Mindfulness vs. Sleeping Pills for Insomnia

Objective: The aim of this study was to investigate the potential
of mindfulness-based stress reduction (MBSR) as a treatment for
chronic primary insomnia.
Design: A randomized controlled trial was conducted.
Setting: The study was conducted at a university health center.
Patients: 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).
Interventions: 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.
Main Outcomes: The Insomnia Severity Index (ISI), Pittsburgh
Sleep Quality Index (PSQI), sleep diaries, and wrist actigraphy
were collected pretreatment, posttreatment (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. 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.
Key words: Chronic primary insomnia, mindfulness, meditation, sleep latency
(Explore 2011; 7:76-87. © 2011 Elsevier Inc. All rights reserved.)

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