time [F (1.88) = 6.975, P = 0.010] were significantly increased in the treatment group. Furthermore, the average apnea index in the patients who received MBSR was significantly decreased than in the control group [F (1.88) = 5.284, P = 0.024]. Conclusion These results suggest that short-term MBSR could improve sleep quality and may serve as an alternative treatment to hypnotics for sleep disturbance in patients with AUD after withdrawal.
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Affiliation(s)
- Yongmei Wang
- Department of Nursing, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Department of Nursing, Hefei Fourth People's Hospital, Hefei, China
| | - Cuiping Chen
- Department of Nursing, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Department of Nursing, Hefei Fourth People's Hospital, Hefei, China
| | - Lina Gu
- Anhui Mental Health Center, Hefei, China
- Department of Material Dependence, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Material Dependence, Hefei Fourth People's Hospital, Hefei, China
| | - Yi Zhai
- Anhui Mental Health Center, Hefei, China
- Department of Material Dependence, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Material Dependence, Hefei Fourth People's Hospital, Hefei, China
| | - Yanhong Sun
- Anhui Mental Health Center, Hefei, China
- Department of Pharmacy, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Pharmacy, Hefei Fourth People's Hospital, Hefei, China
| | - Guoqing Gao
- Anhui Mental Health Center, Hefei, China
- Department of Material Dependence, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Material Dependence, Hefei Fourth People's Hospital, Hefei, China
| | - Yayun Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei, China
| | - Liangjun Pang
- Anhui Mental Health Center, Hefei, China
- Department of Material Dependence, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Department of Material Dependence, Hefei Fourth People's Hospital, Hefei, China
| | - Lianyin Xu
- Department of Nursing, Affiliated Psychological Hospital of Anhui Medical University, Hefei, China
- Anhui Mental Health Center, Hefei, China
- Department of Nursing, Hefei Fourth People's Hospital, Hefei, China
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Urbanová L, Sebalo Vňuková M, Anders M, Ptáček R, Bušková J. The Updating and Individualizing of Sleep Hygiene Rules for Non-clinical Adult Populations. Prague Med Rep 2023; 124:329-343. [PMID: 38069641 DOI: 10.14712/23362936.2023.26] [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: 12/18/2023] Open
Abstract
Sleep hygiene is essential for the prevention of somatic and mental disorders, including the prevention of sleep disorders. However, it does not typically address individual differences. The aim of this review is threefold: first, to outline the empirical evidence for particular components of sleep hygiene rules; second, to indicate the importance of individualized sleep hygiene application with regard to the varying degree of validity of sleep hygiene rules in the population; third, to highlight a new field of sleep hygiene, namely light hygiene. PubMed and Google Scholar were used to identify studies that were published between 2007 and 2022. A search was conducted for studies related to sleeping rules topics: sleep regularity, regular exercise, alcohol, caffeine, napping, relaxation and meditation, food intake and light exposure. In applying these sleep hygiene principles, it is essential to pay attention to individual variables such as age, genetic predisposition, health status, and substance (caffeine, alcohol) possible dependence.
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Affiliation(s)
- Lucie Urbanová
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic.
| | - Martina Sebalo Vňuková
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Martin Anders
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Radek Ptáček
- Department of Psychiatry, First Faculty of Medicine, Charles University and General University Hospital in Prague, Prague, Czech Republic
| | - Jitka Bušková
- Department of Sleep Medicine, National Institute of Mental Health, Klecany, Czech Republic
- Third Faculty of Medicine, Charles University, Prague, Czech Republic
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6
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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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7
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Ramirez Garcia MP, Leclerc-Loiselle J, Côté J, Brouillette MJ, Thomas R. The process of learning the autogenic training relaxation technique and its benefits on the wellness of people living with HIV. BMC Complement Med Ther 2022; 22:86. [PMID: 35331226 PMCID: PMC8953141 DOI: 10.1186/s12906-022-03557-6] [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] [Received: 09/28/2020] [Accepted: 03/08/2022] [Indexed: 11/16/2022] Open
Abstract
Background Various mind-body practices are used by people living with HIV to promote their general well-being. Among these is autogenic training (AT), a self-guided relaxation technique requiring regular practice for observable benefits. However, little has been written about the process of learning this technique, which is obviously a prerequisite to regular practice. This study therefore aims to describe the process by which people living with HIV learn AT. Methods The study is a descriptive qualitative study using semi-structured interviews and a thematic analysis with a mixed approach. Fourteen participants living with HIV completed sessions to learn autogenic training over a period of 3 months. Results The process of learning AT was approached through three themes: initiating the learning process, taking ownership of the technique, and observing its benefits on wellness. To initiate learning, participants had to express a need to take action on an aspect of their well-being and their openness to complementary approaches to care. Taking ownership of the technique was facilitated by guidance from the nurse researcher, the participants’ personal adaptations to overcome barriers to their practice, regular practice, and rapid observation of its benefits. Finally, the participants reported the observation of benefits on their wellness, including personal development, mainly in terms of the creative self, the essential self, and the coping self. This perception of the technique’s benefits was part of the learning process, as it contributed both to the participants’ ownership of the technique and to reinforcing their AT practice. Conclusions People living with HIV see learning AT as a progressive process, in which wellness is a major outcome and a contributing factor in developing a regular practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-022-03557-6.
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Affiliation(s)
- Maria Pilar Ramirez Garcia
- Faculty of Nursing, Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Research Center of the Centre Hospitalier de l'Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada. .,Quebec Nursing Intervention Research Network (RRISIQ), Quebec, QC, Canada.
| | - Jérôme Leclerc-Loiselle
- Faculty of Nursing, Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada
| | - José Côté
- Faculty of Nursing, Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada.,Research Center of the Centre Hospitalier de l'Université de Montréal, P. 6128, succ. Centre-Ville, Montréal, QC, H3C 3J7, Canada.,Quebec Nursing Intervention Research Network (RRISIQ), Quebec, QC, Canada
| | - Marie-Josée Brouillette
- Department of Psychiatry, McGill University, Montréal, QC, Canada.,AIDS and Infectious Disease Network (SIDA-MI), Quebec, Canada
| | - Réjean Thomas
- AIDS and Infectious Disease Network (SIDA-MI), Quebec, Canada.,Clinique médicale l'Actuel, Montréal, Québec, Canada
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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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9
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Razzera BN, Adamoli AN, Ranheiri MF, Oliveira MDS, Feoli AMP. Impacts of mindfulness-based interventions in people undergoing hemodialysis: a systematic review. ACTA ACUST UNITED AC 2021; 44:84-96. [PMID: 34643641 PMCID: PMC8943880 DOI: 10.1590/2175-8239-jbn-2021-0116] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 08/01/2021] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Chronic kidney disease (CKD) is a serious public health problem worldwide, leading to a series of physical and psychological comorbidities, in addition to costly treatments, lifestyle and dietary restrictions. There is evidence that mindfulness-based interventions (MBIs) offer complementary treatment for people with chronic illnesses, including CKD, with the aim of improving overall health, reducing side effects and treatment costs. This review aims to investigate the MBIs impact on people with CKD undergoing hemodialysis, and to identify the methodological quality of the current literature in order to support future studies. METHODS We ran searches in five databases (MEDLINE via PubMed, PsycINFO, Embase, Web of Science and Scopus) in July 2020. The papers were selected and evaluated by two reviewers independently, using predefined criteria, including the Cochrane Group's risk of bias tool and its recommendations (CRD42020192936). RESULTS Of the 175 studies found, 6 randomized controlled trials met the inclusion criteria, and ranged from 2014 to 2019. There were significant improvements in symptoms of anxiety, depression, self-efficacy, sleep quality, and quality of life (n=3) in the groups submitted to the intervention, in addition to physical measures such as blood pressure, heart rate and respiratory rate (n=1). CONCLUSIONS MBIs can offer a promising and safe complementary therapy for people with CKD undergoing hemodialysis, acting on quality of life and physical aspects of the disease.
