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Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia.

Behaviour research and therapy
November 1, 2012
Jason C Ong et al. (3 authors)
Journal ArticleResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov't, Non-P.H.S.ReviewHuman Study
Study Details

Study Goal

The researchers aimed to present a conceptual framework for the cognitive mechanisms of mindfulness and acceptance-based therapies in treating insomnia.

Results Summary

The study proposed that mindfulness and acceptance-based therapies improve insomnia symptoms by enhancing metacognitive processes, such as balanced appraisals and cognitive flexibility, which reduce sleep-related arousal. These therapies promote adaptive responses to insomnia symptoms, potentially leading to remission.

Population

Individuals with insomnia (specific demographics not detailed).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (4)
InterventionDirectionEndpointPopulationDosageImpactClaim #
therapies using mindfulness and acceptance-based approaches
decrease
the symptoms of insomnia
-
-
have benefits for improving
#1
mindfulness and acceptance-based therapies
increase
an adaptive stance to one's response to these symptoms
experiencing insomnia symptoms
-
promote
#2
metacognitive processes
decrease
sleep-related arousal
-
-
reduce
#3
metacognitive processes
decrease
remission from insomnia
-
-
leading to
#4
Abstract

While there is an accumulating evidence to suggest that therapies using mindfulness and acceptance-based approaches have benefits for improving the symptoms of insomnia, it is unclear how these treatments work. The goal of this paper is to present a conceptual framework for the cognitive mechanisms of insomnia based upon mindfulness and acceptance approaches. The existing cognitive and behavioral models of insomnia are first reviewed and a two-level model of cognitive (primary) and metacognitive (secondary) arousal is presented in the context of insomnia. We then focus on the role of metacognition in mindfulness and acceptance-based therapies, followed by a review of these therapies in the treatment of insomnia. A conceptual framework is presented detailing the mechanisms of metacognition in the context of insomnia treatments. This model proposes that increasing awareness of the mental and physical states that are present when experiencing insomnia symptoms and then learning how to shift mental processes can promote an adaptive stance to one's response to these symptoms. These metacognitive processes are characterized by balanced appraisals, cognitive flexibility, equanimity, and commitment to values and are posited to reduce sleep-related arousal, leading to remission from insomnia. We hope that this model will further the understanding and impact of mindfulness and acceptance-based approaches to insomnia.

Medical Subject Headings (MeSH)
Adaptation, PsychologicalAwarenessBehavior TherapyCognitive Behavioral TherapyHumansMeditationModels, PsychologicalSleep Initiation and Maintenance Disorders
Study Links
Quality Scores
SafetyNot Assessed
Efficacy75/10
Quality80/10
Citation Metrics
Total Citations200
Citations/Year15.4
Relative Citation Ratio8.55
NIH Percentile97.2%
Research Impact Scores
APT Score0.95
Weight Score1.67
Normalized Score0.66
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