Mindfulness Training Versus Sleep Hygiene for Insomnia Symptoms in Older Adults: A Randomized Controlled Comparison Trial

Abstract

Purpose: Adequate sleep is vital to our survival, yet sleep problems grow common with age. About 50% of people aged 55 + years experience insomnia weekly. Given that sleep problems often go untreated in older adults, and untreated sleep problems increase the risk for morbidity and all-cause mortality, effective treatments for sleep problems are a priority to improve the health of our aging population. This randomized controlled comparison trial examined the relative efficacy of two 6-week interventions (mindfulness meditation training, MT vs. sleep hygiene, SH) on sleep, inflammatory markers, and brain mor- phology. Methods: Participants (N = 49) were ages 55–90 (M= 66.27, SD=7.43). Inclusion criteria: currently active insomnia symp- toms, age in years > 55, and agreeing to randomization. Exclu- sion criteria: current inflammatory disorder, illness, or infection, current practice of mediation, depression, cognitive impairment, class II or greater obesity, current sleep apnea diagnosis, inability to speak English, and current smoking and/or substance depen- dence. The UCLA IRB approved study procedures. Measures included self-reported sleep, fatigue, and peripheral blood mono- nuclear cell levels of Nuclear Factor-kappa B. Brain images were acquired on a 1.5T Siemens Sonata scanner using an 8-channel head coil and a T1-weighted MPRAGE sequence. Results: Forty-three (88%) participants completed the trial. ITT analyses showed that both groups reported improved sleep and NF-kB levels post-intervention. Sleep improvements in the MT condition were significantly greater than SH (p < .02). Fatigue symptoms improved only in the MT group (p < .01). Significat increases in brain gray matter density were observed in the MT group in the posterior cingulate cortex (p < .05). Conclusion: Findings have implications for broadening treat- ment options for older adults with insomnia symptoms, and novel neuroimmune mechanisms are elucidated. Contact: David Black, davidbla@usc.edu