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Affiliation(s)
- Bruno Nunes Razzera
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Saúde e da Vida, Programa de Pós-Graduação em Psicologia, Porto Alegre, RS, Brasil
| | - Angélica Nickel Adamoli
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Saúde e da Vida, Programa de Pós-Graduação em Psicologia, Porto Alegre, RS, Brasil.,Hospital de Clínicas de Porto Alegre, Serviço de Educação Física e Terapia Ocupacional de Nefrologia, Porto Alegre, RS, Brasil
| | - Maitê Freitas Ranheiri
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Saúde e da Vida, Programa de Pós-Graduação em Psicologia, Porto Alegre, RS, Brasil
| | - Margareth da Silva Oliveira
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Saúde e da Vida, Programa de Pós-Graduação em Psicologia, Porto Alegre, RS, Brasil
| | - Ana Maria Pandolfo Feoli
- Pontifícia Universidade Católica do Rio Grande do Sul, Escola de Ciências da Saúde e da Vida, Programa de Pós-Graduação em Psicologia, Porto Alegre, RS, Brasil
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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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Barros VV, Opaleye ES, Demarzo M, Curado DF, Bowen S, Hachul H, Noto AR. Effects of Mindfulness-Based Relapse Prevention on the Chronic use of Hypnotics in Treatment-Seeking Women with Insomnia: a Randomized Controlled Trial. Int J Behav Med 2021; 29:266-277. [PMID: 34013489 DOI: 10.1007/s12529-021-10002-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/10/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hypnotics are one of the most frequently prescribed drugs worldwide, especially for women, and their chronic use may lead to tolerance, dosage escalation, dependence, withdrawal syndrome, and cognitive impairments, representing a significant public health problem. Consistent evidence from previous studies shows benefits of mindfulness-based interventions (MBIs) for substance use disorders (SUD) and insomnia. However, to date, there is a lack of research about effects of MBIs on reduction/cessation of chronic hypnotic use among women with insomnia. METHOD The present randomized trial evaluated the efficacy of the 8-week group-delivered mindfulness-based relapse prevention (MBRP) program in an intervention group (IG, n = 34) compared with weekly phone monitoring only in the control group (CG, n = 36) in reducing hypnotic use and insomnia severity over a 6-month follow-up period. RESULTS There were significant differences between groups at baseline regarding hypnotic use but not insomnia. Group effects on hypnotic use were found immediately after the intervention (bT1 = 2.01, p < 0.001) and at the 2-month follow-up (bT2 = 2.21, p < 0.001), favoring the IG. The IG also had a greater reduction from baseline levels than the control group in insomnia severity at the 4-month (bT3 = 0.21, p = 0.045) and 6-month (bT4 = 0.32, p = 0.002) follow-ups. CONCLUSIONS The findings provide preliminary evidence of benefits of MBRP for reducing insomnia severity and potentially chronic hypnotic use. However, IG effects on chronic hypnotic use may have resulted from IG and control group differences in chronic hypnotic use at baseline. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT02127411.
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Affiliation(s)
- Viviam Vargas Barros
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center of Research and Training on Mindfulness-Based Relapse Prevention -Departamento de Psicobiologia, Universidade Federal de São Paulo Rua Botucatu, 862, 1st floor, Vila Clementino, 04,023-062, Sao Paulo, SP, Brazil.
| | - Emérita Sátiro Opaleye
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center of Research and Training on Mindfulness-Based Relapse Prevention -Departamento de Psicobiologia, Universidade Federal de São Paulo Rua Botucatu, 862, 1st floor, Vila Clementino, 04,023-062, Sao Paulo, SP, Brazil
| | - Marcelo Demarzo
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion, Departmento de Medicina Preventiva Universidade Federal de São Paulo Avenida Padre José Maria, 545, Santo Amaro, 04,753-060, Sao Paulo, SP, Brazil.,Hospital Israelita Albert Einstein Avenida Albert Einstein, 627/701, Morumbi, 05,652-900, Sao Paulo, SP, Brazil
| | - Daniela Fernández Curado
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center of Research and Training on Mindfulness-Based Relapse Prevention -Departamento de Psicobiologia, Universidade Federal de São Paulo Rua Botucatu, 862, 1st floor, Vila Clementino, 04,023-062, Sao Paulo, SP, Brazil
| | - Sarah Bowen
- Psychology Department, School of Health Professions Pacific University, 190 SE 8th Ave, Ste 260, 97,123, Hillsboro, OR, USA
| | - Helena Hachul
- Departamento de Psicobiologia Universidade Federal de São Paulo Rua Botucatu, 862, 1st floor, Vila Clementino, 04,023-062, Sao Paulo, SP, Brazil.,Departamento de Ginecologia Universidade Federal de São Paulo Rua Napoleão de Barros, 608, Vila Clementino, 04,024-002, Sao Paulo, SP, Brazil.,Departamento de Ginecologia Casa de Saúde Santa Marcelina Rua Santa Marcelina, 91, Itaquera, Sao Paulo, SP, 08,270-070, Brazil
| | - Ana Regina Noto
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center of Research and Training on Mindfulness-Based Relapse Prevention -Departamento de Psicobiologia, Universidade Federal de São Paulo Rua Botucatu, 862, 1st floor, Vila Clementino, 04,023-062, Sao Paulo, SP, Brazil
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Virtual Focus Groups as an Answer to Research During a Pandemic: Implications for Nursing Professional Development. J Nurses Prof Dev 2021; 38:279-286. [PMID: 33935191 DOI: 10.1097/nnd.0000000000000750] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Focus groups are a standard method of qualitative data collection and an excellent method for data collection in nursing professional development. Advances in technology, virtual health care, and the COVID-19 pandemic increase the opportunities to use virtual focus groups for rich data collection. In this perspective article, the authors promote virtual focus groups as an answer to challenging data collection, while exploring ways that privacy and confidentiality can be maintained in an online environment.
