The role of mindfulness and relaxation in improved sleep quality following a mind-body and activity program for chronic pain
James D. Doorley, J. Greenberg, Matthew Stauder, A. Vranceanu
Mindfulness September 1, 2021 DOI: 10.1007/s12671-021-01729-y (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Secondary data analysis of a randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 82 |
| Population | Adults with heterogeneous chronic pain |
| Duration | Post-treatment assessment and 3-month follow-up |
| Measures | Pittsburgh Sleep Quality Index (PSQI), Cognitive and Affective Mindfulness Scale-Revised (CAMS-R), relaxation subscale of the Mood and Anxiety Symptom Questionnaire-Short Form (MOCS-A) |
| Topics | Meditation |
| Key findings | Both intervention groups experienced significant and comparable improvements in sleep quality from baseline to post-treatment, sustained through 3-month follow-up. Improvements in mindfulness and relaxation were associated with improved sleep quality and fully mediated the sleep improvement with medium to large effect sizes, suggesting the mind–body program may sustainably improve sleep even without directly targeting it. |
Abstract
Poor sleep quality is prevalent among individuals with chronic pain and contributes to increased physical and emotional dysfunction. However, treatments that improve sleep quality among individuals with chronic pain are scant. A previously developed mind–body activity program for chronic pain has been shown to be feasible and associated with improvements in pain and physical and emotional function. Using secondary data analysis, the purpose of this study was to understand whether participants also experienced significant and sustained improvements in sleep quality over time and whether these improvements were explained by change in two core treatment targets, relaxation and mindfulness. Participants with heterogenous chronic pain (N = 82) were randomized to a mind–body activity intervention with (GetActive-Fitbit; n = 41) or without (GetActive; n = 41) a Fitbit device. Sleep quality was measured with the PSQI, mindfulness with the CAMS-R, and relaxation with the relaxation subscale of the MOCS-A. Mediation was tested via mixed models analysis. Both intervention groups experienced significant and comparable improvements in sleep quality from baseline to post-treatment, which were sustained through a 3-month follow-up. Mindfulness and relaxation also improved significantly over time, and these improvements were associated with improved sleep quality. Mindfulness and relaxation fully mediated improvement in sleep quality (medium to large effect sizes). Results suggest that, despite not targeting sleep directly, the mind–body activity program holds promise for sustainably improving sleep quality among patients with chronic pain. Targeting mindfulness and relaxation may facilitate these improvements.
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
Cited by 3
- Mindfulness and Buddhist principles in oncology: Risks, misconceptions and recommendations for ethical integration. Journal of Psychosocial Oncology 2026
- A Meta-Regression of psychosocial factors associated with sleep outcomes in mindfulness-based intervention trials. Behavioral Sleep Medicine 2025
- Low mindfulness is related to poor sleep quality from middle adolescents to emerging adults: a process model involving resilience and emotional dysfunction. BMC Psychiatry August 28, 2023
Cites 7
- Common and Dissociable Neural Activity After Mindfulness-Based Stress Reduction and Relaxation Response Programs Psychosomatic Medicine April 11, 2018
- Mindfulness-Based Stress Reduction for Treating Low Back Pain: A Systematic Review and Meta-analysis. Annals of Internal Medicine June 6, 2017
- Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis Annals of Behavioral Medicine September 22, 2016
- Mindfulness and Cognitive-behavioral Interventions for Chronic Pain: Differential Effects on Daily Pain Reactivity and Stress Reactivity Journal of Consulting and Clinical Psychology November 3, 2014
- "I felt like a new person." the effects of mindfulness meditation on older adults with chronic pain: qualitative narrative analysis of diary entries. Journal of Pain September 2008
and 2 more in the library