Sleep

Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

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Improve Autonomic Nervous System Function and Well-Being in Cancer Survivors with Mind-Body Practices.

 

By John M. de Castro, Ph.D.

 

“Tai Chi and Qigong are ancient forms of exercise that fit the bill for helping patients with cancer get moving and improve their overall sense of well-being. Tai Chi practice can help with pain conditions, especially pain involving muscles and joints; it can also reduce stress and anxiety and improve the quality of sleep.” – Susan Yaguda

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress, sleep disturbance, fear, and anxiety and depression. Mind-body practices such as Tai Chi or Qigong, and yoga have been shown to be effective in improving the psychological symptoms occurring in breast cancer patients. These practices work to relieve the emotional distress of cancer survivors.

 

A potential mechanism by which mind-body practices may relieve emotional distress is by altering the balance in the autonomic nervous system. A measure of this balance is Heart Rate Variability (HRV). It refers to the change in the time intervals between consecutive heart beats. Higher levels of HRV are indicative of flexibility in the Autonomic Nervous System and are associated with adaptability to varying environments. Increased heart rate variability signals greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This all signals greater physiological relaxation.

 

In today’s Research News article “Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/ ) Larkey and colleagues recruited female breast cancer survivors and randomly assigned them to receive 12 weeks of either Tai Chi or Sham-Tai Chi practice. Sham-Tai Chi used the same movements but did not incorporate breath control or meditative states. They were measured before and after training for fatigue, sleep, and depression and the electrocardiogram was measured and analyzed for Heart Rate Variability (HRV).

 

They found that after Tai Chi Practice, but not Sham-Tai Chi, there were significant reductions in fatigue and depression and significant improvements in sleep. In addition, in the Tai Chi group there was a significant reduction in low coherence Heart Rate Variability (HRV). Also, the greater the change, over training, in high coherence HRV the greater the reduction in depression levels.

 

This study replicates previous findings that Tai Chi practice reduces fatigue, and depression, and improves sleep. And produces changes in Heart Rate Variability (HRV). But this study used a unique control, comparison, condition of Sham-Tai Chi that had the same movements but lacked the breath control and meditative state of true Tai Chi practice. This suggests that it is not the movements of Tai Chi that produces the benefits but the mindfulness components that are essential.

 

The study also presents some evidence as to the mechanism by which Tai Chi practice improves that physical and psychological state of cancer survivors. The observed changes in Heart Rate Variability (HRV) are indicative of greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. This suggests that Tai Chi practice results in a physiological relaxation that in turn may be responsible for the physical and psychological benefits of the practice.

 

Some advantages of Tai Chi practice include the facts that it is not strenuous, involves slow gentle movements, and is safe, having no appreciable side effects, it is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It can also be practiced without professional supervision and in groups making it inexpensive to deliver and fun to engage in. This makes Tai Chi practice an excellent means to improve the physical and psychological symptoms experienced by cancer survivors.

 

So, improve autonomic nervous system function and well-being in cancer survivors with mind-body practices.

 

“Research in breast cancer patients has shown that tai chi may help to increase strength, balance, flexibility, heart and lung function, [and] feelings of well-being.” – Breast Cancer.org

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Larkey, L., Kim, W., James, D., Kishida, M., Vizcaino, M., Huberty, J., & Krishnamurthi, N. (2020). Mind-Body and Psychosocial Interventions May Similarly Affect Heart Rate Variability Patterns in Cancer Recovery: Implications for a Mechanism of Symptom Improvement. Integrative cancer therapies, 19, 1534735420949677. https://doi.org/10.1177/1534735420949677

 

Abstract

Background:

Advancements in early detection and treatment of cancer have led to increased survival rates and greater need to identify effective supportive care options for resolving symptoms of survivorship. Many non-pharmacological approaches to symptom management during and after cancer treatment involve emotional self-regulation as a central strategy for improving well-being. Identifying commonalities among these strategies’ mechanisms of action may facilitate understanding of what might be useful for optimizing intervention effects. Heart rate variability (HRV) parameters are indicative of improved autonomic nervous system (ANS) balance and resiliency and reduced emotional distress and are thus identified as a mechanism to discuss as a marker of potential for intervention efficacy and a target for optimization.

Methods:

HRV data from 2 studies, 1 examining a mind-body intervention and 1 examining a psychosocial intervention, are presented as a point of discussion about preliminary associations between the interventions, change in HRV, and emotional distress reduction.

Results:

HRV significantly decreased in sympathetic activity in response to a mind-body intervention (Qigong/Tai Chi), and increased vagal tone in response to a psychosocial (storytelling) intervention. In both, these changes in HRV parameters were associated with improved emotional states.

Conclusion:

Our preliminary data suggest that HRV may serve as an important marker of underlying changes that mediate emotional regulation; this observation deserves further investigation. If identified as a worthy target, focusing on interventions that improve HRV within the context of interventions for cancer patients may be important to key outcomes and clinical practice.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425257/

 

Improve the Quality of Sleep with Tai Chi

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Improve the Quality of Sleep with Tai Chi

 

By John M. de Castro, Ph.D.

 

“Tai Chi significantly improved sleep quality for healthy patients and those with chronic health conditions. Their physical performance and psychological well being improved compared with the control group. Along with better sleep, came a reduction in pain. “ – Balanced Life

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, 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. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia.

 

Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving sleep. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Tai Chi Chuan for Subjective Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439202/ ) Si and colleagues review, summarize, and perform a meta-analysis of published randomized controlled trials of the effectiveness of Tai Chi in improving sleep quality. They identified 25 published randomized controlled with adults as participants.

