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Overcoming chronic insomnia through mindfulness

16 October 2017 Journal of Psychotherapy and Psychosomatics

A randomized controlled trial published in the current issue of Psychotherapy and Psychosomatic reports on the use of mindfulness in chronic insomnia. Mindfulness-based cognitive therapy (MBCT) is a potential treatment for chronic insomnia. Authors evaluated the efficacy of MBCT for insomnia (MBCT-I) by comparing it with a sleep psycho-education with exercise control (PEEC) group.

Adults with chronic primary insomnia (n = 216) were randomly allocated to the MBCT-I or PEEC group. The MBCT-I included mindfulness and psycho-education with cognitive and behavioral components under cognitive behavioral therapy for insomnia. PEEC included psycho-education of sleep hygiene and stimulus control, and exercises. Any change in insomnia severity was measured by the Insomnia Severity Index. Secondary outcomes included sleep parameters measured by a sleep diary, health service utilization, absence from work and mindfulness.

Results showed that the score on the Insomnia Severity Index significantly decreased in the MBCT-I group compared with the PEEC group at 2 months (i.e., post-intervention) but not at 5 or 8 months. Treatment response rates and remission rates based on the Insomnia Severity Index cut-off scores were not significantly different between groups. Wake time after sleep onset (WASO) was less in the MBCT-I group at 2 and 5 months. At 8 months, both groups showed a reduced ISI score, sleep onset latency and WASO, and increased sleep efficiency and total sleep time; however, no group differences were seen. Other outcome measures did not significantly improve in either group.

Authors concluded that even though tong-term benefits were not seen in MBCT-I when compared with PEEC, MBCT provided greater short-term benefits.

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