![]() 12 - 14 Psychobehavioral therapies are also recognized nonpharmacological treatments for insomnia. 11 Although such treatments provide only temporary remediation of sleep disturbance for some persons, the benefits often diminish after drug discontinuation, and there is risk for residual daytime effects and dependency syndrome. Insomnia is often treated with pharmacotherapy. 10 However, when clinical insomnia is present, several treatment options are available. 9ĭespite the medical consequences of sleep problems, they often go untreated in older adults, especially among those with moderate sleep disturbances. 1, 4, 8 Addressing moderate sleep disturbances and sleep-related daytime dysfunction using community-accessible programs is a promising public health approach. 1, 6, 7 Moderate sleep disturbances in older adults are often associated with deficits in daytime functioning including elevated levels of fatigue disturbed mood, such as depressive symptoms and reduced quality of life and lead to the onset of clinical insomnia. 1 - 5 Older adults report the highest prevalence of sleep problems compared with younger age groups when quantified by self-report and by biological assessment. An estimated 50% of persons 55 years and older have some form of sleep problem, including initiating and maintaining sleep. Sleep disturbances pose a significant medical and public health concern for our nation’s aging population. Trial Registration Identifier: NCT01534338 Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life. Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups ( P < .05).Ĭonclusions and Relevance The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity ( P < .05 for all). The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. Results Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)–κB. Main Outcomes and Measures The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Interventions A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework. Objective To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances.ĭesign, Setting, and Participants Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean age, 66.3 years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index >5). Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep. ![]() Importance Sleep disturbances are most prevalent among older adults and often go untreated. ![]() Shared Decision Making and Communication.Scientific Discovery and the Future of Medicine.Health Care Economics, Insurance, Payment.Clinical Implications of Basic Neuroscience.Challenges in Clinical Electrocardiography.
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