A short-term mindfulness and auricular acupressure program for preoperative sleep fragmentation in patients with spinal metastases: a retrospective quasi-experimental study.
Dandan Li, Xiaomin Lang, Min Wang, Shaohua Liu, Kejie Ding, Xiaoqing Han, Hui Xu, Dengxing Lun, Yating Wen, Siying Li, Hongyu Wang
Frontiers in Psychiatry 2026 DOI: 10.3389/fpsyt.2026.1761276 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Retrospective quasi-experimental before-and-after cohort study Peer reviewed |
|---|---|
| Sample size | 92 |
| Population | Patients with spinal metastases who underwent surgical treatment at Weifang People's Hospital between January 2023 and January 2025 |
| Interventions | Mindfulness-based stress reduction auricular acupressure |
| Duration | One-week preoperative program; data collected at baseline and prespecified preoperative time points |
| Measures | Athens Insomnia Scale (AIS), Self-Rating Anxiety Scale (SAS), Visual Analogue Scale (VAS), salivary cortisol levels, wake after sleep onset (WASO), number of nighttime awakenings |
| Topics | Meditation |
| Keywords | Auricular acupressure Mindfulness-based stress reduction Non-pharmacological intervention Preoperative sleep disturbance Spinal metastases |
| Key findings | The authors report that a one-week preoperative mindfulness-based stress reduction plus auricular acupressure program was associated with lower anxiety, pain, and salivary cortisol and with better objective sleep continuity (reduced wake after sleep onset and fewer nighttime awakenings) compared with standard care. They suggest these findings indicate possible benefit but caution that subjective insomnia (AIS) results were attenuated after covariate adjustment. |
Abstract
To evaluate the association of a short-term mindfulness-based stress reduction program combined with auricular acupressure with preoperative sleep fragmentation, anxiety, pain, and physiological stress responses in patients with spinal metastases using a retrospective quasi-experimental before-and-after design. This retrospective quasi-experimental before-and-after cohort study included patients with spinal metastases who underwent surgical treatment at Weifang People's Hospital between January 2023 and January 2025. Patients admitted before implementation of the program were assigned to the control cohort, whereas patients admitted after program implementation were assigned to the intervention cohort. 92 patients were assigned to either the intervention group (n = 46), who received mindfulness-based stress reduction and auricular acupressure, or the control group (n = 46), who received standard care only. The intervention group received a one-week preoperative program combining short-term MBSR and auricular acupressure, delivered in two phases: outpatient instruction and home-based self-practice. A WeChat-based mini-program was used to deliver standardized mindfulness audio guidance and provide routine reminders during the intervention period. Auricular acupressure points were selected in accordance with national standards. The control group received standard perioperative care and educational materials, without any psychological or auricular interventions. Both groups were managed under the same pharmacological protocol. Outcome measures included subjective sleep quality (Athens Insomnia Scale, AIS), anxiety (Self-Rating Anxiety Scale, SAS), pain (Visual Analogue Scale, VAS), salivary cortisol levels, and objective sleep parameters-wake after sleep onset (WASO) and the number of nighttime awakenings-measured via a wearable device. Data were collected at baseline and prespecified time points before surgery. The intervention group showed more favorable changes across several domains compared to the control group. Anxiety levels were significantly lower (SAS: 52.28 ± 2.75 vs. 56.20 ± 3.06, P < 0.001), as were pain scores (VAS: 4.20 ± 0.86 vs. 6.09 ± 1.35 preoperatively; 4.02 ± 0.88 vs. 5.52 ± 1.07 on admission; both P < 0.001) and salivary cortisol concentrations (580.24 ± 10.67 ng/dL vs. 609.43 ± 22.56 ng/dL, P < 0.001). Objective sleep indicators also favored the intervention, with reduced average WASO (30.00 ± 1.87 min vs. 39.87 ± 1.77 min, P < 0.001) and fewer nighttime awakenings (2.54 ± 0.21 vs. 3.55 ± 0.22, P < 0.001). These findings suggest that short-term MBSR combined with auricular acupressure may help improve sleep continuity indicators, reduce anxiety and pain, and modulate physiological stress responses in this patient population. The intervention was associated with improvements in anxiety, pain, salivary cortisol, and objective sleep continuity indicators, including reduced WASO and fewer nighttime awakenings. Although AIS scores were lower in the intervention group at an intermediate preoperative time point, the association between the intervention and AIS score change was attenuated after adjustment for covariates. Therefore, subjective insomnia outcomes should be interpreted cautiously.
Comparable studies
Other experimental studies on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| The benefits of being present: Mindfulness and its role in psychological well-being. Cancer patients (clinical intervention study) | 2003 | Mixed methods: scale development, correlational, quasi-experimental, laboratory, experience-sampling, and clinical intervention study | |
| Loving-kindness meditation increases social connectedness. | 2008 | Controlled laboratory experiment | |
| Mindfulness and mind-wandering: Finding convergence through opposing constructs. | 2012 | Two studies: correlational study and experimental study | |
| Mental Training Enhances Attentional Stability: Neural and Behavioral Evidence | 2009 | Experimental study | |
| Mindfulness meditation and substance use in an incarcerated population. Incarcerated population | 2006 | Quasi-experimental with treatment-as-usual control condition |
Citations in the library
Cites 14
- Mindfulness‐based stress reduction for psychological distress among nurses: A systematic review Journal of Clinical Nursing July 3, 2019
- Mindfulness-based stress reduction for treating chronic headache: A systematic review and meta-analysis Cephalalgia June 4, 2018
- Effect of mindfulness-based stress reduction (MBSR) program on depression, emotion regulation, and sleep problems: A randomized controlled trial study on depressed elderly. BMC Public Health January 23, 2024
- Effect of short-term mindfulness-based stress reduction on sleep quality in male patients with alcohol use disorder. Frontiers in Psychiatry 2023
- Mindfulness-based stress reduction may decrease stress, disease activity, and inflammatory cytokine levels in patients with autoimmune hepatitis. JHEP reports : innovation in hepatology May 2022
and 9 more in the library