Duke-NUS researchers found that a four-week mindfulness training programme helped to reduce participants' pre-sleep cognitive arousal, and the amount of time they spent awake at night.
Mindfulness training involves focusing on emotions, thoughts and sensations in the present moment. This has been shown to improve sleep outcomes in patients with primary insomnia and depression.
Researchers from Duke-NUS Medical School, in collaboration with Brahm Centre, investigated whether a relatively short four-week introductory mindfulness course would have similar effects on improving sleep quality and reducing levels of cognitive arousal prior to sleep, compared to those commonly observed over eight-week programmes. This study suggests that a short course of mindfulness training may lay the groundwork for improving sleep quality by reducing anxious thoughts at bedtime. The team is continuing their research in this area, hoping to eventually make mindfulness-based treatments for sleep problems more widely available.
Sleep difficulties are common in Singapore, which sees an insomnia prevalence rate of approximately 15 per cent. About a quarter of the population reportedly suffers from poor quality sleep, and more than 40 per cent of Singaporeans get insufficient sleep on weekdays. Poor quality or insufficient sleep can lead to acute adverse effects such as negative moods, cognitive impairment and low quality of life. More importantly, chronic sufferers of poor quality sleep are at higher risk of developing more serious health problems such as diabetes and cardiovascular disorders, along with having a higher overall mortality risk.
"Mindfulness training may improve sleep quality by reducing both the level of cognitive arousal prior to sleep and night-time awakenings. Most prior studies of mindfulness and sleep have involved an eight-week intervention period, with a more demanding homework load. Although these mostly report positive effects, eight-week programmes have lower uptake and higher attrition rates because of the commitment required to complete them," said Dr Julian Lim, Assistant Professor at the Centre for Cognitive Neuroscience, Neuroscience and Behavioural Disorders Programme, Duke-NUS Medical School.
The team recruited 96 participants, aged between 15 and 75, from a four-week Mindfulness Foundation Course conducted at the Brahm Centre, for their study. They measured the effect of this course on their sleep quality using both subjective reporting and activity tracking. These revealed that the training helped to reduce pre-sleep cognitive arousal in the participants, which was associated with improved sleep quality. The team also observed that the four-week training had a small but significant effect on the amount of time the participants spent awake during the night.
"Our four-week Mindfulness Foundation Course is our most popular offering, with over 3,700 people benefiting from it. Many participants have gained awareness on how to apply mindfulness techniques to empower themselves and create their own happiness. We are encouraged to see the scientific evidence supporting the efficacy of the course in helping people to improve their sleep quality," said Mr Eric Lim, Mindfulness Psychologist, Brahm Centre.
The team is currently performing a clinical trial of mindfulness-based therapy for insomnia on older adults with poor sleep quality. This trial will conclude by May 2020, and uses more sophisticated measurements, including polysomnography (the gold standard method for measuring and staging sleep) and magnetic resonance imaging.
Reference: Hassirim Z, Lim E, Lo JC and Lim J (2019). Pre-sleep cognitive arousal decreases following a four-week introductory mindfulness course. Mindfulness.