 

They report that the published research studies found that Tai Chi practiced produced a significant improvement in sleep quality with moderate effect size. They report that the optimum effects were produced by practices that lasted 60 to 90 minutes. Tai Chi was effective in both healthy and clinical populations but it had its greatest effects on sleep in healthy populations. In addition, Tai Chi practice produced large significant improvements in the sleep quality of Asian participants but not American participants.

 

Importantly, the largest effects were seen in studies with low methodological quality while 8 studies with the highest methodological quality did not observe significant improvements in sleep quality. The primary differences between low and high methodological quality studies revolved around how much the participants knew about the study and its intentions. This suggests that participant expectancy factors may be very important here.

 

That participant expectancies may be driving the results is further reflected in the fact that the largest effects were present in Asian participants while they were not significant in American participants. Tai Chi has been practiced in Asia for centuries and is believed to be very beneficial. It has only recently been practiced in America and Americans are generally ignorant or skeptical of its benefits. Hence, Asian participants would be expected to have the largest participant expectancies of positive benefits and they were the only population showing significant effects.

 

In summary, the results suggest that 60 to 90 minutes of Tai Chi practice produce improvements in sleep quality in healthy and clinical populations. But there is a strong suspicion that participant expectancies of Tai Chi efficacy my be responsible for the effects. There is a need, then, for more tightly controlled studies to determine if Tai Chi and not participant bias is responsible for the established benefits.

 

So, improve the quality of sleep with Tai Chi.

 

“Tai chi was reported useful in alleviating insomnia, and when combined with qigong, it improved sleep dysfunction and depression.“ – Christina Seluzicki

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Si, Y., Wang, C., Yin, H., Zheng, J., Guo, Y., Xu, G., & Ma, Y. (2020). Tai Chi Chuan for Subjective Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-based complementary and alternative medicine : eCAM, 2020, 4710527. https://doi.org/10.1155/2020/4710527

Abstract

Background

This review aims to investigate the efficacy of Tai Chi Chuan on subjective sleep quality among adults.

Methods

We systematically searched PubMed, Embase, Cochrane Library, Scopus, CNKI (China National Knowledge Infrastructure), and the Wanfang Database from their inception to August 2019 and identified 25 eligible studies that were published in both English and Chinese.

Results

24 out of 25 studies were identified to be high-quality studies according to the PEDro scale. The pooled results confirmed that Tai Chi Chuan elicited moderate improvements in subjective sleep quality (SMD = −0.512, 95% CI [−0.767, −0.257], P < 0.001). Notably, Tai Chi Chuan yielded more significant effects on sleep quality among the healthy population (SMD = −0.684, 95% CI [−1.056, −0.311], P < 0.001) than the clinical population (SMD = −0.395, 95% CI [−0.742, −0.047], P=0.026) and more benefits among the Asian population (SMD = −0.977, 95% CI [−1.446, −0.508], P < 0.001) than the American population (SMD = −0.259, 95% CI [−0.624, 0.105], P=0.164). After controlling the methodological quality of studies, it has been noted that Asians could achieve the most significant sleep-promoting benefit when Tai Chi Chuan was practiced between 60 and 90 min per session.

Conclusions

Available data implied that subjective sleep quality was improved via Tai Chi training, but more thorough studies must be executed to ascertain our findings and optimize Tai Chi practices accordingly toward various populations.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439202/

 

Improve Sleep and Reduce Insomnia with Mindfulness

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Improve Sleep and Reduce Insomnia with Mindfulness

 

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.” – Sleep Foundation

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, 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. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia.

 

Acceptance and Commitment Therapy (ACT) is a mindfulness-based psychotherapy technique that is employs many of the techniques of Cognitive Behavioral Therapy (CBT). ACT focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes. It would seem reasonable to expect that Acceptance and Commitment Therapy (ACT) might improve sleep and relieve insomnia. A number of studies have been performed. So, it makes sense to examine what has been learned.

 

In today’s Research News article “The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425538/ ) Salari and colleagues review and summarize the published research studies on the effects of Acceptance and Commitment Therapy (ACT) on sleep and insomnia.

 

They identified 19 published studies with a total of 1577 participants. They report that the published research found that Acceptance and Commitment Therapy (ACT) significantly improved sleep quality and reduced insomnia in healthy individuals and in patients with chronic insomnia. These benefits of ACT were still present up to a year after the completion of training.

 

Acceptance and Commitment Therapy (ACT) is a complex therapy and the studies do not identify which components or combination of components are necessary to produce the benefits. Nevertheless, the results clearly demonstrate that ACT is a safe and effective therapy for the improvement of sleep and the reduction in insomnia. This should have secondary effects of improving health and well-being

 

So, improve sleep and reduce insomnia with mindfulness.

 

“The idea is to create a reflex to more easily bring forth a sense of relaxation. That way, it’s easier to evoke the relaxation response at night when you can’t sleep.” – Herbert Benson

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Salari, N., Khazaie, H., Hosseinian-Far, A., Khaledi-Paveh, B., Ghasemi, H., Mohammadi, M., & Shohaimi, S. (2020). The effect of acceptance and commitment therapy on insomnia and sleep quality: A systematic review. BMC neurology, 20(1), 300. https://doi.org/10.1186/s12883-020-01883-1

 

Abstract

Background

Acceptance and Commitment Therapy (ACT), as a type of behavioral therapy, attempts to respond to changes in people’s performance and their relationship to events. ACT can affect sleep quality by providing techniques to enhance the flexibility of patients’ thoughts, yet maintaining mindfullness. Therefore, for the first time, a systematic review on the effects of ACT on sleep quality has been conducted.

