Mindfulness meditation and cognitive behavioral therapy for insomnia: a naturalistic 12-month follow-up.
Jason C Ong, Shauna L. Shapiro, Rachel Manber
Explore (New York, N.Y.) 2009 DOI: 10.1016/j.explore.2008.10.004 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Longitudinal follow-up of an open-label study Peer reviewed |
|---|---|
| Sample size | 21 |
| Population | Participants who completed a combined mindfulness meditation and CBT-I intervention and provided follow-up data |
| Interventions | Mindfulness meditation Cognitive behavioral therapy for insomnia (CBT-I) |
| Duration | 12-month follow-up posttreatment |
| Measures | Pre-Sleep Arousal Scale, Glasgow Sleep Effort Scale, Kentucky Inventory of Mindfulness Skills, Insomnia Episode Questionnaire |
| Topics | Meditation |
| Key findings | Most sleep-related benefits of the combined intervention were maintained over 12 months. Higher presleep arousal and sleep effort at end of treatment were associated with occurrence of insomnia episodes during follow-up. Mindfulness skills negatively correlated with daytime sleepiness but not nocturnal insomnia symptoms. |
Abstract
A unique intervention combining mindfulness meditation with cognitive behavioral therapy for insomnia (CBT-I) has been shown to have acute benefits at posttreatment in an open label study. The aim of the present study was to examine the long-term effects of this integrated intervention on measures of sleep and sleep-related distress in an attempt to characterize the natural course of insomnia following this treatment and to identify predictors of poor long-term outcome. Analyses were conducted on 21 participants, who provided follow-up data at six and 12 months posttreatment. At each time point, participants completed one week of sleep and meditation diaries and questionnaires related to mindfulness, sleep, and sleep-related distress, including the Pre-Sleep Arousal Scale, the Glasgow Sleep Effort Scale, the Kentucky Inventory of Mindfulness Skills, and the Insomnia Episode Questionnaire. Analyses examining the pattern of change across time (baseline, end of treatment, six months, and 12 months) revealed that several sleep-related benefits were maintained during the 12-month follow-up period. Participants who reported at least one insomnia episode (>or=1 month) during the follow-up period had higher scores on the Pre-Sleep Arousal Scale (P < .05) and the Glasgow Sleep Effort Scale (P < .05) at end of treatment compared with those with no insomnia episodes. Correlations between mindfulness skills and insomnia symptoms revealed significant negative correlations (P < .05) between mindfulness skills and daytime sleepiness at each of the three time points but not with nocturnal symptoms of insomnia. These results suggest that most sleep-related benefits of an intervention combining CBT-I and mindfulness meditation were maintained during the 12-month follow-up period, with indications that higher presleep arousal and sleep effort at end of treatment constitute a risk for occurrence of insomnia during the 12 months following treatment.