One of the problems with antidepressants is that they sometimes don’t work.
Though many people try, it can be difficult to treat depression with antidepressants alone. And the side effects, like fatigue, anxiety, loss of libido, and sleep disturbance, can be frustrating.
Dr. Willoughby Britton and her research team at the University of Arizona wanted to find out whether mindfulness could help with sleep disturbance – one of the most common side effects of antidepressants.
Researchers randomly assigned 23 participants, all of whom were taking antidepressant medications, to one of two interventions. Some received a mindfulness-based cognitive therapy course while others were placed on a waitlist to serve as a control.
Throughout the 9-week study, subjects in both groups completed sleep diaries, including their total sleep time, time in bed, latency of sleep onset, sleep quality, and other measures.
Researchers also took polysomnographic and electroencephalographic recordings before and after the treatment phase.
There were two major findings.
First, people who got the mindfulness training reported significantly greater sleep time compared to the controls. They also reported a better ratio of time asleep to total time spent in bed.
But what’s even more interesting is that the polysomnographic data supported the self-report measures. In other words, people who got mindfulness training were getting more sleep – objectively.
This study adds to the research that suggests mindfulness could be a useful aid for patients who are taking antidepressants.
Imagine if mindfulness could help with side effects of other medications – I’d be interested to see more research done on this.
There is one caveat, however, and that is that when we use the no-treatment design for our control group, there are limitations on how we can generalize the findings. That’s because we don’t know whether the treatment group is responding to the treatment (in this case, the mindfulness training), or to the special attention they receive. I would love to see this study redone, but with a different control group in place of the waitlist group.
If you’d like to learn more about this study, it was published in August of 2012 in Psychotherapy and Psychosomatics.
Have you ever suggested mindfulness to a client who was having trouble sleeping? Please leave a comment below and tell us about your experience.
I would love to see an RCT comparing 30 minutes of meditation/day with 30 minutes of brisk walking/day using both sleep and Quality of Life measures as the outcome variables. We already know that antidepressants can interfere with sleep with a notable exception– Trazadone is often a much better choice for insomnia than Ambien. A third arm (Trazadone) to a study of this nature might be informative.
You have to be a special kind of pesorn to be able to run a daycare. To have to take care of others peoples children, dealing with different pesornalities and different parents day in and out. Not just anyone can do what you do and I think you will be right at home with your career choice.
Positive results for chronic sleeper
A randomized controlled trial of mindfulness meditation for chronic insomnia. Sept 2014
Link http://www.ncbi.nlm.nih.gov/pubmed/25142566
Dear, Dr. Buczynski,
I so enjoy your blog. You and your readers might be very surprised to learn that EFT, an old technique brought to attention in recent years, is remarkably effective in alleviating sleep disorders.
Are you aware of the repeated (anecdotal and some clinical work in process) effectiveness of EFT? It is quite complimentary to “mindfulness” but in my opinion offers lasting results, easier. It differs as a tactic in that it provides a physical tool (tapping on recognized meridians on the body) to penetrate and release the cellular memories which play a role in sleep disturbances.
The busier and more complex one’s life, the deeper the need for good sleep.
EFT is my Sleep Miracle of Choice!
Sweet Dreams to all!
Victoria
Victoria Smith Downing
Producer: ScholarCHIPS educational media project for inner city and rural public school students
Venture Capitalist, Mom, Civic leader, and Certified EFT practitioner (private)
victoria.victoria@mac.com
I along with our Physiotherapist run a Pain Management Programme, this is Minfulness based.
People are taught mindfull meditation and engage in Mindful Awareness excersices. We have been running the programme for sixteen years and the programme was initailly CBT based. For the last five years it has been mindfulness based and the audits show that the Questionnaires from the last five years show an almost double report of peoples sleep having improved compared to the previous eleven years outcomes.
Our patients write a small summary of what in there opinion has helped them best in managing their pain, on our last audit 89% said Mindfulness.
Thank you for this research it has been interesting.
I regularly invite my clients to use a mindfulness ritual before going to sleep. Far safer and more effective than any medications.