Methods

This systematic review was performed to determine the effect of ACT on insomnia and sleep quality. To collect articles, the PubMed, Web of Science (WOS), Cochrane library, Embase, Scopus, Science Direct, ProQuest, Mag Iran, Irandoc, and Google Scholar databases were searched, without a lower time-limit, and until April 2020.

Results

Related articles were derived from 9 research repositories, with no lower time-limit and until April 2020. After assessing 1409 collected studies, 278 repetitive studies were excluded. Moreover, following the primary and secondary evaluations of the remaining articles, 1112 other studies were removed, and finally a total of 19 intervention studies were included in the systematic review process. Within the remaining articles, a sample of 1577 people had been assessed for insomnia and sleep quality.

Conclusion

The results of this study indicate that ACT has a significant effect on primary and comorbid insomnia and sleep quality, and therefore, it can be used as an appropriate treatment method to control and improve insomnia.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7425538/

 

A Healthy Lifestyle is Promoted by Mindfulness

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A Healthy Lifestyle is Promoted by Mindfulness

 

By John M. de Castro, Ph.D.

 

“Let’s say you find yourself eating a bag of chips in front of the TV — your evening pattern. Being mindful can help you break free from the autopilot trance and take a moment to make a different choice. You could trade the chips for carrots, or decide to skip TV and take a walk around the block instead.” – WebMD

 

We tend to think that illness is produced by physical causes, disease, injury, viruses, bacteria, etc. But many health problems are behavioral problems or have their origins in maladaptive behavior. This is evident in car accident injuries that are frequently due to behaviors, such as texting while driving, driving too fast or aggressively, or driving drunk. Other problematic behaviors are cigarette smoking, alcoholism, drug use, or unprotected sex. Problems can also be produced by lack of appropriate behavior such as sedentary lifestyle, not eating a healthy diet, not getting sufficient sleep or rest, or failing to take medications according to the physician’s orders. Additionally, behavioral issues can be subtle contributors to disease such as denying a problem and failing to see a physician timely or not washing hands. In fact, many modern health issues, costing the individual or society billions of dollars each year, and reducing longevity, are largely preventable. Hence, promoting healthy behaviors and eliminating unhealthy ones has the potential to markedly improve health.

 

Mindfulness training has been shown to promote health and improve illness. It is well established that if patterns and habits of healthy behaviors can be promoted, ill health can be prevented. There is, however, little research on the effects of mindfulness practice on promotion healthy behaviors.

 

In today’s Research News article “.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468720/) Soriano-Ayala and colleagues recruited college students and randomly assigned them to a wait-list control group or to receive 7 weekly 2-hour sessions of mindfulness training. Mindfulness training involved breath and body scan meditations, and training on letting thoughts flow. Before and after training they completed measures of lifestyle choices, including alcohol consumption, cannabis consumption, tobacco use, eating habits, and rest habits. They were also measured for eating consumption patterns and eating responses to negative emotions.

 

They found that in comparison to the wait-list control group, the group that received mindfulness training had significant improvements in healthy lifestyles, including eating a balanced diet, rest habits, and alcohol consumption. It is, however, not possible to determine from the current study how lasting these changes may be. The authors did not state how long they waited before the post-test. So, it is not clear that there was sufficient time for the mindfulness training to register an alteration of the lifestyle behaviors.   In addition, the control condition was a passive wait-list control. This leave open the possibility of confound variables like placebo, attentional, or experimenter bias effects being responsible for the observed differences. Nevertheless, these improved lifestyle behaviors would predict better future health and better college performance for the students after mindfulness training.

 

So, promote a healthy lifestyle with mindfulness.

 

“While meditation can help you manage stress, sleep well and feel better, it shouldn’t replace lifestyle changes like eating healthier, managing your weight, and getting regular physical activity. It’s also not a substitute for medication or medical treatment your doctor may have prescribed.” – Heart.org

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Encarnación Soriano-Ayala, Alberto Amutio, Clemente Franco, Israel Mañas. Promoting a Healthy Lifestyle through Mindfulness in University Students: A Randomized Controlled Trial. Nutrients. 2020 Aug; 12(8): 2450. Published online 2020 Aug 14. doi: 10.3390/nu12082450

 

Abstract

The present study explored the effects of a second-generation mindfulness-based intervention known as flow meditation (Meditación-Fluir) in the improvement of healthy life behaviors. A sample of university students (n = 51) in Spain were randomly assigned to a seven-week mindfulness treatment or a waiting list control group. Results showed that compared to the control group, individuals in the mindfulness group demonstrated significant improvements across all outcome measures including healthy eating habits (balanced diet, intake rate, snacking between meals, decrease in consumption by negative emotional states, increased consumption by negative emotional states, amount of consumption, meal times, consumption of low-fat products), tobacco, alcohol, and cannabis consumption, and resting habits. There were differences between males and females in some of these variables and a better effect of the treatment was evident in the females of the experimental group when compared to the males. The flow meditation program shows promise for fostering a healthy lifestyle, thus decreasing behaviors related to maladaptive eating, tobacco, alcohol, and cannabis consumption as well as negative rest habits in university students. This mindfulness program could significantly contribute to the treatment of eating disorders and addictions, wherein negative emotional states and impulsivity are central features of the condition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7468720/

 

Improve Psychological Health with a Mindfulness App

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Improve Psychological Health with a Mindfulness App

 

By John M. de Castro, Ph.D.

 

“The Mindfulness App opens up a world of professional guided meditations. It helps you towards a more peaceful and healthier state of mind. Newbie or guru? Don’t worry, we’ve got you. The Mindfulness App offers guided meditations for everyone.” – Google Play

 

Mindfulness training has been shown through extensive research to be effective in improving physical and psychological health and particularly with reducing the physical and psychological reactions to stress and increasing resilience in the face of stress. Indeed, these practices have been found to reduce stress and improve psychological health in college students.

