The Effects of Dose, Practice Habits, and Objects of Focus on Digital Meditation Effectiveness and Adherence: Longitudinal Study of 280,000 Digital Meditation Sessions Across 103 Countries.
Micah Cearns, Scott R Clark
Journal of Medical Internet Research September 19, 2023 DOI: 10.2196/43358 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Observational cohort Longitudinal Peer reviewed |
|---|---|
| Population | Large and globally diverse population of meditators in their naturalistic practice environments |
| Intervention | digital meditation |
| Duration | 14-month period |
| Topics | Meditation |
| Keywords | Digital health intervention Digital meditation Ecological memory assessment Healthy lifestyle Longitudinal meditation research Meditation adherence Meditation dose-response Mental well-being Mindfulness adherence Mindfulness dose-response Outcome |
| Key findings | Long-term real-world digital meditation practice is effective and associated with improvements in mood, equanimity, and resilience, with practice consistency and variety rather than length best predicting improvement. |
Abstract
The efficacy of digital meditation is well established. However, the extent to which the benefits remain after 12 weeks in real-world settings remains unknown. Additionally, findings related to dosage and practice habits have been mixed, and the studies were conducted on small and homogeneous samples and used a limited range of analytical procedures and meditation techniques. Findings related to the predictors of adherence are also lacking and may help inform future meditators and meditation programs on how to best structure healthy sustainable practices. This study aimed to measure outcome change across a large and globally diverse population of meditators and meditations in their naturalistic practice environments, assess the dose-response relationships between practice habits and outcome change, and identify predictors of adherence. We used ecological momentary assessment to assess participants' well-being over a 14-month period. We engineered outcomes related to the variability of change over time (equanimity) and recovery following a drop in mood (resilience) and established the convergent and divergent validity of these outcomes using a validated scale. Using linear mixed-effects and generalized additive mixed-effects models, we modeled outcome changes and patterns of dose-response across outcomes. We then used logistic regression to study the practice habits of participants in their first 30 sessions to derive odds ratios of long-term adherence. Significant improvements were observed in all outcomes (P<.001). Generalized additive mixed models revealed rapid improvements over the first 50-100 sessions, with further improvements observed until the end of the study period. Outcome change corresponded to 1 extra day of improved mood for every 5 days meditated and half-a-day-faster mood recovery compared with baseline. Overall, consistency of practice was associated with the largest outcome change (4-7 d/wk). No significant differences were observed across session lengths in linear models (mood: P=.19; equanimity: P=.10; resilience: P=.29); however, generalized additive models revealed significant differences over time (P<.001). Longer sessions (21-30 min) were associated with the largest magnitude of change in mood from the 20th session onward and fewer sessions to recovery (increased resilience); midlength sessions (11-20 min) were associated with the largest decreases in recovery; and mood stability was similar across session lengths (equanimity). Completing a greater variety of practice types was associated with significantly greater improvements across all outcomes. Adhering to a long-term practice was best predicted by practice consistency (4-7 d/wk), a morning routine, and maintaining an equal balance between interoceptive and exteroceptive meditations. Long-term real-world digital meditation practice is effective and associated with improvements in mood, equanimity, and resilience. Practice consistency and variety rather than length best predict improvement. Long-term sustainable practices are best predicted by consistency, a morning routine, and a practice balanced across objects of focus that are internal and external to the body.
Comparable studies
Other observational and cohort studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Using Self-Report Assessment Methods to Explore Facets of Mindfulness Undergraduate students | 2006 | Observational cohort | |
| Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders Patients with generalized anxiety disorder or panic disorder with or without agoraphobia | 1992 | Observational cohort | n = 22 |
| Meditation experience is associated with increased cortical thickness Participants with extensive Insight meditation experience and matched controls | 2005 | Observational cohort | n = 20 |
| Meditation experience is associated with differences in default mode network activity and connectivity Experienced meditators and matched meditation-naive controls | 2011 | Observational cohort | |
| Long-term meditators self-induce high-amplitude gamma synchrony during mental practice Long-term Buddhist practitioners and controls | 2004 | Observational cohort |
Citations in the library
Cited by 8
- Mindfulness, cognition, and long-term meditators: Toward a science of advanced meditation. Imaging Neuroscience 2025
- Real-World Meditation App Engagement: Longitudinal Study of the Medito Meditation App. JMIR mHealth and uHealth June 8, 2026
- Assessing willingness and preference for body scan practices in ADHD: a survey study. BMC Complementary Medicine and Therapies March 29, 2025
- Co-designed yoga nidra targeting anxiety in autistic children: A mixed methods feasibility study. Research in Developmental Disabilities September 2026
- Immediate mood changes and practice adherence during a self-directed SKT1 meditation program in university students: An intensive longitudinal study. PLoS One May 29, 2026
and 3 more in the library
Cites 22
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