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Batalla-Martín D, Martorell-Poveda MA, Belzunegui-Eraso A, Miralles Garijo E, Del-Cuerpo Serratosa A, Valdearcos Pérez J, Montané Escobar M, Lopez-Ruiz M. The Experience of Insomnia in Patients With Schizophrenic Disorder: A Qualitative Study. Front Psychiatry 2021; 12:805601. [PMID: 35111091 PMCID: PMC8801919 DOI: 10.3389/fpsyt.2021.805601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/23/2021] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Insomnia is a health problem that particularly affects people with schizophrenia. Its repercussions go beyond the disorder itself and affect many areas of life. The aim of the present study is to explore the clinical symptoms and consequences of insomnia in patients diagnosed with schizophrenic disorder and the perceptions of these patients regarding the care they receive. METHODS The study takes a qualitative approach and uses semi-structured interviews to conduct a descriptive and interpretive analysis of 3 clinically different clusters of patients. These 3 clusters have been defined by using two-step cluster analysis based on the results of the ISI (Insomnia Severity Index) and EQ-5D scales (EuroQol-5D) and the presence of certain diagnostic symptoms in a sample of 170 patients. The final sample was 31 subjects. The analysis was based on a hermeneutic analysis of the patients' narratives regarding their experiences of insomnia. RESULTS The patients' narratives show differences in the intensity and experience of insomnia depending on the severity, as well as its impact on their quality of life. Insomnia has a huge emotional impact. Participants describe ruminations and obsessive thoughts as a key factor hindering falling asleep. Some of the everyday actions they perform encourage the chronicity of insomnia. The desired health response must include interventions that are effective, such as cognitive-behavioural therapy, and powerful, such as pharmacological solutions. Psychoeducation and advice on sleep hygiene are highly valued tools as preventive strategies. CONCLUSIONS To know the experience of users gives us a more comprehensive understanding of insomnia complexities and brings some new intervention strategies in patients with mental disorders. It is important that health professionals intervene preventively to stop the disorder from becoming chronic.
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Affiliation(s)
| | | | | | | | | | | | | | - Marina Lopez-Ruiz
- Service of Psychiatry and Psychology, HM-Sant Jordi Clinic, Barcelona, Spain
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Godzik C, Crawford S, Ryan E. Feasibility of an online cognitive behavioral therapy program to improve insomnia, mood, and quality of life in bereaved adults ages 55 and older. Geriatr Nurs 2020; 42:99-106. [PMID: 33340917 DOI: 10.1016/j.gerinurse.2020.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 11/19/2022]
Abstract
The aim of the current study was to assess the feasibility and preliminary efficacy of utilizing an online Cognitive Behavioral Therapy for Insomnia (CBT-I) program in bereaved older adults (ages 55 and older). Participants were randomized to receive either a 6-week online CBT-I program or six weeks of online psychoeducational modules on insomnia and grief. The sample included 30 adults with mild to severe symptoms of insomnia. Results suggest that the study was feasible to conduct, as evidenced by the brief 5-week recruitment time, 87% retention rate, and 100% completion rate of the intervention modules. There were no treatment effects by time difference shown in the study and no significant differences in study outcomes were found between the CBT-I and control groups, as both demonstrated similar improvements in insomnia. However, this study suggests that it is feasible to recruit bereaved older adults for an online educational program and successfully administer an online protocol targeting insomnia and well-being.
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Affiliation(s)
- Cassandra Godzik
- Dartmouth College/Dartmouth Hitchcock Medical Center, Dartmouth Centers for Health and Aging, 46 Centerra Parkway, Box 201, Lebanon, New Hampshire 03766 USA.
| | - Sybil Crawford
- University of Massachusetts Medical School, Graduate School of Nursing, 55 North Lake Avenue, Worcester, Massachusetts, 01655 USA
| | - Elizabeth Ryan
- Veterans Association Boston Healthcare System, 150 South Huntington Avenue, Boston, Massachusetts, 02130 USA
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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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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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Experiences and Management of Incidents That Influence Sleep in Patients With Cardiovascular Disease and Insomnia. J Cardiovasc Nurs 2020; 35:364-374. [DOI: 10.1097/jcn.0000000000000626] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Salvador VF, Berenguer C, Ribeiro C, Costa RM. Validação portuguesa do multidimensional assessment of interoceptive awareness (maia). PSYCHOLOGY, COMMUNITY & HEALTH 2020. [DOI: 10.5964/pch.v8i1.298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Objectivo
Consciência interoceptiva refere-se à percepção consciente dos estados internos do organismo. O presente trabalho pretendeu a validação do Multidimensional Assessment of Interoceptive Awareness (MAIA) recolhida a partir de uma amostra não probabilística de 755 indivíduos.
Método
O MAIA é originalmente constituído por 32 itens (divididos em oito dimensões) que assumem como possibilidade de resposta uma escala de Likert de 6 pontos. O estudo das qualidades métricas deste instrumento realizou-se com recurso a análise factorial exploratória (N = 376) e, numa amostra diferente, a análise factorial confirmatória (N = 379).
Resultados
Verificou-se uma estrutura diferente da original, mantendo-se o seu significado psicológico e características de validade, sensibilidade e fiabilidade adequadas.
Conclusão
Obtiveram-se quatro dimensões (Regulação Atencional; Consciência Emocional; Escuta Corporal e Confiança), as quais correspondem a dimensões da medida original.
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Psychosocial intervention for discontinuing benzodiazepine hypnotics in patients with chronic insomnia: A systematic review and meta-analysis. Sleep Med Rev 2019; 48:101214. [DOI: 10.1016/j.smrv.2019.101214] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2019] [Revised: 09/04/2019] [Accepted: 09/09/2019] [Indexed: 12/22/2022]
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Pan C, Wang X, Deng Y, Li P, Liao Y, Ma X, Yang GP, Dai L, Tang Q. Efficacy of mindfulness-based intervention ('mindfulness-based joyful sleep') in young and middle-aged individuals with insomnia using a biomarker of inflammatory responses: a prospective protocol of a randomised controlled trial in China. BMJ Open 2019; 9:e027061. [PMID: 31296508 PMCID: PMC6624060 DOI: 10.1136/bmjopen-2018-027061] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
INTRODUCTION Insomnia is a prevalent and significant public health concern. Insomnia can lead to increased inflammatory markers associated with chronic diseases such as cardiovascular disease, diabetes and cancer. Studies suggest that mindfulness-based interventions (MBIs) are more easily delivered within the community than cognitive behavioural therapy for insomnia (CBT-I) which was recommended as the preferred non-pharmacological treatment by the American Academy of Sleep Medicine, are effective in insomnia treatment and can reduce inflammatory markers level in older individuals with insomnia. This study aims to compare the effectiveness of an MBI to CBT-I in young and middle-aged individuals with insomnia disorder and explore its effect on nuclear factor kappa B (NF-κB), a transcription factor that controls the expression of genes involved in inflammation. METHODS AND ANALYSIS This report describes a protocol for a randomised controlled trial. Seventy eligible participants will be assigned to mindfulness-based joyful sleep or CBT-I for 2-hour sessions weekly for 8 weeks. The primary outcome is sleep quality assessed by the Pittsburgh Sleep Quality Index, severity of insomnia symptoms assessed by the Insomnia Severity Index and sleep parameters recorded using sleep diary and polysomnography. Secondary outcomes include perceived stress, anxiety and depression. The exploratory outcome is serum level of NF-κB. Outcomes will be evaluated at baseline, the end of the ntervention period and at a 3 month follow-up. Data will be analysed using general linear models, specifically analysis of covariance and analysis of variance will be used. ETHICS AND DISSEMINATION Full ethical approval for this study has been obtained from the Ethics Committee of the Third Xiangya Hospital, Central South University, Changsha, China (2018-S236). If Mindfulness-Based Joyful Sleep is proven effective, its dissemination will help bridge the gap between the unmet need and the demand for insomnia interventions in China. TRIAL REGISTRATION NUMBER NCT03268629; Pre-results.
