A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia
A Randomized Controlled Trial of Mindfulness Meditation for Chronic Insomnia
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DOI：
10.5665/sleep.4010
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发表时间：
2014-09-01
期刊：
影响因子：
5.6
通讯作者：
Wyatt, James K.
中科院分区：
文献类型：
--
作者：
Ong, Jason C.;Manber, Rachel;Wyatt, James K.
研究目的：评价正念冥想治疗慢性失眠症的疗效。设计：三组、单中心、随机对照试验。环境：学术医疗中心。参与者：54名患有慢性失眠症的成年人。干预：参与者被随机分配到基于正念的减压（MBSR），基于正念的失眠治疗（MBTI），或者一个为期八周的自我监控（SM）状态。测量和结果：患者报告的结果测量是睡眠日记中的总清醒时间（TWT），睡眠前唤醒量表（PSAS），测量失眠的显著清醒相关性，以及失眠严重程度指数（ISI），以确定缓解和反应作为临床终点。目的通过实验室多导睡眠仪和手腕活动仪测量睡眠。线性混合模型显示，与SM相比，接受基于冥想的干预（MBSR或MBTI）的患者从基线到后期的TWT分钟（43.75 vs 1.09）， PSAS （7.13 vs 0.16）和ISI （4.56 vs 0.06）显著减少。事后分析显示，在每项患者报告的测量中，每项干预都优于SM，但在比较MBSR和MBTI时，从基线到后期没有发现显著差异。从基线到随访6个月，MBTI比MBSR在ISI得分上有更大的下降（P < 0.05），在随访3个月时差异最大。MBTI和MBSR的缓解率和反应率从治疗后一直持续到随访，MBTI在6个月的随访中显示出最高的治疗缓解率（50%）和反应率（78.6%）。结论：正念冥想似乎是成人慢性失眠症的一种可行的治疗选择，可以为失眠的传统治疗提供另一种选择。
Study Objectives: To evaluate the efficacy of mindfulness meditation for the treatment of chronic insomnia.Design: Three-arm, single-site, randomized controlled trial.Setting: Academic medical center.Participants: Fifty-four adults with chronic insomnia.Interventions: Participants were randomized to either mindfulness-based stress reduction (MBSR), mindfulness-based therapy for insomnia (MBTI), or an eight-week self-monitoring (SM) condition.Measurements and Results: Patient-reported outcome measures were total wake time (TWT) from sleep diaries, the pre-sleep arousal scale (PSAS), measuring a prominent waking correlate of insomnia, and the Insomnia Severity Index (ISI) to determine remission and response as clinical endpoints. Objective sleep measures were derived from laboratory polysomnography and wrist actigraphy. Linear mixed models showed that those receiving a meditation-based intervention (MBSR or MBTI) had significantly greater reductions on TWT minutes (43.75 vs 1.09), PSAS (7.13 vs 0.16), and ISI (4.56 vs 0.06) from baseline-to-post compared to SM. Post hoc analyses revealed that each intervention was superior to SM on each of the patient-reported measures, but no significant differences were found when comparing MBSR to MBTI from baseline-to-post. From baseline to 6-month follow-up, MBTI had greater reductions in ISI scores than MBSR (P < 0.05), with the largest difference occurring at the 3-month follow-up. Remission and response rates in MBTI and MBSR were sustained from post-treatment through follow-up, with MBTI showing the highest rates of treatment remission (50%) and response (78.6%) at the 6-month follow-up.Conclusions: Mindfulness meditation appears to be a viable treatment option for adults with chronic insomnia and could provide an alternative to traditional treatments for insomnia.