 

The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient. As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants.

 

In today’s Research News article “Feasibility and Acceptability of a Mobile Mindfulness Meditation Intervention Among Women: Intervention Study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298633/) Rung and colleagues recruited adult women and had them train for at least 30 days with 10-minute sessions of an online mindfulness app (Headspace) based upon the Mindfulness-Based Stress Reduction (MBSR) program. They were measured before participation and 45 days later for feasibility and acceptability of the mindfulness app, mindfulness, depression, perceived stress, sleep quality, physical activity, body size, and healthy eating.

 

Of the women enrolled only 14% completed the Headspace program while 60% of the women completed all measures but did not engage in the Headspace program. Of the women who used the Headspace App three quarters liked or loved the program while 85% stated that they would recommend the app to others. They found that in comparison to baseline and to the participants who did not participate with Headspace, there were significant reductions in depression, sleep latency, and perceived stress, and increases in sleep quality and duration, and physical activity. Interestingly, there was no significant increase in mindfulness.

 

The fact that improvements in psychological health and sleep occurred without an increase in mindfulness is puzzling. Online apps have been found previously to increase mindfulness and mindfulness has been shown to decrease depression and perceived stress, and improve sleep quality. This suggests that the app can be beneficial independent of changes in mindfulness. This needs to be further explored in future research.

 

The willingness to use the mindfulness app was disappointingly low indicating that many of the women did not have the time or desire to use it. But if they used it, they tended to like it, recommend it to others, and have improvements in their psychological health and sleep. Obviously, more research is needed to identify why so few women were willing to utilize the app as this markedly limits its usefulness.

 

So, improve psychological health with a mindfulness app.

 

“Meditation apps aren’t just a boon for consumers hoping to learn how to be more present at an affordable price. If effective, they also have implications for workplaces, schools, and even nations, who want to cultivate happier and healthier communities.” – Kira Newman

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Rung, A. L., Oral, E., Berghammer, L., & Peters, E. S. (2020). Feasibility and Acceptability of a Mobile Mindfulness Meditation Intervention Among Women: Intervention Study. JMIR mHealth and uHealth, 8(6), e15943. https://doi.org/10.2196/15943

 

Abstract

Background

Traditional mindfulness-based stress reduction programs are resource intensive for providers and time- and cost-intensive for participants, but the use of mobile technologies may be particularly convenient and cost-effective for populations that are busy, less affluent, or geographically distant from skilled providers. Women in southern Louisiana live in a vulnerable, disaster-prone region and are highly stressed, making a mobile program particularly suited to this population.

Objective

This study aimed to (1) assess the feasibility and acceptability of a mobile mindfulness app in real-world conditions in a pilot study of a community sample of women residing in southern Louisiana, (2) describe predictors of app usage, and (3) assess the effect of the app on secondary health outcomes.

Methods

Women were recruited from an oil spill study on health. A total of 236 women completed a baseline survey, were offered the mobile mindfulness program, and completed a follow-up survey. Subjects were asked to download and use the app for at least 30 days for 10 min. All study procedures were completed on the web. Primary outcomes were feasibility and acceptability of the app and characteristics of app utilization. Secondary outcomes included mindfulness, depression, perceived stress, sleep quality, physical activity, BMI, and healthy eating.

Results

Overall, 74.2% (236/318) of subjects completed the follow-up survey, and 13.5% (43/318) used the app. The main barrier to app usage was lack of time, cited by 37% (16/43) of users and 48.7% (94/193) of nonusers of the app. Women who chose to use the app were more highly educated (16/43, 63% had a college education vs 65/193, 33.7% of nonparticipants; P<.001), had higher incomes (23/43, 58% had incomes >US $50,000 per year vs 77/193, 43.0% of nonparticipants), and were employed (34/43, 79% vs 122/193, 63.2% of nonparticipants; P=.047). Those who engaged with the app did so at high levels, with 72% (31/43) of participants self-reporting the completion of some or all sessions and 74% (32/43) reporting high levels of satisfaction with the app. Participation with the app had a beneficial impact on depression (odds ratio [OR] 0.3, 95% CI 0.11-0.81), sleep quality (OR 0.1, 95% CI 0.02-0.96), sleep duration (OR 0.3, 95% CI 0.07-0.86), sleep latency (OR 0.3, 95% CI 0.11-0.81), and physical activity (2.8 95% CI 1.0-7.8), but mindfulness scores did not change from baseline to follow-up.

Conclusions

The Headspace mobile mindfulness app was easy and cost-effective to implement and acceptable to those who participated, but few women elected to try it. The unique characteristics of this southern Louisiana population suggest that more intense promotion of the benefits of mindfulness training is needed, perhaps in conjunction with some therapist or researcher support. Several short-term benefits of the app were identified, particularly for depression and sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298633/

 

Meditation and Yogic Breathing Techniques Improve Respiration and Psychological Well-Being

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Meditation and Yogic Breathing Techniques Improve Respiration and Psychological Well-Being

 

By John M. de Castro, Ph.D.

 

“Yoga, meditation and other relaxation techniques all depend on focusing on the breath. There are many benefits of meditation and proper breathing is an important part of learning how to calm the mind and body.” – Home Care Assistance

 

Breathing is essential for life and generally occurs automatically. It’s easy to take for granted as it’s been there our entire lives. Nevertheless, we become more aware of it when it varies with circumstances, such as when we exercise and also in emotional states, especially fear and anxiety. But we rarely notice it during everyday ongoing life. Yet, its characteristics are associated with our state of well-being. Slow deep breathing is characteristic of a healthy relaxed state. Breathing exercises are common in yoga and meditation practices and have been found to have a number of beneficial effects.