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Affiliation(s)
- Chen Pan
- Department of Clinical Psychology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiang Wang
- Department of Clinical Psychology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yunlong Deng
- Psychosomatic Health Institute, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Peihuan Li
- Department of Clinical Psychology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yanhui Liao
- Department of Psychiatry and Mental Health Institute, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- National Clinical Research Center on Mental Disorders and National Technology Institute on Mental Disorders. Hunan Key Laboratory of Psychiatry and Mental Health, the Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xin Ma
- Department of Clinical Psychology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Guo-Ping Yang
- Center of Clinical Pharmacology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Lisha Dai
- Department of Clinical Psychology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Qiuping Tang
- Department of Clinical Psychology, the Third Xiangya Hospital, Central South University, Changsha, Hunan, China
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Caldwell JA, Caldwell JL, Thompson LA, Lieberman HR. Fatigue and its management in the workplace. Neurosci Biobehav Rev 2019; 96:272-289. [DOI: 10.1016/j.neubiorev.2018.10.024] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 10/04/2018] [Accepted: 10/31/2018] [Indexed: 01/01/2023]
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Sandlund C, Kane K, Ekstedt M, Westman J. Patients' experiences of motivation, change, and challenges in group treatment for insomnia in primary care: a focus group study. BMC FAMILY PRACTICE 2018; 19:111. [PMID: 29986651 PMCID: PMC6038282 DOI: 10.1186/s12875-018-0798-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/19/2018] [Indexed: 11/23/2022]
Abstract
Background The majority of patients who seek help for insomnia do so in primary health care. Nurse-led group treatment in primary care based on cognitive behavioral therapy for insomnia (CBT-I) can lead to improvements in both day- and nighttime symptoms. This study aimed to explore patients’ experiences of nurse-led group treatment for insomnia in primary health care. Methods Seventeen patients who had participated in the group treatment program were interviewed in five focus groups. Interview transcriptions were analyzed with qualitative content analysis. Results Four themes emerged that described patients’ experiences of the group treatment program. Involvement and trust open the door for change: Motivation to engage in treatment arose from patients’ own desire for change, from being together with others who shared or understood their struggles, and from feeling emotionally affirmed and trustful. Competence arising from deeper understanding: Patients obtained knowledge and made it their own, which enabled them to develop functional sleep habits and let go of sleep performance and worry. The ability to impact their insomnia increased patients’ trust in their own efficacy and helped them persist in behavioral change. Struggling with vulnerability and failure: Treatment was tough, and patients could feel challenged by external circumstances. Moreover, they could distrust their own efficacy. Tailoring treatment to individual needs: Patients experienced different life circumstances and adapted the techniques to their needs and abilities by focusing on what felt right for them. Conclusions Patients went through a process of motivation, change, and challenges. They experienced certain aspects of treatment as essential to changing behavior and achieving improvements. Examples included being in a group with others who shared similar experiences, gaining knowledge about sleep, keeping a sleep diary, and practicing the sleep restriction technique. The study provides insights into patients’ struggles during treatment, both those related to external circumstances and those related to feelings of vulnerability and failure. It also highlights the importance of adapting treatment to patients’ differing needs, underscoring the value of person-centered care.
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Affiliation(s)
- Christina Sandlund
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. .,Academic Primary Health Care Centre, Stockholm County Council, Solnavägen 1 E, Box 45436, 104 31, Stockholm, Sweden.
| | - Kimberly Kane
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Academic Primary Health Care Centre, Stockholm County Council, Solnavägen 1 E, Box 45436, 104 31, Stockholm, Sweden.,Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Mirjam Ekstedt
- Department of Health and Caring Sciences, Linnaeus University, Stagneliusgatan 14, SE-392 34, Kalmar, Sweden.,Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Jeanette Westman
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Academic Primary Health Care Centre, Stockholm County Council, Solnavägen 1 E, Box 45436, 104 31, Stockholm, Sweden
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Moosavi Nejad M, Shahgholian N, Samouei R. The effect of mindfulness program on general health of patients undergoing hemodialysis. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2018; 7:74. [PMID: 29963567 PMCID: PMC6009148 DOI: 10.4103/jehp.jehp_132_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/19/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Patients undergoing hemodialysis have a low level of health and mindfulness technique in mind-body medicine is used to help patients with chronic illness. Therefore, this clinical trial was conducted to determine the effect of the mindfulness program on the general health of patients undergoing treatment with hemodialysis. METHODS Sixty hemodialysis patients were selected through the convenient method and randomly divided into experimental and control groups. Both groups completed demographic information questionnaire and general health questionnaire. Then, the experimental group received 8 sessions of mindfulness training and the control group received 8 sessions of education in relation to end-stage renal disease and hemodialysis. Educational sessions were performed for both groups in the second 30 min after hemodialysis for 1 h in six individual sessions and two 1.5 h group sessions. Immediately after and 1 month after the intervention, the General Health Questionnaire was completed by both groups. RESULTS Analysis of the findings showed no significant differences between the mean score of general health disorder and its subscales before the intervention in to two groups (P > 0.05). Nevertheless, after intervention in the experimental group, the mean of general health disorder score decreased from 44.17 ± 12.32 to 21.9 ± 6.4 and 1 month after the intervention, the mean score of this score was 23.6 ± 6.2. The mean score of physical symptoms, anxiety and sleep disorder, social functioning deficiency, and depression were also significantly lower in the experimental group immediately after intervention and 1 month after the intervention; however, there were no significant differences between the mean of this score immediately and 1 month after the intervention. In addition, the mean score of general health disorder changes immediately and 1 month after the intervention in the experimental group was significantly more than the control group. In the control group, there was no significant difference between the mean score of general health disorder and its subscales before, immediately, and 1 month after the intervention (P > 0.05). CONCLUSIONS The results of this research showed that mindfulness has been effective in reducing physical and anxiety symptoms, sleep disorder, social dysfunction, and depression symptoms. Therefore, the use of mindfulness as a complementary treatment can improve the general health level in these patients.
