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Research: GROSS and COLLEAGUES,
Listed in Issue 209
Abstract
GROSS and COLLEAGUES, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA. gross002@umn.edu set out to investigate the potential of mindfulness-based stress reduction (MBSR) as a treatment for chronic primary insomnia.
Background
Methodology
A randomized controlled trial was conducted at a university health centre. Thirty adults with primary chronic insomnia based on criteria of the Diagnostic and Statistical Manual of Mental Disorders, Text Revision, 4th Edition were randomized 2:1 to MBSR or pharmacotherapy (PCT). Mindfulness-based stress reduction, a program of mindfulness meditation training consisting of eight weekly 2.5 hour classes and a daylong retreat, was provided, with ongoing home meditation practice expectations during three-month follow-up; PCT, consisting of three milligrams of eszopiclone (LUNESTA) nightly for eight weeks, followed by three months of use as needed. A 10-minute sleep hygiene presentation was included in both interventions. The Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy were collected pre-treatment, post-treatment (eight weeks), and at five months (self-reports only).
Results
Between baseline and eight weeks, sleep onset latency (SOL) measured by actigraphy decreased 8.9 minutes in the MBSR arm (P < .05). Large, significant improvements were found on the ISI, PSQI, and diary-measured total sleep time, SOL, and sleep efficiency (P < .01, all) from baseline to five-month follow-up in the MBSR arm. Changes of comparable magnitude were found in the PCT arm. Twenty-seven of 30 patients completed their assigned treatment.
Conclusion
This study provides initial evidence for the efficacy of MBSR as a viable treatment for chronic insomnia as measured by sleep diary, actigraphy, well-validated sleep scales, and measures of remission and clinical recovery.
References
Gross CR, Kreitzer MJ, Reilly-Spong M, Wall M, Winbush NY, Patterson R, Mahowald M and Cramer-Bornemann M. Mindfulness-based stress reduction versus pharmacotherapy for chronic primary insomnia: a randomized controlled clinical trial. Explore: The Journal of Science & Healing. 7(2): 76-87. Mar-Apr 2011. Other ID Source: NLM. NIHMS260691 [Available on 03/01/12] Source: NLM. PMC3077056 [Available on 03/01/12]