 

Modern medicine has also developed respiratory therapies for the treatment of patients with cardiovascular and pulmonary diseases. Many of these techniques are similar to those practiced in meditation and yoga. In today’s Research News article “Analogy between classical Yoga/Zen breathing and modern clinical respiratory therapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429199/) Tobe and Saito examine the similarities of meditation and yoga breathing exercises and respiratory therapies and their relative effects.

 

Respiratory therapy has been shown to be essential in the treatment of respiratory diseases. But, breathing techniques are not new. They’ve been practiced for over 3000 years. Yoga incorporates a number of different techniques. Even the Buddha emphasized breathing techniques during meditation and these were greatly elaborated on in Zen meditation. There are considerable similarities with respiratory therapy and meditation and yogic breathing techniques. They all emphasize deep inhalation, slow exhalation with some resistance, low respiratory frequency, and even counting of breaths.

 

Tobe and Saito note that research has shown that meditation and yogic breathing techniques, like respiratory therapy, have considerable positive effects on respiration including improved “vital capacity, timed vital capacity, maximum voluntary ventilation, breath-hold time, maximal inspiratory and expiratory pressures and oxygen saturation.” They also increase the psychological well-being of practitioners including reducing panic attacks, depression, and headaches, relieving pain, and improving sleep.

 

Tobe and Saito conclude that meditation and yogic breathing techniques are effective in modern clinical practice improving respiratory function and psychological well-being, and relieving chronic pain. Indeed, research on meditation and yogic breathing techniques suggest that they improve physiological and respiratory function and are effective for the treatment of a number of diseases and psychological problems.

 

So, meditation and yogic breathing techniques improve respiration and psychological well-being.

 

“By inducing stress resilience, breath work enables us to rapidly and compassionately relieve many forms of suffering.” – Richard Brown

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Tobe, M., & Saito, S. (2020). Analogy between classical Yoga/Zen breathing and modern clinical respiratory therapy. Journal of anesthesia, 1–6. Advance online publication. https://doi.org/10.1007/s00540-020-02840-5

 

Abstract

Anesthesiologists and intensivists are modern-day professionals who provide appropriate respiratory care, vital for patient survival. Recently, anesthesiologists have increasingly focused their attention on the type of spontaneous breathing made by non-intubated patients with pulmonary disease cared for in an intensive care unit, and also patients with chronic pain receiving cognitive behavioral therapy. Prior to our modern understanding of respiratory physiology, Zen meditators recognized that breathing has a significant impact on a person’s mental state and general physical well-being. Examples of this knowledge regarding respiration include the beneficial effects of deep inhalation and slow exhalation on anxiety and general wellness. The classical literature has noted many suggestions for breathing and its psycho-physical effects. In the present review, we examine the effect of classical breathing methods and find an analogy between typical Yoga/Zen breathing and modern clinical respiratory therapy. Evidence is increasing about historical breathing and related meditation techniques that may be effective in modern clinical practice, especially in the field of anesthesiology, such as in improving respiratory function and reducing chronic pain. Clarification of the detailed mechanisms involved is anticipated.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7429199/

 

Improve Sleep and Social Anxiety with Mindfulness

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Improve Sleep and Social Anxiety with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Self-compassionate people tend to have lower levels of social anxiety—perhaps because self-compassion includes mindfulness, which soothes the stress associated with anxiety.” – Jill Suttie

 

It is a common human phenomenon that being in a social situation can be stressful and anxiety producing. Most people can deal with the anxiety and can become quite comfortable. But many do not cope well and the anxiety is overwhelming, causing the individual to withdraw. Social Anxiety Disorder (SAD) is characterized by a persistent, intense, and chronic fear of being watched and judged by others and feeling embarrassed or humiliated by their actions. This fear may be so severe that it interferes with work, school, and other activities and may negatively affect the person’s ability to form relationships.

 

Anxiety disorders have generally been treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments. Recently, it has been found that mindfulness training can be effective for anxiety disorders including Social Anxiety Disorder (SAD).

 

Social Anxiety Disorder (SAD) has also been found to be associated with sleep disturbance. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia. So, it makes sense to explore the interactions of mindfulness training, sleep quality, and Social Anxiety Disorder (SAD).

 

In today’s Research News article “Sleep quality and treatment of social anxiety disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698895/) Horenstein and colleagues recruited healthy control participants and adult patients diagnosed with Social Anxiety Disorder (SAD). The patients were randomly assigned to either a wait-list control condition or to receive 12 weekly 2.5 hour sessions of either Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) along with home readings and practices. MBSR training employs meditation, body scan, yoga, discussions, and home practice. CBGT explores and attempts to change inaccurate or negative thinking so the patient can view challenging situations more clearly and respond to them in a more effective way. They were measured before and after the 12-week treatment period and 12 months later for mental illness, sleep quality, and social anxiety.

 

They found that at baseline the patients diagnosed with Social Anxiety Disorder (SAD) had significantly poorer sleep quality than healthy control participants. After treatment both the Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) groups had significant improvements in Social Anxiety Disorder (SAD) compared to baseline and the wait-list control participants. In addition, the patients who received MBSR had significant improvement in sleep quality. But this did not significantly differ from patients receiving CBGT. Sleep quality, however, did not significantly modify the treatment responses and changes in sleep quality over treatment did not predict changes in social anxiety.

 

These results are interesting and demonstrate that both Cognitive Behavioral Group Therapy (CBGT) or Mindfulness-Based Stress Reduction (MBSR) effectively reduce social anxiety in patients with Social Anxiety Disorder (SAD) while MBSR also improves sleep quality in these patients. This replicates previous findings that mindfulness training improves SAD and sleep. The new contribution of the present study was that sleep quality was not related to improvements in SAD.