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Affiliation(s)
- Maryam Moosavi Nejad
- Student Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Social Security Organization, Isfahan, Iran
| | - Nahid Shahgholian
- Department of Critical Care Nursing, Kidney Disease Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Rahele Samouei
- Social Determinants of Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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Barros VV, Opaleye ES, Demarzo M, Bowen S, Curado DF, Hachul H, Noto AR. Dispositional mindfulness, anticipation and abstinence symptoms related to hypnotic dependence among insomniac women who seek treatment: A cross-sectional study. PLoS One 2018; 13:e0194035. [PMID: 29547622 PMCID: PMC5856331 DOI: 10.1371/journal.pone.0194035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 02/20/2018] [Indexed: 11/19/2022] Open
Abstract
Introduction Dispositional mindfulness can be described as the mental ability to pay attention to the present moment, non-judgmentally. There is evidence of inverse relation between dispositional mindfulness and insomnia and substance use, but as of yet, no studies evaluating the specific association between dispositional mindfulness and the components of hypnotic use disorder. Objective To evaluate the association between dispositional mindfulness and the components of dependence among female chronic hypnotic users. Design and method Seventy-six women, chronic users of hypnotics, who resorted to Mindfulness-Based Relapse Prevention for the cessation of hypnotic use were included in the study. The Five Facet Mindfulness Questionnaire (FFMQ) evaluated the levels and facets of mindfulness, and the subscales of the Benzodiazepine Dependence Questionnaire (BENDEP) assessed dependence on hypnotics. We also evaluated sociodemographic variables and symptoms of insomnia and anxiety. The associations between the FFMQ facets and the BENDEP subscales were evaluated with binomial logistic regression, adjusted for income, schooling, anxiety, and insomnia. Results We observed associations between facets of the FFMQ and specific aspects of hypnotic dependence. The facet “observing” was inversely associated with the “concern about lack of availability of the hypnotic” [aOR = 0.87 95% CI (0.79–0.97)], and the facet “non-reacting to inner experience” with “noncompliance with the prescription recommendations” [aOR = 0.86 95% CI (0.75–0.99)]. The total score of the FFMQ was inversely associated to those two dependence subscales [aOR = 0.94 95% CI (0.89–0.99)]. “Observing” and “non-reactivity to inner experience” were also inversely associated with the “impairments related to the withdrawal symptoms” [aOR = 0.84 95% CI (0.73–0.97)] and [aOR = 0.78 95% CI (0.63–0.96)], respectively. The FFMQ was not associated with “awareness of problematic hypnotic use”. Conclusion Dispositional mindfulness, specifically the facets “observing” and “non-reactivity to inner experience, were inversely associated with the components of hypnotic dependence related to the anticipation of having the substance, its expected effect, and the impairments caused by the abstinence. We discuss the implications of those results for the clinical practice and future investigations.
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Affiliation(s)
- Víviam Vargas Barros
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center for Research and Training in Mindfulness-Based Relapse Prevention, São Paulo, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Emérita Sátiro Opaleye
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center for Research and Training in Mindfulness-Based Relapse Prevention, São Paulo, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Marcelo Demarzo
- Mente Aberta - Brazilian Center for Mindfulness and Health Promotion - Department of Preventive Medicine, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
- Hospital Israelita Albert Einstein, São Paulo, Brazil
| | - Sarah Bowen
- Psychology Department, Pacific University, School of Health Professions. Hillsboro, Oregon, United States of America
| | - Daniela Fernández Curado
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center for Research and Training in Mindfulness-Based Relapse Prevention, São Paulo, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
| | - Helena Hachul
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center for Research and Training in Mindfulness-Based Relapse Prevention, São Paulo, Brazil
- Department of Gynecology & Obstetrics, Casa de Saúde Santa Marcelina, São Paulo, Brazil
| | - Ana Regina Noto
- Nepsis - Research Center on Health and Substance Use - MBRP Brasil - Brazilian Center for Research and Training in Mindfulness-Based Relapse Prevention, São Paulo, Brazil
- Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, São Paulo, Brazil
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Abstract
Insomnia, or inadequate or poor sleep leading to significant distress or impairment in functioning, is a prevalent disorder treated by primary care providers (PCPs). With millions of people across the United States suffering from insomnia, PCPs must understand the disorder's pathophysiology, perpetuating factors, and treatment, as well as its effect on patient health and the economy. Although PCPs traditionally treat insomnia with pharmaceuticals, behavioral measures are effective and should be used whenever possible. This article reviews clinically relevant principles of diagnosing and treating insomnia, highlighting nonpharmacologic treatments.
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Gross CR, Reilly-Spong M, Park T, Zhao R, Gurvich OV, Ibrahim HN. Telephone-adapted Mindfulness-based Stress Reduction (tMBSR) for patients awaiting kidney transplantation. Contemp Clin Trials 2017; 57:37-43. [PMID: 28342990 DOI: 10.1016/j.cct.2017.03.014] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Revised: 03/07/2017] [Accepted: 03/21/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Patients with progressive kidney disease experience increasing physiologic and psychosocial stressors and declining health-related quality of life (HRQOL). METHODS We conducted a randomized, active-controlled, open-label trial to test whether a Mindfulness-based Stress Reduction (MBSR) program delivered in a novel workshop-teleconference format would reduce symptoms and improve HRQOL in patients awaiting kidney transplantation. Sixty-three transplant candidates were randomized to one of two arms: i) telephone-adapted MBSR (tMBSR, an 8-week program of meditation and yoga); or ii) a telephone-based support group (tSupport). Participants completed self-report questionnaires at baseline, post-intervention, and after 6-months. Anxiety, measured by the State-Trait Anxiety Inventory (STAI) post-intervention served as the primary outcome. Secondary outcomes included: depression, sleep quality, pain, fatigue, and HRQOL assessed by SF-12 Physical and Mental Component Summaries (PCS, MCS). RESULTS 55 patients (age 54±12yrs) attended their assigned program (tMBSR, n=27; tSupport, n=28). 49% of patients had elevated anxiety at baseline. Changes in anxiety were small and did not differ by treatment group post-intervention or at follow-up. However, tMBSR significantly improved mental HRQOL at follow-up: +6.2 points on the MCS - twice the minimum clinically important difference (95% CI: 1.66 to 10.8, P=0.01). A large percentage of tMBSR participants (≥90%) practiced mindfulness and reported it helpful for stress management. CONCLUSIONS Neither mindfulness training nor a support group resulted in clinically meaningful reductions in anxiety. In contrast, finding that tMBSR was more effective than tSupport for bolstering mental HRQOL during the wait for a kidney transplant is encouraging and warrants further investigation. ClinicalTrials.govNCT01254214.
