Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: a randomized controlled clinical trial.
Cynthia R Gross, Mary Jo Kreitzer, Maryanne Reilly-Spong, Melanie Wall, Nicole Y Winbush, Robert Patterson, Mark W. Mahowald, Michel A. Cramer Bornemann
Explore (New York, N.Y.) 2011 DOI: 10.1016/j.explore.2010.12.003 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 30 |
| Population | Adults with chronic primary insomnia |
| Interventions | Mindfulness-based stress reduction Eszopiclone Sleep hygiene presentation |
| Dose | 3 mg eszopiclone nightly for eight weeks, then as needed for three months |
| Duration | 8-week intervention, 5-month follow-up |
| Measures | Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, wrist actigraphy |
| Topics | Meditation |
| Key findings | MBSR and eszopiclone both produced significant improvements in insomnia measures from baseline to five months, with comparable magnitude. Actigraphy-measured sleep onset latency decreased 8.9 minutes in the MBSR arm by eight weeks. |
Abstract
The aim of this study was to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia. A randomized controlled trial was conducted. The study was conducted at a university health center. Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT). Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions. The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pretreatment, posttreatment (eight weeks), and at five months (self-reports only). Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment. This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.