Mindfulness physical therapy, pain management, rehabilitation

Mindfulness and Sleep

Patients with chronic insomnia are thought to suffer hyperarousal and experience mind-racing and rumination when trying to fall asleep. Training in mindful awareness is hypothesized to disrupt rumination and worry, reduce arousal and promote the disengagement necessary to fall asleep.1

Ong and colleagues randomized 54 adults with chronic insomnia to Mindfulness-Based Stress Reduction (MBSR), a Mindfulness-Based Stress Reduction program that included specific behavioral techniques for insomnia (MBTI) or self-monitoring (SM).2 From baseline to post treatment, compared to the SM group, the mindfulness groups had significantly greater reductions in total wake time in bed (43.75 minutes for MBSR/MBTI versus 1.09 minutes for SM), scores on the Insomnia Severity Index (4.56 MBSR/MBTI versus 0.06 SM) and scores on the pre-sleep arousal scale (7.13 MBSR/MBTI versus 0.16 SM). Improvements in the mindfulness groups were sustained at 6 months.

A previous study by Gross and colleagues demonstrated that MBSR, when combined with a brief sleep hygiene presentation, reduced insomnia symptoms and improved sleep quality in adults with chronic insomnia to a degree comparable to the regular use of an FDA-approved sedative medication (Lunesta).3 The sample sizes in both these studies are small and further research is warranted, however the results are promising and consistent with my clinical experience. I find patients often improve their sleep by monitoring and reducing their stress reaction during the day and practicing mindful breathing and body scan at bedtime. Patients are especially grateful to have a non-pharmacological approach to treating insomnia.

1 Martires J, Zeidler M. The value of mindfulness meditation in the treatment of insomnia. Curr Opin Pulm Med. 2015;21(6):547-552.

2 Ong JC, Manber R, Segal Z, et al. A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep. 2014;37(9):1553-63.

3 Gross CR, Kreitzer MJ, Reilly-Spong M, et al. Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: a randomized controlled clinical trial. 2011;7(2):76-87.