Effects of Mindfulness-Acceptance-Insight-Commitment (MAIC) Training on Stress and Sleep Quality in Elite Swimmers: A Randomized Controlled Mixed-Methods Trial.
Ning Su, Bingyan Zhang, Xiyu Zhou, Jiayu Hu, Wei Liang, Dong Wang
Behavioral Sciences June 29, 2026 DOI: 10.3390/bs16071068 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled mixed-methods design Qualitative Peer reviewed |
|---|---|
| Sample size | 30 |
| Population | Elite swimmers from a provincial high-performance program in China |
| Intervention | Mindfulness-Acceptance-Insight-Commitment (MAIC) program |
| Duration | 8-week intervention, 3-month follow-up |
| Topics | Meditation |
| Keywords | Maic Elite swimmers Mixed methods Psychological stress Sleep quality |
| Key points | The MAIC program reduced psychological strain and cortisol, improved subjective sleep quality, and increased mindfulness in elite swimmers compared to usual-practice controls. |
Abstract
Elite swimmers are exposed to sustained high training loads, early-morning sessions, and restricted recovery opportunities, all of which may increase psychological strain and compromise sleep. This study examined the effects of an 8-week Mindfulness-Acceptance-Insight-Commitment (MAIC) program, embedded within routine high-load training, on athlete-specific psychological stress, subjective sleep quality, and mindfulness in elite swimmers. A randomized controlled mixed-methods design was used. Thirty elite swimmers from a provincial high-performance program in China were randomly assigned to an MAIC group or a usual-practice control group (n = 15 per group). Quantitative outcomes were assessed at baseline, post-intervention, and three-month follow-up using the Athlete Psychological Strain Questionnaire, salivary cortisol, the Pittsburgh Sleep Quality Index, and the Athlete Mindfulness Questionnaire. Semi-structured interviews were conducted with all athletes in the MAIC group after the intervention. Mixed-design ANOVAs revealed significant Group × Time interactions for athlete-specific psychological stress, salivary cortisol, sleep quality, and mindfulness. Compared with the control group, the MAIC group showed lower psychological strain and cortisol, better subjective sleep quality, and higher mindfulness at post-intervention. At follow-up, improvements in psychological stress and mindfulness remained evident relative to baseline, whereas lower salivary cortisol and more favorable self-reported sleep quality remained evident relative to the control group. Qualitative findings further showed that MAIC was experienced as feasible, low-burden, and readily integrated into the training context. Athletes described attentional resets, acceptance-based responses to discomfort, and brief post-session or pre-sleep practices as helpful for regulating cognitive reactivity and arousal. Overall, MAIC appears to be a culturally grounded and practically viable adjunct strategy for supporting psychological regulation and self-reported sleep quality in elite swimmers during demanding training periods.
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cites 13
- Home practice in Mindfulness-Based Cognitive Therapy and Mindfulness-Based Stress Reduction: A systematic review and meta-analysis of participants' mindfulness practice and its association with outcomes Behaviour Research and Therapy May 10, 2017
- Effectiveness of providing university students with a mindfulness-based intervention to increase resilience to stress: 1-year follow-up of a pragmatic randomised controlled trial Journal of Epidemiology & Community Health September 10, 2020
- Effect of Brief Mindfulness Induction on University Athletes’ Sleep Quality Following Night Training Frontiers in Psychology April 12, 2018
- Impact of mindfulness-based interventions on sports performance and mental health: An umbrella review. Journal of exercise science and fitness October 1, 2025
- Restoration Skills Training in a Natural Setting Compared to Conventional Mindfulness Training: Sustained Advantages at a 6-Month Follow-Up Frontiers in Psychology August 1, 2022
and 8 more in the library