Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial.
John C Sieverdes, Frank A Treiber, Christopher E Kline, Martina Mueller, Brenda Brunner-Jackson, Luke R. Sox, Mercedes Cain, Maria Swem, Vanessa Diaz, Jessica Chandler
JMIR Formative Research October 6, 2020 DOI: 10.2196/20501 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized dose-response feasibility trial Longitudinal Peer reviewed |
|---|---|
| Sample size | 64 |
| Population | Prehypertensive adults (systolic blood pressure <139 mm Hg), including 31 African Americans and 33 non-Hispanic Whites |
| Interventions | Breathing awareness meditation (BAM) app Tension Tamer |
| Dose | 5, 10, or 15 min twice daily |
| Duration | 6 months (assessments at baseline and 1, 3, and 6 months) |
| Measures | Pittsburgh Sleep Quality Index (PSQI), wrist actigraphy |
| Topics | Meditation |
| Keywords | Sleep Mobile phone Ethnicity Prehypertension |
| Key findings | A breathing awareness meditation app produced a dose effect on sleep that was modulated by ethnicity. Non-Hispanic Whites showed the most favorable self-reported sleep efficiency, quality, and PSQI global improvements at the 5-minute dose compared with 10- and 15-minute doses, while among African Americans actigraphy showed lower sleep fragmentation at 5 minutes and longer sleep duration at 10 minutes. The authors indicate a need for further study of ethnicity's modulating influence and culturally tailored app refinement. |
Abstract
Background: African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols.
Objective: This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs.
Methods: A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894).
Results: At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03).
Conclusions: These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.
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 14
- Meditation Programs for Psychological Stress and Well-being JAMA Internal Medicine January 6, 2014
- Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances JAMA Internal Medicine February 16, 2015
- A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia Sleep August 29, 2014
- Blood Pressure Response to Transcendental Meditation: A Meta-analysis American Journal of Hypertension February 29, 2008
- Formative evaluation on cultural tailoring breathing awareness meditation smartphone apps to reduce stress and blood pressure mHealth October 19, 2017
and 9 more in the library