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 L 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.
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 14
- The effect of mindfulness meditation on sleep quality: a systematic review and meta‐analysis of randomized controlled trials Annals of the New York Academy of Sciences December 21, 2018
- Effectiveness of a Mindfulness-Based Group Intervention for Chinese University Students with Sleep Problems International Journal of Environmental Research and Public Health January 10, 2022
- Effectiveness and Mechanisms of a Digital Mindfulness-Based Intervention for Subthreshold to Clinical Insomnia Symptoms in Pregnant Women: Randomized Controlled Trial. Journal of Medical Internet Research May 5, 2025
- A guided internet-delivered mindfulness-based cognitive therapy for insomnia: study protocol for a randomized controlled study. Frontiers in Psychiatry 2025
- From Stress Reduction to Contemplative Cultivation: a Mixed-Methods Study of Meditation Motives, Challenges and Risks in Hong Kong Mindfulness November 1, 2025
and 9 more in the library
Cites 15
- Mindfulness training as a clinical intervention: A conceptual and empirical review. Clinical Psychology Science and Practice 2003
- Mindfulness-Based Stress Reduction in Relation to Quality of Life, Mood, Symptoms of Stress, and Immune Parameters in Breast and Prostate Cancer Outpatients Psychosomatic Medicine July 1, 2003
- Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances JAMA Internal Medicine February 16, 2015
- The mindfulness‐based cognitive therapy adherence scale: inter‐rater reliability, adherence to protocol and treatment distinctiveness Clinical Psychology & Psychotherapy March 1, 2002
- A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia Sleep August 29, 2014
and 10 more in the library