Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: a randomized controlled clinical trial.
Study Goal
The researchers aimed to investigate the efficacy of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia compared to pharmacotherapy.
Results Summary
MBSR showed significant improvements in sleep onset latency, total sleep time, and sleep efficiency, with comparable effects to pharmacotherapy. These benefits were sustained at the five-month follow-up.
Population
Thirty adults with chronic primary insomnia based on DSM-IV-TR criteria.
Effective Dosage
Eight weekly 2.5-hour MBSR classes plus a daylong retreat, with ongoing home practice for three months.
Duration
Eight weeks of active intervention with follow-up to five months.
Interactions
None mentioned
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-based stress reduction (MBSR) | decrease | sleep onset latency (SOL) measured by actigraphy | adults with primary chronic insomnia | 8.9 minutes | decreased | #1 |
Mindfulness-based stress reduction (MBSR) | increase | Insomnia Severity Index (ISI) | adults with primary chronic insomnia | - | Large, significant improvements were found | #2 |
Mindfulness-based stress reduction (MBSR) | increase | Pittsburgh Sleep Quality Index (PSQI) | adults with primary chronic insomnia | - | Large, significant improvements were found | #3 |
Mindfulness-based stress reduction (MBSR) | increase | diary-measured total sleep time | adults with primary chronic insomnia | - | Large, significant improvements were found | #4 |
Mindfulness-based stress reduction (MBSR) | decrease | diary-measured sleep onset latency (SOL) | adults with primary chronic insomnia | - | Large, significant improvements were found | #5 |
Mindfulness-based stress reduction (MBSR) | increase | diary-measured sleep efficiency | adults with primary chronic insomnia | - | Large, significant improvements were found | #6 |
pharmacotherapy (PCT) with eszopiclone | increase | sleep outcomes | adults with primary chronic insomnia | - | Changes of comparable magnitude were found | #7 |
OBJECTIVE: The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia. DESIGN: A randomized controlled trial was conducted. SETTING: The study was conducted at a university health center. PATIENTS: Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT). INTERVENTIONS: Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions. MAIN OUTCOMES: The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only). RESULTS: Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.