 

So, improve sleep and social anxiety with mindfulness.

 

“Lack of sleep, or poor quality sleep, can worsen social anxiety in those with the disorder and even trigger similar feelings in others.” – Relax Melodies

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Horenstein, A., Morrison, A. S., Goldin, P., Ten Brink, M., Gross, J. J., & Heimberg, R. G. (2019). Sleep quality and treatment of social anxiety disorder. Anxiety, stress, and coping, 32(4), 387–398. https://doi.org/10.1080/10615806.2019.1617854

 

Abstract

Background and Objectives:

Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may affect treatment outcome. We examined whether: (1) individuals with SAD differed from healthy controls (HCs) in sleep quality, (2) baseline sleep quality moderated the effects of treatment (Cognitive-behavioral group therapy [CBGT] vs. mindfulness-based stress reduction [MBSR] vs. waitlist [WL]) on social anxiety, (3) sleep quality changed over treatment, and (4) changes in sleep quality predicted anxiety 12-months post-treatment.

Design:

Participants were 108 adults with SAD from a randomized controlled trial of CBGT vs. MBSR vs. WL and 38 HCs.

Methods:

SAD and sleep quality were assessed pre-treatment and post-treatment, and SAD was assessed again 12-months post-treatment.

Results:

Participants with SAD reported poorer sleep quality than HCs. The effect of treatment condition on post-treatment social anxiety did not differ as a function of baseline sleep quality. Sleep quality improved in MBSR, significantly more than WL, but not CBGT. Sleep quality change from pre- to post-treatment in CBGT or MBSR did not predict later social anxiety.

Conclusions:

MBSR, and not CBGT, improved sleep quality among participants. Other results were inconsistent with prior research; possible explanations, limitations, and implications for future research are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6698895/

 

Relieve Sleep Disturbances with Mindfulness Meditation

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Relieve Sleep Disturbances with Mindfulness Meditation

 

By John M. de Castro, Ph.D.

 

“meditation helps lower the heart rate by igniting the parasympathetic nervous system and encouraging slower breathing, thereby increasing the prospect of a quality night’s sleep.” – Headspace

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, 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. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557693/), Rusch and colleagues review, summarize and perform a meta-analysis of the published controlled research studies of the effects of meditation on sleep. They identified 18 published randomized controlled trials that included a total of 1654 participants with clinically significant sleep disturbances.

 

They report that the published research found that when mindfulness meditation was compared to other evidenced-based sleep treatment there were no significant differences in improvements in sleep quality. But when the mindfulness meditation groups were compared to other active controls that did not include evidenced-based sleep treatments, the mindfulness meditation produced significant improvements in sleep quality with moderate effect sizes.

 

The results of the meta-analysis of the published research suggests that mindfulness meditation is as effective as other evidenced-based sleep treatments for improving sleep in patients with clinically significant sleep disturbances. Importantly, mindfulness meditation was significantly more effective than non-sleep treatment active control conditions. Hence, mindfulness meditation appears to be a safe and effective treatment for the improvement of sleep quality that has equivalent efficacy to other treatments.

 

So, relieve sleep disturbances with mindfulness meditation.

 

“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.” – Sleep Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Rusch, H. L., Rosario, M., Levison, L. M., Olivera, A., Livingston, W. S., Wu, T., & Gill, J. M. (2019). The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials. Annals of the New York Academy of Sciences, 1445(1), 5–16. https://doi.org/10.1111/nyas.13996

 

Abstract

There is a growing interest in the effectiveness of mindfulness meditation for sleep disturbed populations. Our study sought to evaluate the effect of mindfulness meditation interventions on sleep quality. To assessTo assess for relative efficacy, comparator groups were restricted to specific active controls (such as evidenced-based sleep treatments) and nonspecific active controls (such as time/attention-matched interventions to control for placebo effects), which were analyzed separately. From 3303 total records, 18 trials with 1654 participants were included. We determined the strength of evidence using four domains (risk of bias, directness of outcome measures, consistency of results, and precision of results). At post-treatment and follow-up, there was low strength of evidence that mindfulness meditation interventions had no effect on sleep quality compared with specific active controls (ES 0.03 [95% CI −0.43–0.49]) and (ES −0.14 [95% CI −0.62–0.34]) respectively. Additionally, there was moderate strength of evidence that mindfulness meditation interventions significantly improved sleep quality compared with nonspecific active controls at post-intervention (ES 0.33 [95% CI 0.17–0.48]) and at follow-up (ES 0.54 [95% CI 0.24–0.84]). These preliminary findings suggest that mindfulness meditation may be effective in treating some aspects of sleep disturbance. Further research is warranted.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557693/

 

Improve Sleep Quality in Women with Sleep Disturbance with Yoga

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Improve Sleep Quality in Women with Sleep Disturbance with Yoga

 

By John M. de Castro, Ph.D.

 

“When people who have insomnia perform yoga on a daily basis, they sleep for longer, fall asleep faster, and return to sleep more quickly if they wake up in the middle of the night.” – Sleep Foundation

 

Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, 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. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia

 

Sleep difficulties are associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia. It makes sense to explore the effectiveness of different mindfulness techniques to improve sleep quality.

 

In today’s Research News article “The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193366/), Wang and colleagues review, summarize, and perform a meta-analysis of the published research literature on the effectiveness of yoga practice for the improvement of sleep in women with sleep problems. They found 19 randomized controlled trials with a total of 1832 participants.

 

They report that the published studies found that yoga practice produced a significant reduction in sleep problems but not insomnia and a significant increase in sleep quality. Healthy patients had greater improvements in sleep quality than breast cancer patients and peri/postmenopausal women had significantly less improvement in sleep quality.

