Mindfulness is Associated with Fewer Worries about Cessation of the Use of Sleeping Pills for Insomnia
By John M. de Castro, Ph.D.
“If insomnia is at the root of your sleepless nights, it may be worth trying meditation. The deep relaxation technique has been shown to increase sleep time, improve sleep quality, and make it easier to fall (and stay) asleep.” – National Sleep Foundation
It is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. Yet over 70 million Americans suffer from disorders of sleep and about half of these have a chronic disorder. It has been estimated that about 4% of Americans revert to sleeping pills. But, these do not always produce high quality sleep and can have problematic side effects. In addition, these medications can become addictive such that the individual cannot sleep without them. So, there is a need to find better methods to improve sleep.
Mindfulness-based practices have been reported to improve sleep amount and quality and to help treat addictions. Indeed, Mindfulness-based Relapse Prevention (MBRP) was developed to specifically assist in relapse prevention and has been shown to be effective. In today’s Research News article “Dispositional mindfulness, anticipation and abstinence symptoms related to hypnotic dependence among insomniac women who seek treatment: A cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5856331/ ), Barros and colleagues examined the relationship between mindfulness and addiction to sleeping pills in women.
They recruited adult women who used sleeping pills on a daily basis and had them complete paper and pencil measures of mindfulness, insomnia severity, anxiety, and dependence on sleeping pills, including problematic use, preoccupation with availability, lack of compliance with prescription, and withdrawal symptoms. They performed a regression analysis to examine the relationships between these variables.
They found that the higher the levels of mindfulness and particularly the observing facet of mindfulness, the lower the preoccupation with the availability of sleeping pills. This preoccupation frequently involves anxiety about not having the medication available for use. In addition, the higher the levels of mindfulness and particularly the non-reacting facet of mindfulness, the lower the lack of compliance with prescription. The women with high mindfulness were less likely to use the sleeping pills more often or in different circumstances than prescribed by their physician. Finally, the higher the levels of the mindfulness facets of observing and non-reacting, the lower the belief that withdrawal would produce severe uncomfortable experiences.
This study was correlative and as such conclusions regarding causation cannot be reached, Nevertheless, the results suggest that the levels of mindfulness prior to treatment for sleeping pill addiction are associated with the characteristics of the addiction and the patients’ anxieties regarding the availability of the pills and the consequences of withdrawal. This suggests that more mindful women would find it easier to withdraw from their use and treatment for the addiction would be more likely to be effective. It remains for future research to examine whether high levels of mindfulness prior to treatment is predictive of greater success in treatment.
“Imagine a country where we no longer have to depend on medication to help manage depression, chronic pain, or insomnia. . . mindfulness is just as effective as side-effect loaded medications. “ – Ruth Buczynski
CMCS – Center for Mindfulness and Contemplative Studies
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Barros, V. V., Opaleye, E. S., Demarzo, M., Bowen, S., Curado, D. F., Hachul, H., & Noto, A. R. (2018). Dispositional mindfulness, anticipation and abstinence symptoms related to hypnotic dependence among insomniac women who seek treatment: A cross-sectional study. PLoS ONE, 13(3), e0194035. http://doi.org/10.1371/journal.pone.0194035
Dispositional mindfulness can be described as the mental ability to pay attention to the present moment, non-judgmentally. There is evidence of inverse relation between dispositional mindfulness and insomnia and substance use, but as of yet, no studies evaluating the specific association between dispositional mindfulness and the components of hypnotic use disorder.
To evaluate the association between dispositional mindfulness and the components of dependence among female chronic hypnotic users.
Design and method
Seventy-six women, chronic users of hypnotics, who resorted to Mindfulness-Based Relapse Prevention for the cessation of hypnotic use were included in the study. The Five Facet Mindfulness Questionnaire (FFMQ) evaluated the levels and facets of mindfulness, and the subscales of the Benzodiazepine Dependence Questionnaire (BENDEP) assessed dependence on hypnotics. We also evaluated sociodemographic variables and symptoms of insomnia and anxiety. The associations between the FFMQ facets and the BENDEP subscales were evaluated with binomial logistic regression, adjusted for income, schooling, anxiety, and insomnia.
We observed associations between facets of the FFMQ and specific aspects of hypnotic dependence. The facet “observing” was inversely associated with the “concern about lack of availability of the hypnotic” [aOR = 0.87 95% CI (0.79–0.97)], and the facet “non-reacting to inner experience” with “noncompliance with the prescription recommendations” [aOR = 0.86 95% CI (0.75–0.99)]. The total score of the FFMQ was inversely associated to those two dependence subscales [aOR = 0.94 95% CI (0.89–0.99)]. “Observing” and “non-reactivity to inner experience” were also inversely associated with the “impairments related to the withdrawal symptoms” [aOR = 0.84 95% CI (0.73–0.97)] and [aOR = 0.78 95% CI (0.63–0.96)], respectively. The FFMQ was not associated with “awareness of problematic hypnotic use”.
Dispositional mindfulness, specifically the facets “observing” and “non-reactivity to inner experience, were inversely associated with the components of hypnotic dependence related to the anticipation of having the substance, its expected effect, and the impairments caused by the abstinence. We discuss the implications of those results for the clinical practice and future investigations.