Comparing the Effects of Mindfulness-Based Cognitive Therapy and Sleep Psycho-Education with Exercise on Chronic Insomnia: A Randomised Controlled Trial.
Samuel Yeung-Shan Wong, De-Xing Zhang, Carole Chi-Kwan Li, Benjamin Hon-Kei Yip, Dicken Cheong-Chun Chan, Yuet-Man Ling, Cola Siu-Lin Lo, Doris Mei-Sum Woo, Yu-Ying Sun, Helen Ma, Winnie Wing-Sze Mak, Ting Gao, Tatia Mei-Chun Lee, Yun-Kwok Wing
Psychotherapy and Psychosomatics 2017 DOI: 10.1159/000470847 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 216 |
| Population | Adults with chronic primary insomnia |
| Intervention | sleep psycho-education with exercise control (PEEC) |
| Duration | Assessments at 2 months (post-intervention), 5 months, and 8 months |
| Measures | Insomnia Severity Index (ISI), sleep diary, Five Facet Mindfulness Questionnaire |
| Topics | Meditation |
| Keywords | Adult Chinese population Intervention Mindfulness-based cognitive therapy Primary chronic insomnia Primary health care Sleep |
| Key findings | MBCT-I produced a small short-term reduction in insomnia severity compared with PEEC at 2 months (effect size -0.360, 95% CI -0.675 to -0.046), but no significant difference at 5 or 8 months. Treatment response and remission rates did not differ between groups, and wake time after sleep onset was lower with MBCT-I at 2 and 5 months. The authors conclude long-term benefits were not seen. |
Abstract
Mindfulness-based cognitive therapy (MBCT) is a potential treatment for chronic insomnia. We evaluated the efficacy of MBCT for insomnia (MBCT-I) by comparing it with a sleep psycho-education with exercise control (PEEC) group. Adults with chronic primary insomnia (n = 216) were randomly allocated to the MBCT-I or PEEC group. The MBCT-I included mindfulness and psycho-education with cognitive and behavioural components under cognitive behavioural therapy for insomnia. PEEC included psycho-education of sleep hygiene and stimulus control, and exercises. Any change in insomnia severity was measured by the Insomnia Severity Index (ISI). Secondary outcomes included sleep parameters measured by a sleep diary, health service utilisation, absence from work and mindfulness measured by the Five Facet Mindfulness Questionnaire. The ISI score significantly decreased in the MBCT-I group compared with the PEEC group at 2 months (i.e., post-intervention) (p = 0.023, effect size [95% CI] -0.360 [-0.675, -0.046]) but not at 5 or 8 months. Treatment response rates and remission rates based on the ISI cut-off scores were not significantly different between groups. Wake time after sleep onset (WASO) was less in the MBCT-I group at 2 and 5 months. At 8 months, both groups showed a reduced ISI score, sleep onset latency and WASO, and increased sleep efficiency and total sleep time; however, no group differences were seen. Other outcome measures did not significantly improve in either group. Long-term benefits were not seen in MBCT-I when compared with PEEC, although short-term benefits were seen.