I am an advocate for mindfulness yet I have to take medication for sleep and still don’t get a good night’s rest. I have some RLS and when I try to focus on my legs and what is going on at the time, it doesn’t help any other than get me more frustrated. Have been experimenting with minerals and nutritional aids and sometimes that helps.
I would like to support mental imagery and mindfullness, but for my restless leg syndrome (perhaps part of my ParKinson’s), it is not bothering me now that I take Requip/Ropinirole for my Parkinson’s. Another approach might be to try John Thomas Adams Shaffer’s Transformational Fantasy, a type of mental imagery that goes inside and utilizes the wisdom there.
I have always thought in terms of mindfulness being about ‘falling awake’ not falling asleep, and have encouraged people to do mindfulness practice at a time when they can be reasonably alert, and have discouraged them from doing it to try to get to sleep. I would be interested in others comments about this. Even with guided visualisations for relaxation I encourage people to stick to one that they use to help them sleep, and use others to practice relaxation as a skill during the day time – I figure people could become ‘cued’ to fall asleep when practicing the body scan if they use it to fall asleep.
Having said that, I definitely advocate the benefits of better sleep from practicing mindfulness, so it’s great to see even more science behind it as Ruth has posted.
I’ve had insomnia for 20+ years–first during PMS and now on anti-depressants at age 58.
Just read this. You have nailed my isuses. I can face anything with Peanut Butter (lie, lie, lie). I love the way that you ask us to analyze the fear after the binge. It’s definitely fight/flight fear but looking back into that window of time could certainly be so helpful to learn what it is I really want or what I’m afraid of. Thanks again for your wisdom. Peanut butter hasn’t seen the inside of my house in years. I’ll do a test to see when I’m ready. Thanks Martha!!!
This is my second visit today Paul, after asikng my self what am I doing and how does this relate to what I’m doing I think I wrote a better blog post. So a small step in the right direction.
I fully agree with mindfulness, though, I think that meditation with underlying ethics may, in the long run, be more helpful. Metta meditation may be very useful. Sleep hygiene is also very important using the bedroom only for sex and sleep. If an antidepressant is effective but causes insomnia, adding low dose Trazadone, 25-100mg, one hour before bedtime while taking the stimulating antidepressant in the AM may also be helpful.
Simple mindfulness awareness exercises like the body scan (starting with the toes slowly becoming aware of each part of our body individually) has been amazingly effective especially in the middle of the night wakefulness. I taught it to 15-17 year olds in Juvenile Detention and it worked like magic. They were so grateful.
It’s all in your mind , but isn’t it more accurate to say, it’s all in your state of mind? Either way, watveher happens, it all starts there.I’m still learning to give my own mind the attention it deserves instead of the inattention it usually receives. Be well.
For many years I’ve taught progressive muscle relaxation a form of mindfulness, to my anxious clients. Most reported better sleep quality as another benefit. What reduces the stress response in the body will help with sleep also.
Evidence-based or not, it’s obvious that both mindfulness and “special attention” are both profoundly “therapeutic.” I’ve spent enough time around Jack Kornfield and Ram Dass to be certain that mindfulness or “loving awareness” is a powerful tool, but it seems that “positive regard” and “attunement” are taken for granted in this field and, in themselves, as Carl Rogers, Rollo May, Jim Bugental and other humanists often said, are miraculously healing, but cannot easily be measured or scientifically verified. Thus, the research becomes the dominant factor in clinical practice. Carl knew this and dedicated the second half of his life to validating his discoveries about human relationships, but unfortunately, through the legislature and the medical establishment, behavioral science has become a scripture. I guess I am just old-fashioned. Thank you Ruth for your great work with mindfulness and your loving awareness!
I recommend mindfulness practices to all my patients for whatever is troubling them, including insomnia. I find that for those patients who are willing to accept this suggestion and do daily mindful breathing and/or other mindfulness exercises, it can provide powerful help.