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Affiliation(s)
- Cynthia R Gross
- University of Minnesota College of Pharmacy, United States; University of Minnesota School of Nursing, United States; University of Minnesota Center for Spirituality & Healing, United States.
| | | | - Taehwan Park
- St. Louis College of Pharmacy, Pharmacy Administration, United States
| | - Ruizhi Zhao
- University of Minnesota College of Pharmacy, United States
| | - Olga V Gurvich
- University of Minnesota School of Nursing, United States
| | - Hassan N Ibrahim
- University of Minnesota School of Medicine, Department of Nephrology, United States
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[Contribution of mindfulness meditation in cognitive behavioral therapy for insomnia]. Encephale 2017; 44:134-140. [PMID: 28213988 DOI: 10.1016/j.encep.2016.12.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 12/13/2016] [Accepted: 12/14/2016] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Insomnia is considered to be a serious public health issue affecting approximately 10% of adults. Chronic insomnia may increase the risk of health problem, psychological vulnerability and proneness to accidents. Cognitive behavioral therapy for insomnia (CBT-I) is recommended as the first line of treatment. Even though CBT-I is widely considered as an effective therapy, 20 to 30% of patients do not respond to this treatment. Mindfulness therapy, known to reduce rumination and stress, could be an interesting complement to enhance CBT-I. The aim of this study is to evaluate the efficacy of therapy combining mindfulness meditation and CBT-I for the treatment of chronic insomnia. METHODS Thirty-three patients, diagnosed with chronic insomnia, aged 18 to 75 years (51±15 years) were recruited between October 2015 and June 2016 at the Sleep Center of Marseille. The patients were then divided into two groups according to their psychotherapy method: group CBT-I alone (17 patients) or a group therapy combining CBT-I and Mindfulness (16 patients). All participants were given five sessions of standard CBT during eight weeks. The patient-reported outcome measures were sleep onset latency, wake after sleep onset (WASO), total wake time, total sleep time, time in bed, sleep efficiency and number of awakening from sleep diaries before treatment (T0) and six weeks later (T1). Assessments were done using Pittsburgh Sleep quality index (PSQI), Insomnia severity Index (ISI), the Epworth sleepiness scale, the hospital anxiety and depression scale (HAD), the dysfunctional beliefs and attitude about sleep (DBAS-16); further, the use of sleeping pills was also recorded at T0 and T1. RESULTS Out of the 33 participants who began the treatment, 29 completed all sessions and were included in the analyses (4 dropouts in the group CBT-I alone). The data shows that each treatment yielded significant improvements over time in sleep variables from the diary, PSQI, ISI, anxiety (P=0.004), DBAS 16, sleeping pill use and vitality measured by SF36 health survey (P=0.004). Comparing the results of the two therapy groups, the meditation associated to CBT-I shows significantly greater rates of reduction in WASO relative to CBT-I group (P=0.009). CONCLUSIONS This study confirms the beneficial effects of CBT for patients suffering from insomnia on sleep parameters, anxiety symptoms and quality of life. Furthermore, this study suggests, for the first time, that combining CBT and mindfulness is a superior approach compared to that of only conventional CBT-I in improving sleep.
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Araújo T, Jarrin DC, Leanza Y, Vallières A, Morin CM. Qualitative studies of insomnia: Current state of knowledge in the field. Sleep Med Rev 2017; 31:58-69. [PMID: 27090821 PMCID: PMC4945477 DOI: 10.1016/j.smrv.2016.01.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 01/05/2016] [Accepted: 01/07/2016] [Indexed: 10/22/2022]
Abstract
Despite its high prevalence and burden, insomnia is often trivialized, under-diagnosed, and under-treated in practice. Little information is available on the subjective experience and perceived consequences of insomnia, help-seeking behaviors, and treatment preferences. The use of qualitative approaches (e.g., ethnography, phenomenology, grounded theory) may help gain a better understanding of this sleep disorder. The present paper summarizes the evidence derived from insomnia studies using a qualitative research methodology (e.g., focus group, semi-structured interviews). A systematic review of the literature was conducted using PsycINFO and Medline databases. The review yielded 22 studies and the quality of the methodology of each of them was evaluated systematically using the critical appraisal skills programme (CASP) appraisal tool. Selected articles possess at least a very good methodological rigor and they were categorized according to their main focus: "Experience of insomnia", "Management of insomnia" and "Medicalization of insomnia". The main findings indicate that: 1) insomnia is often experienced as a 24-h problem and is perceived to affect several domains of life, 2) a sense of frustration and misunderstanding is very common among insomnia patients, which is possibly due to a mismatch between patients' and health care professionals' perspectives on insomnia and its treatment, 3) health care professionals pay more attention to sleep hygiene education and medication therapies and less to the patient's subjective experience of insomnia, and 4) health care professionals are often unaware of non-pharmacological interventions other than sleep hygiene education. An important implication of these findings is the need to develop new clinical measures with a broader scope on insomnia and more targeted treatments that take into account the patient's experience of insomnia. Greater use of qualitative approaches in future research may produce novel and more contextualized information leading to a more comprehensive understanding of insomnia.
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Affiliation(s)
- Taís Araújo
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada.