 

The review found that in general yoga practice improves sleep in women with sleep problems except insomnia. The included studies did not have a control condition involving exercise. So, it is not clear if the exercise provided by yoga or a yoga specific factor was responsible for the sleep improvements. Future research should compare yoga practice to another form of exercise, e.g. brisk walking, in improving sleep. In addition, yoga practice does not appear to improve sleep when the disturbance is caused by a physical issue such as breast cancer or menopause. This suggests that yoga works best with sleep disturbances caused by psychological issues.

 

So, improve sleep quality in women with sleep disturbance with yoga.

 

“As a result of the activity’s physical, emotional, and mental relaxation, practitioners of yoga nidra report sleeping better at night, and tend to suffer less with issues such as racing thoughts.” – Sleep.org

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Wang, W. L., Chen, K. H., Pan, Y. C., Yang, S. N., & Chan, Y. Y. (2020). The effect of yoga on sleep quality and insomnia in women with sleep problems: a systematic review and meta-analysis. BMC psychiatry, 20(1), 195. https://doi.org/10.1186/s12888-020-02566-4

 

Abstract

Background

To examine the effectiveness and safety of yoga of women with sleep problems by performing a systematic review and meta-analysis.

Methods

Medline/PubMed, ClinicalKey, ScienceDirect, Embase, PsycINFO, and the Cochrane Library were searched throughout the month of June, 2019. Randomized controlled trials comparing yoga groups with control groups in women with sleep problems were included. Two reviewers independently evaluated risk of bias by using the risk of bias tool suggested by the Cochrane Collaboration for programming and conducting systematic reviews and meta-analyses. The main outcome measure was sleep quality or the severity of insomnia, which was measured using subjective instruments, such as the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI), or objective instruments such as polysomnography, actigraphy, and safety of the intervention. For each outcome, a standardized mean difference (SMD) and confidence intervals (CIs) of 95% were determined.

Results

Nineteen studies in this systematic review included 1832 participants. The meta-analysis of the combined data conducted according to Comprehensive Meta-Analysis showed a significant improvement in sleep (SMD = − 0.327, 95% CI = − 0.506 to − 0.148, P < 0.001). Meta-analyses revealed positive effects of yoga using PSQI scores in 16 randomized control trials (RCTs), compared with the control group in improving sleep quality among women using PSQI (SMD = − 0.54; 95% CI = − 0.89 to − 0.19; P = 0.003). However, three RCTs revealed no effects of yoga compared to the control group in reducing insomnia among women using ISI (SMD = − 0.13; 95% CI = − 0.74 to 0.48; P = 0.69). Seven RCTs revealed no evidence for effects of yoga compared with the control group in improving sleep quality for women with breast cancer using PSQI (SMD = − 0.15; 95% CI = − 0.31 to 0.01; P = 0.5). Four RCTs revealed no evidence for the effects of yoga compared with the control group in improving the sleep quality for peri/postmenopausal women using PSQI (SMD = − 0.31; 95% CI = − 0.95 to 0.33; P = 0.34). Yoga was not associated with any serious adverse events.

Discussion

This systematic review and meta-analysis demonstrated that yoga intervention in women can be beneficial when compared to non-active control conditions in term of managing sleep problems. The moderator analyses suggest that participants in the non-breast cancer subgroup and participants in the non-peri/postmenopausal subgroup were associated with greater benefits, with a direct correlation of total class time with quality of sleep among other related benefits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7193366/

 

Improve the Psychological Health in Breast Cancer Patients with Mindfulness

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Improve the Psychological Health in Breast Cancer Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a state of mind which we can all acquire and use to support our wellbeing physically, emotionally and mentally.  . . Having cancer, or specifically breast cancer, is no exception. Our cancer experiences take up a lot of energies, mental focus and can drain us emotionally. It is important to have a few tools to help us create ‘down’ and ‘out’ times, and to replenish and reconnect with who we are. “ – Breast Cancer Now

 

Receiving a diagnosis of cancer has a huge impact on most people. Feelings of depression, anxiety, and fear are very common and are normal responses to this life-changing and potentially life-ending experience. But cancer diagnosis is not necessarily a death sentence. Over half of the people diagnosed with cancer are still alive 10 years later and this number is rapidly increasing. But, surviving cancer carries with it a number of problems. Anxiety, depression, fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbance, fear, and anxiety and depression. There has been considerable research conducted on the effectiveness of mindfulness practices in treating the psychological issues associated with cancer. So, it makes sense to step back and summarize what has been learned.

 

In today’s Research News article “Mindfulness-based stress reduction for women diagnosed with breast cancer.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/), Schell and colleagues review, summarize, and perform a meta-analysis of the published research studies investigating the effectiveness of the Mindfulness-Based Stress Reduction (MBSR) program for the treatment of the psychological problems that occur in women who survive breast cancer. MBSR includes meditation, body scan, yoga practices, and discussion along with daily home practice. They identified 14 randomized controlled trials.

 

They report that the published research studies provide evidence that the Mindfulness-Based Stress Reduction (MBSR) program improves the quality of life and sleep and reduces anxiety, depression, and fatigue in breast cancer patients. The effect sizes are small and the effects were no longer present at long-term follow-up a year after the end of treatment. MBSR is a complex of practices and the research to date cannot differentiate which components or which combination of components are responsible for the benefits.

 

There is substantial evidence that mindfulness training improves quality of life and sleep and reduces anxiety, depression, and fatigue in a wide variety of healthy and ill individuals. The present results suggest that it also has these benefits for women suffering with breast cancer. Hence, MBSR may be recommended to improve the psychological health of breast cancer patients.