I never suggested mindfulness to a patient with trouble sleeping. However, i have had insomnia and
been on medication for 18 or so years. I restarted mindfulness perhaps 6 weeks ago and my sleep is much better. I can’t be sure it’s literally cause and effect, but I do sleep better. (not going to give up the anti-depressants however–or the mindfulness, for that matter)
It will be interesting to see what my psychiatrist says–she doesn’t seem very mindfulness-oriented, but I do lots of “New Age”things I learned elsewhere.
One thing that always really bothers me is this use of the term Mindfulness. It doesn’t give any information about what was really taught. When you say CBT most many therapists know the fundamental CBT techniques. But Mindfulness could be about anything from doing autogenic relaxing exercises, progressive muscle relaxation, free form paying attention to the body to deep meditation techniques. I’m so tired of this latest trendy catch phrase that leaves people clueless as to what is being proposed. Of course it sure sounds nice. But I think it makes many people feel “stupid” and left out and afraid to ask because they “should” know.
I agree with you. There are many types of mindfulness practices and sometimes specificity would be helpful.
Hi Linda,Evelyn,
I am a housewife ,not a therapist ,so not sure what you search,but maybe the following website from the Wellspringinstitute,institute for neuroscience and contemplative traditions,could help:
http://Www.wisebrain.org
See skillful means
Choose between psychological/spiritual/other practices
You got a great deal of information for every practice!
Thanks for the post. Just want to make a small correction: Dr. Willoughby Britton is a woman. 🙂
I’ve taught mindfulness techniques to many students who used them to sleep better. The body scan with relaxation prompts is helpful for many to “get out of their head” – but I’ve found that attentive focusing on the body alone (regular body scan) can keep them wakeful (especially if they have health issues or “don’t like” certain parts of their body), so I build in a mindful/heart-full component of self compassion and gratitude.
Also, when they truly understand that worrying has no productive benefit to problem solving, the “middle of the night brain spin” becomes something they can learn to let go of. A restful sleep allows them to deal with whatever they are facing in a more productive way.
Hi Suzanne,
Thanks for the correction! We’ve made the changes to correct the oversight.
Best regards,
Jeff
NICABM Staff
Thanks for this latest report Ruth.
I do my best to keep up with the latest research on this topic.
It’s interesting that in an earlier reports Dr. Willoughby Britton reported worst sleep in meditators, even though they reported otherwise. The meditators self reports didn’t match their polysomnographic data. I found this very interesting, as it contradicted past findings and assumptions. Seems that those that practiced mindfulness had more *awake* brains even when sleeping.
See:http://tinyurl.com/2a7zduk
In that study, though, the subjects weren’t taking antidepressant medications. I would be interested in Dr. Brittions comments.
Thanks
Dear Ruth
Heartfelt thanks, as ever, for your valuable wisdom. Yes, a regular practice of Tibetan mindfulness (just watching the breath) meditation at the same time as palm /clasping/warming as taught for millenia in China and more recently by Dr Patricia Norris PhD. Anecdotally this practice seems to work very well, sometimes within seconds. I observe that, if practiced day-after-day-after-day for twenty-one days, it becomes a self-fulfilling pathway that is embedded in the intrinsic brain plasticity….
I use “the watching the breath” with clts and myself – but wasn’t sure about the “palm/clasping/warming ?? could u tell me more about that?
Thanks so much,
Page
Yes, please explain the hand clasping. Thanks
I find the combination of Mindfulness and CBT makes most impact on my stressful moods. I feel MBCBT is ambiguous about how far it has a trad CBT basis. So I think this is another issue.
I routinely teach mindfulness in my groups and ask for a show of hands for how many got tired during the practice. I then encourage folks to practice at bedtime, or when awake at night. It is a great intervention!
How to practice mindfullness
WE HAD A BREAK IN OUR COMPLEX A YEAR AGO ANS SINS I COULD NOT FALL A SLEEP, I HAVE
TO TAKE MEDICATION CALLED ADCO-ZOLPIDEM HEMITARTRATE 10 mg. MY SLEEP PROBLEM’
THANKS, RUBY