Mindfulness Versus Pharmacotherapy: Changes in Sleep Following Treatment of Primary Chronic Insomnia

2.50
Hdl Handle:
http://hdl.handle.net/10755/160954
Type:
Presentation
Title:
Mindfulness Versus Pharmacotherapy: Changes in Sleep Following Treatment of Primary Chronic Insomnia
Abstract:
Mindfulness Versus Pharmacotherapy: Changes in Sleep Following Treatment of Primary Chronic Insomnia
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2010
Author:Gross, Cynthia, PhD
P.I. Institution Name:University of Minnesota
Contact Address:Mail code 1332, 308 Harvard St SE, Minneapolis, MN, 55455, USA
Contact Telephone:612-624-8676
Co-Authors:C.R. Gross, M. Reilly-Spong, College of Pharmacy, University of Minnesota, Minneapolis, MN; C.R. Gross, M. Kreitzer, School of Nursing, University of Minnesota, Minneapolis, MN; M. Kreitzer, Center for Spirituality and Health, University of Minnesota, Min
Background: Chronic insomnia reduces quality of life, health and work productivity. It affects about 10% of the population, with higher rates among women, older adults and those with chronic conditions. Purpose: To determine if Mindfulness-Based Stress Reduction(MBSR) could improve sleep outcomes, with impacts comparable to pharmacotherapy(PCT). Conceptual/Theoretical Framework: Mindfulness training was hypothesized to disrupt sleep-incompatible cognitions such as worry and rumination, and facilitate relaxation to improve sleep. Method: 30 patients (ages 21 to 65, 73% women) meeting DSM-IV-TR criteria for primary chronic insomnia were randomized 2:1 to: MBSR (8 weekly mindfulness meditation classes plus retreat, N=20); or pharmacotherapy(PCT) (3 mg of eszoplicone (LUNESTA) nightly for 8 weeks, N=10). Sleep parameters (TST=total sleep time; SOL=sleep onset latency; WASO=wake after sleep onset; and SE=sleep efficiency) were measured by actigraphy, a wristwatch-like motion detector, for 2 weeks at pre-treatment baseline and during the last 2 weeks of the 8-week intervention period. The Insomnia Severity Index(ISI) and Pittsburgh Sleep Quality Index(PSQI) were self-reported at baseline and at 8 weeks (post-course/nightly dosing). Comparisons were made using non-parametric tests. Results: 18 patients completed MBSR (attended equal to or greater than 5 classes) and 9 PCT patients used study medication (adherence M=86%, weeks 1-8). Compared to baseline, MBSR patients significantly reduced SOL (M=8.9 minutes, 95% CI: 1.7 to19.4), and improved ISI (M=6.9, 95% CI: 4.7 to 9.1) and PSQI (M=4.3, 2.9 to 6.5) scores. PCT patients significantly improved TST, SE and ISI scores. PCT had greater impact on TST than MBSR. No other between-group difference was found. All patients exceeded the threshold for insomnia (ISI>7) at baseline. After 8 weeks, only 33% of MBSR patients and 44% of PCT patients exceeded the insomnia threshold. Conclusions: Pilot results indicate MBSR may be a promising alternative to sleep medications for treatment of primary chronic insomnia, and a rigorous comparative trial is warranted. Funding: UMN-AHC Faculty Development Grant
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleMindfulness Versus Pharmacotherapy: Changes in Sleep Following Treatment of Primary Chronic Insomniaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160954-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Mindfulness Versus Pharmacotherapy: Changes in Sleep Following Treatment of Primary Chronic Insomnia</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2010</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Gross, Cynthia, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Minnesota</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">Mail code 1332, 308 Harvard St SE, Minneapolis, MN, 55455, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">612-624-8676</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">gross002@umn.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">C.R. Gross, M. Reilly-Spong, College of Pharmacy, University of Minnesota, Minneapolis, MN; C.R. Gross, M. Kreitzer, School of Nursing, University of Minnesota, Minneapolis, MN; M. Kreitzer, Center for Spirituality and Health, University of Minnesota, Min</td></tr><tr><td colspan="2" class="item-abstract">Background: Chronic insomnia reduces quality of life, health and work productivity. It affects about 10% of the population, with higher rates among women, older adults and those with chronic conditions. Purpose: To determine if Mindfulness-Based Stress Reduction(MBSR) could improve sleep outcomes, with impacts comparable to pharmacotherapy(PCT). Conceptual/Theoretical Framework: Mindfulness training was hypothesized to disrupt sleep-incompatible cognitions such as worry and rumination, and facilitate relaxation to improve sleep. Method: 30 patients (ages 21 to 65, 73% women) meeting DSM-IV-TR criteria for primary chronic insomnia were randomized 2:1 to: MBSR (8 weekly mindfulness meditation classes plus retreat, N=20); or pharmacotherapy(PCT) (3 mg of eszoplicone (LUNESTA) nightly for 8 weeks, N=10). Sleep parameters (TST=total sleep time; SOL=sleep onset latency; WASO=wake after sleep onset; and SE=sleep efficiency) were measured by actigraphy, a wristwatch-like motion detector, for 2 weeks at pre-treatment baseline and during the last 2 weeks of the 8-week intervention period. The Insomnia Severity Index(ISI) and Pittsburgh Sleep Quality Index(PSQI) were self-reported at baseline and at 8 weeks (post-course/nightly dosing). Comparisons were made using non-parametric tests. Results: 18 patients completed MBSR (attended equal to or greater than 5 classes) and 9 PCT patients used study medication (adherence M=86%, weeks 1-8). Compared to baseline, MBSR patients significantly reduced SOL (M=8.9 minutes, 95% CI: 1.7 to19.4), and improved ISI (M=6.9, 95% CI: 4.7 to 9.1) and PSQI (M=4.3, 2.9 to 6.5) scores. PCT patients significantly improved TST, SE and ISI scores. PCT had greater impact on TST than MBSR. No other between-group difference was found. All patients exceeded the threshold for insomnia (ISI&gt;7) at baseline. After 8 weeks, only 33% of MBSR patients and 44% of PCT patients exceeded the insomnia threshold. Conclusions: Pilot results indicate MBSR may be a promising alternative to sleep medications for treatment of primary chronic insomnia, and a rigorous comparative trial is warranted. Funding: UMN-AHC Faculty Development Grant</td></tr></table>en_GB
dc.date.available2011-10-26T23:13:29Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:13:29Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
All Items in this repository are protected by copyright, with all rights reserved, unless otherwise indicated.