| | - Denise C Jarrin
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
| | - Yvan Leanza
- École de psychologie, Université Laval, Québec City, Québec, Canada; Laboratoire Psychologie et Cultures, Québec, Québec, Canada
| | - Annie Vallières
- École de psychologie, Université Laval, Québec City, Québec, Canada; Laboratoire Psycho|Socio|Culturel du sommeil, Centre de recherche de l'Institut en santé mentale de Québec, Centre de recherche du Centre hospitalier universitaire de Québec, Québec, Canada
| | - Charles M Morin
- École de psychologie, Université Laval, Québec City, Québec, Canada; Centre d'étude des troubles du sommeil, Centre de recherche de l'Institut universitaire en santé mentale de Québec, Québec, Canada
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DeSilva Mousseau AM, Lund TJ, Liang B, Spencer R, Walsh J. Stressed and Losing Sleep: Sleep Duration and Perceived Stress Among Affluent Adolescent Females. ACTA ACUST UNITED AC 2016. [DOI: 10.1080/0161956x.2016.1227186] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Absolon N, Balneaves L, Truant T, Cashman R, Wong M, Hamm J, Witmans M. A Self-Administered Sleep Intervention for Patients With Cancer Experiencing Insomnia. Clin J Oncol Nurs 2016; 20:289-97. [DOI: 10.1188/16.cjon.289-297] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Garland SN, Rouleau CR, Campbell T, Samuels C, Carlson LE. The Comparative Impact of Mindfulness-Based Cancer Recovery (MBCR) and Cognitive Behavior Therapy for Insomnia (CBT-I) on Sleep and Mindfulness in Cancer Patients. Explore (NY) 2015; 11:445-54. [PMID: 26386748 DOI: 10.1016/j.explore.2015.08.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2014] [Indexed: 11/26/2022]
Abstract
BACKGROUND Insomnia is an important but often overlooked side effect of cancer. Dysfunctional sleep beliefs have been identified as an important perpetuating factor for insomnia. Mindfulness practice has been demonstrated to improve sleep quality but it is unknown whether these effects relate to changes in dysfunctional sleep beliefs. PURPOSE This study is a secondary analysis of a randomized controlled trial comparing mindfulness-based cancer recovery (MBCR) to cognitive behavior therapy for insomnia (CBT-I) in cancer patients with insomnia. This present analysis compares program impact on mindfulness, dysfunctional sleep beliefs, and insomnia severity clinical cutoffs. METHODS Patients (MBCR, n = 32; CBT-I, n = 40) were assessed at baseline, post-program, and 3-month follow-up. RESULTS Across both groups, patients showed improvements over time in acting with awareness (P = .021) and not judging experiences (P = .023). Changes in dysfunctional sleep beliefs produced by the CBT-I group exceeded those produced by MBCR at post-program and follow-up (P < .001). Acting with awareness, non-judging, and non-reacting were the facets of mindfulness associated with an overall reduction in dysfunctional sleep beliefs. There were no significant differences between the MBCR and CBT-I groups in the percentage of patients exceeding insomnia severity clinical cutoffs at post-program or follow-up. CONCLUSIONS This study supports the use of both CBT-I and MBCR to reduce insomnia severity and suggests the development of mindfulness facets as a method of reducing dysfunctional sleep beliefs.
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Affiliation(s)
- Sheila N Garland
- Department of Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, 415 Curie Blvd, Philadelphia, PA 19104.
| | - Codie R Rouleau
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada
| | - Tavis Campbell
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada
| | - Charles Samuels
- Department of Family Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Linda E Carlson
- Department of Psychology, Faculty of Arts, University of Calgary, Calgary, Alberta, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Kemper KJ, Mo X, Khayat R. Are Mindfulness and Self-Compassion Associated with Sleep and Resilience in Health Professionals? J Altern Complement Med 2015. [PMID: 26218885 DOI: 10.1089/acm.2014.0281] [Citation(s) in RCA: 121] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES To describe the relationship between trainable qualities (mindfulness and self-compassion), with factors conceptually related to burnout and quality of care (sleep and resilience) in young health professionals and trainees. DESIGN Cross-sectional survey. SETTING Large Midwestern academic health center. PARTICIPANTS 213 clinicians and trainees. OUTCOME MEASURES Sleep and resilience were assessed by using the 8-item PROMIS Sleep scale and the 6-item Brief Resilience Scale. Mindfulness and self-compassion were assessed using the 10-item Cognitive and Affective Mindfulness Scale, Revised and the 12-item Self-Compassion Scale. Health was assessed with Patient-Reported Outcomes Measurement Information System (PROMIS) Global Health measures, and stress was assessed with the 10-item Perceived Stress Scale. After examination of descriptive statistics and Pearson correlations, multiple regression analyses were done to determine whether mindfulness and self-compassion were associated with better sleep and resilience. RESULTS Respondents had an average age of 28 years; 73% were female. Professions included dieticians (11%), nurses (14%), physicians (38%), social workers (24%), and other (12%). Univariate analyses showed normative values for all variables. Sleep disturbances were significantly and most strongly correlated with perceived stress and poorer health, but also with less mindfulness and self-compassion. Resilience was strongly and significantly correlated with less stress and better mental health, more mindfulness, and more self-compassion. CONCLUSIONS In these young health professionals and trainees, sleep and resilience are correlated with both mindfulness and self-compassion. Prospective studies are needed to determine whether training to increase mindfulness and self-compassion can improve clinicians' sleep and resilience or whether decreasing sleep disturbances and building resilience improves mindfulness and compassion.
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Affiliation(s)
- Kathi J Kemper
- 1 Department of Pediatrics, College of Nursing: School of Health and Rehabilitation Sciences, Ohio State University College of Medicine , Columbus, OH.,2 Center for Integrative Health and Wellness, Ohio State University College of Medicine , Columbus, OH
| | - Xiaokui Mo
- 2 Center for Integrative Health and Wellness, Ohio State University College of Medicine , Columbus, OH.,3 Center for Biostatistics, Department of Biomedical Informatics, Ohio State University College of Medicine , Columbus, OH
| | - Rami Khayat
- 3 Center for Biostatistics, Department of Biomedical Informatics, Ohio State University College of Medicine , Columbus, OH.,4 The OSU Sleep Heart Program, Department of Medicine, and Davis Heart-Lung Research Institute, Ohio State University College of Medicine , Columbus, OH
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Reilly-Spong M, Reibel D, Pearson T, Koppa P, Gross CR. Telephone-adapted mindfulness-based stress reduction (tMBSR) for patients awaiting kidney transplantation: Trial design, rationale and feasibility. Contemp Clin Trials 2015; 42:169-84. [PMID: 25847578 DOI: 10.1016/j.cct.2015.03.013] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Revised: 03/26/2015] [Accepted: 03/27/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND Mindfulness-based stress reduction (MBSR) has demonstrated benefits for stress-related symptoms; however, for patients with burdensome treatment regimens, multiple co-morbidities and mobility impairment, time and travel requirements pose barriers to MBSR training. PURPOSE To describe the design, rationale and feasibility results of Journeys to Wellness, a clinical trial of mindfulness training delivered in a novel workshop and teleconference format. The trial aim is to reduce symptoms and improve quality of life in people waiting for a kidney transplant. METHODS The standard 8-week MBSR program was reconfigured for delivery as two in-person workshops separated in time by six weekly teleconferences (tMBSR). A time and attention comparison condition (tSupport) was created using the workshop-telephone format. FEASIBILITY RESULTS Kidney transplant candidates (N = 63) were randomly assigned to tMBSR or tSupport: 87% (n = 55) attended ≥ 1 class, and for these, attendance was high (6.6 ± 1.8 tMBSR and 7.0 ± 1.4 tSupport sessions). Fidelity monitoring found that all treatment elements were delivered as planned and few technical problems occurred. Patients in both groups reported high treatment satisfaction, but more tMBSR (83%) than tSupport (43%) participants expected their intervention to be quite a bit or extremely useful for managing their health. Symptoms and quality of life outcomes collected before (baseline, 8 weeks and 6 months) and after kidney transplantation (2, 6 and 12 months) will be analyzed for efficacy. CONCLUSIONS tMBSR is an accessible intervention that may be useful to people with a wide spectrum of health conditions. Clinicaltrials.gov: NCT01254214.