 

So, improve the psychological health in breast cancer patients with mindfulness.

 

“Studies have shown mindfulness-based stress reduction can be effective in alleviating anxiety and depression, decreasing long-term emotional and physical side effects of treatments and improving the quality of sleep in breast cancer patients.” – Breast Cancer Research Foundation

 

CMCS – Center for Mindfulness and Contemplative Studies

 

This and other Contemplative Studies posts are also available on Google+ https://plus.google.com/106784388191201299496/posts and on Twitter @MindfulResearch

 

Study Summary

 

Schell, L. K., Monsef, I., Wöckel, A., & Skoetz, N. (2019). Mindfulness-based stress reduction for women diagnosed with breast cancer. The Cochrane database of systematic reviews, 3(3), CD011518. https://doi.org/10.1002/14651858.CD011518.pub2

 

Abstract

Background

Breast cancer is the most common cancer in women. Diagnosis and treatment may drastically affect quality of life, causing symptoms such as sleep disorders, depression and anxiety. Mindfulness‐based stress reduction (MBSR) is a programme that aims to reduce stress by developing mindfulness, meaning a non‐judgmental, accepting moment‐by‐moment awareness. MBSR seems to benefit patients with mood disorders and chronic pain, and it may also benefit women with breast cancer.

Objectives

To assess the effects of mindfulness‐based stress reduction (MBSR) in women diagnosed with breast cancer.

Search methods

In April 2018, we conducted a comprehensive electronic search for studies of MBSR in women with breast cancer, in the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and two trial registries (World Health Organization’s International Clinical Trials Registry Platform (WHO ICTRP) and ClinicalTrials.gov). We also handsearched relevant conference proceedings.

Selection criteria

Randomised clinical trials (RCTs) comparing MBSR versus no intervention in women with breast cancer.

Data collection and analysis

We used standard methodological procedures expected by Cochrane. Using a standardised data form, the review authors extracted data in duplicate on methodological quality, participants, interventions and outcomes of interest (quality of life, fatigue, depression, anxiety, quality of sleep, overall survival and adverse events). For outcomes assessed with the same instrument, we used the mean difference (MD) as a summary statistic for meta‐analysis; for those assessed with different instruments, we used the standardised mean difference (SMD). The effect of MBSR was assessed in the short term (end of intervention), medium term (up to 6 months after intervention) and long term (up to 24 months after intervention).

Main results

Fourteen RCTs fulfilled our inclusion criteria, with most studies reporting that they included women with early breast cancer. Ten RCTs involving 1571 participants were eligible for meta‐analysis, while four studies involving 185 participants did not report usable results. Queries to the authors of these four studies were unsuccessful. All studies were at high risk of performance and detection bias since participants could not be blinded, and only 3 of 14 studies were at low risk of selection bias. Eight of 10 studies included in the meta‐analysis recruited participants with early breast cancer (the remaining 2 trials did not restrict inclusion to a certain cancer type). Most trials considered only women who had completed cancer treatment.

MBSR may improve quality of life slightly at the end of the intervention (based on low‐certainty evidence from three studies with a total of 339 participants) but may result in little to no difference up to 6 months (based on low‐certainty evidence from three studies involving 428 participants). Long‐term data on quality of life (up to two years after completing MBSR) were available for one study in 97 participants (MD 0.00 on questionnaire FACT‐B, 95% CI −5.82 to 5.82; low‐certainty evidence).

In the short term, MBSR probably reduces fatigue (SMD −0.50, 95% CI −0.86 to −0.14; moderate‐certainty evidence; 5 studies; 693 participants). It also probably slightly reduces anxiety (SMD −0.29, 95% CI −0.50 to −0.08; moderate‐certainty evidence; 6 studies; 749 participants), and it reduces depression (SMD −0.54, 95% CI −0.86 to −0.22; high‐certainty evidence; 6 studies; 745 participants). It probably slightly improves quality of sleep (SMD −0.38, 95% CI −0.79 to 0.04; moderate‐certainty evidence; 4 studies; 475 participants). However, these confidence intervals (except for short‐term depression) are compatible with both an improvement and little to no difference.

In the medium term, MBSR probably results in little to no difference in medium‐term fatigue (SMD −0.31, 95% CI −0.84 to 0.23; moderate‐certainty evidence; 4 studies; 607 participants). The intervention probably slightly reduces anxiety (SMD −0.28, 95% CI −0.49 to −0.07; moderate‐certainty evidence; 7 studies; 1094 participants), depression (SMD −0.32, 95% CI −0.58 to −0.06; moderate‐certainty evidence; 7 studies; 1097 participants) and slightly improves quality of sleep (SMD −0.27, 95% CI −0.63 to 0.08; moderate‐certainty evidence; 4 studies; 654 participants). However, these confidence intervals are compatible with both an improvement and little to no difference.

In the long term, moderate‐certainty evidence shows that MBSR probably results in little to no difference in anxiety (SMD −0.09, 95% CI −0.35 to 0.16; 2 studies; 360 participants) or depression (SMD −0.17, 95% CI −0.40 to 0.05; 2 studies; 352 participants). No long‐term data were available for fatigue or quality of sleep.

No study reported data on survival or adverse events.

Authors’ conclusions

MBSR may improve quality of life slightly at the end of the intervention but may result in little to no difference later on. MBSR probably slightly reduces anxiety, depression and slightly improves quality of sleep at both the end of the intervention and up to six months later. A beneficial effect on fatigue was apparent at the end of the intervention but not up to six months later. Up to two years after the intervention, MBSR probably results in little to no difference in anxiety and depression; there were no data available for fatigue or quality of sleep.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6436161/