Dissociable changes in sleep architecture with mindfulness and sleep hygiene intervention in older adults: Secondary and exploratory analysis of polysomnography data from the Mindfulness Sleep Therapy (MIST) trial.
Study Goal
The researchers aimed to compare the effects of Mindfulness-Based Therapy for Insomnia (MBTI) and a sleep hygiene education and exercise program (SHEEP) on sleep macroarchitecture and microarchitecture.
Results Summary
Both MBTI and SHEEP improved self-reported sleep quality, with MBTI increasing N2 sleep and SHEEP increasing N3 sleep. No significant differences were found in N1, REM, or sleep fragmentation, but SHEEP showed decreased higher frequency non-REM EEG power.
Population
48 MBTI and 46 SHEEP participants with insomnia.
Effective Dosage
8 weekly 2-hour group sessions and daily practice.
Duration
8 weeks.
Interactions
None mentioned.
| Intervention | Direction | Endpoint | Population | Dosage | Impact | Claim # |
|---|---|---|---|---|---|---|
Mindfulness-Based Therapy for Insomnia (MBTI) | increase | self-reported sleep quality | MBTI participants | - | improved | #1 |
sleep hygiene education and exercise program (SHEEP) | increase | self-reported sleep quality | SHEEP participants | - | improved | #2 |
Mindfulness-Based Therapy for Insomnia (MBTI) | increase | N2 | MBTI participants | - | significant increases | #3 |
sleep hygiene education and exercise program (SHEEP) | no change | N2 | SHEEP participants | - | no significant increases | #4 |
sleep hygiene education and exercise program (SHEEP) | increase | N3 | SHEEP participants | - | significant increases | #5 |
Mindfulness-Based Therapy for Insomnia (MBTI) | no change | N3 | MBTI participants | - | no significant increases | #6 |
Mindfulness-Based Therapy for Insomnia (MBTI) | no change | N1 | MBTI and SHEEP participants | - | No significant differences | #7 |
sleep hygiene education and exercise program (SHEEP) | no change | N1 | MBTI and SHEEP participants | - | No significant differences | #8 |
Mindfulness-Based Therapy for Insomnia (MBTI) | no change | REM | MBTI and SHEEP participants | - | No significant differences | #9 |
sleep hygiene education and exercise program (SHEEP) | no change | REM | MBTI and SHEEP participants | - | No significant differences | #10 |
Mindfulness-Based Therapy for Insomnia (MBTI) | no change | sleep fragmentation | MBTI and SHEEP participants | - | No significant differences | #11 |
sleep hygiene education and exercise program (SHEEP) | no change | sleep fragmentation | MBTI and SHEEP participants | - | No significant differences | #12 |
sleep hygiene education and exercise program (SHEEP) | decrease | Higher frequency non-REM EEG power | SHEEP participants | - | decreased | #13 |
Mindfulness-Based Therapy for Insomnia (MBTI) | no change | Higher frequency non-REM EEG power | MBTI participants | - | did not decrease | #14 |
Mindfulness-Based Therapy for Insomnia (MBTI) | no change | Slow wave activity | MBTI and SHEEP participants | - | did not differ | #15 |
sleep hygiene education and exercise program (SHEEP) | no change | Slow wave activity | MBTI and SHEEP participants | - | did not differ | #16 |
Mindfulness-Based Therapy for Insomnia (MBTI) | no change | slow wave activity dissipation | MBTI and SHEEP participants | - | did not differ | #17 |
sleep hygiene education and exercise program (SHEEP) | no change | slow wave activity dissipation | MBTI and SHEEP participants | - | did not differ | #18 |
OBJECTIVES: We conducted a secondary analysis of the Mindfulness Sleep Therapy study, a randomized controlled trial testing Mindfulness-Based Therapy for Insomnia (MBTI) against a sleep hygiene education and exercise program (SHEEP). We investigated whether the interventions led to changes in sleep macroarchitecture (N2, N3 and REM), and microarchitecture (sleep fragmentation, slow wave activity, spectral band power) measured by ambulatory polysomnography (PSG). METHODS: 48 MBTI and 46 SHEEP participants provided usable PSG and subjective sleep quality data both pre- and post intervention. The interventions consisted of 8 weekly 2-hour group sessions, and daily practice. PSG data were staged according to the American Academy of Sleep Medicine criteria by 2 technicians blind to time point and condition. Repeated-measures ANOVA and permutation analysis were used to test for differences over time and between the interventions. RESULTS: Self-reported sleep quality improved in both study groups. We observed significant increases in N2 in MBTI but not SHEEP (p = .045), and significant increases in N3 in SHEEP but not MBTI (p = .012). No significant differences over time or between group were observed in N1, REM, or sleep fragmentation. Higher frequency non-REM EEG power decreased in SHEEP but not MBTI. Slow wave activity and slow wave activity dissipation did not differ over time or between groups. Among all variables, significant time by group interactions were observed in only N3 and non-REM alpha power. CONCLUSIONS: MBTI and sleep hygiene education had different effects on sleep macro and microarchitecture, suggesting that the underlying mechanisms of mindfulness training in improving sleep quality may differ from traditional interventions.