Engaging in mindfulness awareness practices may be more helpful for older people who have trouble sleeping than just learning about how to make their bedrooms more conducive to sleep, according to a small new study.
"These simple yet challenging meditation practices provide the opportunity for people to expand their nonjudgmental awareness of sensory experiences arising in each moment," said David Black, the study's lead author from the University of Southern California, Los Angeles.
"Our findings arise from a structured mindfulness course with a skilled mindfulness instructor," he said. "As compared to attempting mindfulness practice for the first time on your own, you are likely to gain the most benefit from a standardised course with an experienced teacher."
Previous studies found sleep benefits from movement-based meditation programmes, such as tai chi, but none have looked at the possible benefits of non-movement meditation, the researchers write in JAMA Internal Medicine.
A recent meta-analysis found that only mindfulness meditation, compared to other types of meditation, provided consistent benefits for stress-related conditions, Black told Reuters Health by email.
For the study, researchers included 49 people who were at least 55 years old with at least moderately disturbed sleep. After a phone interview and an in-person visit, they were randomly divided into two groups.
One group visited the study centre for six weekly two-hour sessions of a course in Mindfulness Awareness Practices for daily living. Those included meditation, eating, walking, movement and friendly or loving-kindness practices.
A certified teacher, who led the exercises, handed out other resources. The teacher also told participants to meditate for five minutes daily, gradually increasing to 20 minutes daily.
The other group attended six weeks of a sleep hygiene and education course, where they learned about sleep problems, stress biology and stress reduction, self-monitoring of sleep behaviour, relaxation methods for improving sleep, and weekly behavioural sleep hygiene strategies.
When the researchers measured sleep quality before the six-week programmes, the average sleep quality questionnaire score was 10. A score of five or more indicates moderately disturbed sleep.
When the 49 participants completed the questionnaires again after the study, those in the meditation group had improved by an average of 2.8 points, compared to 1.1 points in the sleep hygiene group.
Daytime impairments, including symptoms of insomnia, fatigue and depression, improved more for people in the meditation group than those in the sleep hygiene group, too. Anxiety symptoms improved equally in both groups.
This study is commendable because sleep disturbances are very common among older adults, according to Adam Spira of the Johns Hopkins Bloomberg School of Public Health in Baltimore.
"It turns out that some of the most widely used treatments are actually potentially harmful," said Spira, who wrote an editorial accompanying the study.
Psychoactive sedative medications like benzodiazepine have been linked to poor health outcomes for older people, including cognitive decline, falls and general "fogginess", he said.
"There's a whole branch of effective interventions, cognitive behavioural interventions, that are very effective across age groups at treating insomnia," but many physicians are not aware of providers in their area who may administer these services, Spira said.
Mindfulness meditation is not the same as cognitive behavioural therapy, but based on this study it does seem to improve sleep, he said, adding that it's not clear how the method works.
Relaxing and decreasing physiological arousal may make it easier to fall asleep, or improving mood and reducing fatigue may help, enabling more exercise during the day which has been shown to improve sleep, he said.
Mindfulness meditation is particularly promising because it could be disseminated widely through the community, and would even be available to people with physical impairments for whom movement-based practices may not be an option, he said.
"This is definitely something worth investigating further," Spira said. "I'm a little bit reluctant to make recommendations at this point, but if people have an interest in mindfulness meditation it's probably fine to try."