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Affiliation(s)
| | - Diane Reibel
- Jefferson-Myrna Brind Center of Integrative Medicine Mindfulness Institute, United States
| | - Terry Pearson
- University of Minnesota Center for Spirituality & Healing, United States
| | - Pat Koppa
- Public Health Consultants, LLC, United States
| | - Cynthia R Gross
- University of Minnesota College of Pharmacy, United States; University of Minnesota School of Nursing, United States.
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Black DS, O'Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med 2015; 175:494-501. [PMID: 25686304 PMCID: PMC4407465 DOI: 10.1001/jamainternmed.2014.8081] [Citation(s) in RCA: 234] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
IMPORTANCE Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. OBJECTIVE To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5). INTERVENTIONS A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. MAIN OUTCOMES AND MEASURES The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)-κB. RESULTS Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05). CONCLUSIONS AND RELEVANCE The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT01534338.
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Affiliation(s)
- David S Black
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Gillian A O'Reilly
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, University of California, Los Angeles
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Lind AB, Delmar C, Nielsen K. Searching for existential security: a prospective qualitative study on the influence of mindfulness therapy on experienced stress and coping strategies among patients with somatoform disorders. J Psychosom Res 2014; 77:516-21. [PMID: 25481403 DOI: 10.1016/j.jpsychores.2014.07.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2014] [Revised: 07/16/2014] [Accepted: 07/17/2014] [Indexed: 12/25/2022]
Abstract
OBJECTIVE The aim was to explore how mindfulness group therapy for somatoform disorders influenced the patients' stress experiences, coping strategies and contextual psychosocial processes. METHODS A longitudinal pre- and post-treatment design, using 22 semi-structured individual pre- and post-treatment interviews. Data-analysis was based on a thematic methodology. RESULTS Pre-treatment patients were struggling in an existential crisis, feeling existentially insecure about their social identity, the causes, consequences and management of their illness; experiencing difficulties identifying and expressing stress-related cognitions, emotions and feelings, and low bodily and emotional self-contact; often leading to avoidant coping, making these individuals highly stress-vulnerable. Post-treatment, the overall change was conceptualized as increased existential security, defined by patients being more self-confident; more clarified with their social identity, the nature, management and future prospects of their illness; generally using more flexible coping strategies to reduce their daily stress experiences. Four related subthemes were identified contributing to increased existential security: 1) more secure illness perceptions - feeling existentially recognized as "really" ill, 2) enhanced relaxation ability - using mindfulness techniques, 3) increased awareness - connecting differently to mind and body 4) improved ability to identify and express needs and feelings of distress - more active communicating. Patients suggested that mindfulness therapy could be expanded with more time for group-discussions followed by additional individual therapy. CONCLUSION Generally, treatment positively influenced the patients' illness perceptions, stress-experiences, body- and self-awareness, coping strategies, self-image, social identity and social functioning. However, patients identified potentials for treatment improvements, and they needed further treatment to fully recover.
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Affiliation(s)
- Annemette Bondo Lind
- Department of Psychology and Behavioural Sciences, Aarhus University, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - Charlotte Delmar
- Department of Clinical Medicine, Aarhus University, Denmark; Department of Science in Nursing, Aarhus University, Denmark
| | - Klaus Nielsen
- Department of Psychology and Behavioural Sciences, Aarhus University, Denmark
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Black DS, O'Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness-based intervention for prodromal sleep disturbances in older adults: design and methodology of a randomized controlled trial. Contemp Clin Trials 2014; 39:22-7. [PMID: 24993561 DOI: 10.1016/j.cct.2014.06.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/17/2014] [Accepted: 06/24/2014] [Indexed: 12/26/2022]
Abstract
Sleep problems are prevalent among older adults, often persist untreated, and are predictive of health detriments. Given the limitations of conventional treatments, non-pharmacological treatments such as mindfulness-based interventions (MBIs) are gaining popularity for sleep ailments. However, nothing is yet known about the impact of MBIs on sleep in older adults with prodromal sleep disturbances. This article details the design and methodology of a 6-week parallel-group RCT calibrated to test the treatment effect of the Mindful Awareness Practices (MAPs) program versus sleep hygiene education for improving sleep quality, as the main outcome, in older adults with prodromal sleep disturbances. Older adults with current sleep disturbances will be recruited from the urban Los Angeles community. Participants will be randomized into two standardized treatment conditions, MAPs and sleep hygiene education. Each condition will consist of weekly 2-hour group-based classes over the course of the 6-week intervention. The primary objective of this study is to determine if mindfulness meditation practice as engaged through the MAPs program leads to improved sleep quality relative to sleep hygiene education in older adults with prodromal sleep disturbances.
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Affiliation(s)
- David S Black
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
| | - Gillian A O'Reilly
- Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Richard Olmstead
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Elizabeth C Breen
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
| | - Michael R Irwin
- Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience & Human Behavior, University of California, Los Angeles, USA
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Lengacher CA, Reich RR, Paterson CL, Jim HS, Ramesar S, Alinat CB, Budhrani PH, Farias JR, Shelton MM, Moscoso MS, Park JY, Kip KE. The effects of mindfulness-based stress reduction on objective and subjective sleep parameters in women with breast cancer: a randomized controlled trial. Psychooncology 2014; 24:424-32. [PMID: 24943918 DOI: 10.1002/pon.3603] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Revised: 05/12/2014] [Accepted: 05/19/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The purpose of this study was to investigate the effects of mindfulness-based stress reduction for breast cancer survivors (MBSR(BC)) on multiple measures of objective and subjective sleep parameters among breast cancer survivors (BCS). METHODS Data were collected using a two-armed randomized controlled design among BCS enrolled in either a 6-week MBSR(BC) program or a usual care (UC) group with a 12-week follow-up. The present analysis is a subset of the larger parent trial (ClinicalTrials.gov Identifier: NCT01177124). Seventy-nine BCS participants (mean age 57 years), stages 0-III, were randomly assigned to either the formal (in-class) 6-week MBSR(BC) program or UC. Subjective sleep parameters (SSP) (i.e., sleep diaries and the Pittsburgh Sleep Quality Index (PSQI)) and objective sleep parameters (OSP) (i.e., actigraphy) were measured at baseline, 6 weeks, and 12 weeks after completing the MBSR(BC) or UC program. RESULTS Results showed indications of a positive effect of MBSR(BC) on OSP at 12 weeks on sleep efficiency (78.2% MBSR(BC) group versus 74.6% UC group, p = 0.04), percent of sleep time (81.0% MBSR(BC) group versus 77.4% UC group, p = 0.02), and less number waking bouts (93.5 in MBSR(BC) group versus 118.6 in the UC group, p < 0.01). Small nonsignificant improvements were found in SSP in the MBSR(BC) group from baseline to 6 weeks (PSQI total score, p = 0.09). No significant relationship was observed between minutes of MBSR(BC) practice and SSP or OSP. CONCLUSIONS These data suggest that MBSR(BC) may be an efficacious treatment to improve objective and subjective sleep parameters in BCS.
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