Improve Mental Health in Older Adults with Mental Health Problems with Mindfulness

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Improve Mental Health in Older Adults with Mental Health Problems with Mindfulness

 

By John M. de Castro, Ph.D.

 

“You can think of emotional regulation like stopping a train—it works better if you can stop before the train (your emotions) starts rolling too fast.  It also helps when your brakes work immediately, without interference. Mindfulness lets you know right away that you need to stop and keeps thoughts and emotions from interfering.” – University of Minnesotta

 

As we age, there are systematic progressive declines in every system in the body, the brain included. This includes our mental abilities and results in impairments in memory, attention, and problem-solving ability. Aging also results in changes in mental health. Depression is very common in the elderly. The elderly cope with increasing loss of friends and family, deteriorating health, as well as concerns regarding finances on fixed incomes. In addition, many elderly experience withdrawal and isolation from social interactions producing increased loneliness, worry and anxiety.

 

Mindfulness appears to be effective for an array of psychological issues that occur with aging. It has also been shown to be beneficial in slowing or delaying physical and mental decline with aging. and improve cognitive processes. It has also been shown to reduce anxiety, worry, and depression and improve overall mental health. But not everyone responds to mindfulness training with improvement. Identifying who will respond and who won’t is important in determining the best treatment option for each individual.

 

In today’s Research News article “Predictors of Improvements in Mental Health From Mindfulness Meditation in Stressed Older Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802968/ ), Oken and colleagues recruited generally healthy, meditation naïve, older individuals aged 50 to 85 years who reported high levels of perceived stress. They were randomly assigned to a wait-list control group or to receive a 6-week program of Mindfulness-Based Cognitive Therapy (MBCT) including home practice. MBCT training occurred once a week for 60 to 90 minutes and involves mindfulness training, containing sitting, walking and body scan meditations, and cognitive therapy That is designed to alter how the patient relates to the thought processes that often underlie and exacerbate psychological symptoms.

 

The participants were measured before and after treatment and 2 months later for perceived stress, life experience stressors, neuroticism, positive and negative emotions, depression, health-related quality of life, sleep quality, fatigue, self-efficacy, and mindfulness. The researchers separated the participants by their response to the treatment with responders (half the participants) showing significant improvement in mental health.

 

They found that the responders had poorer mental health at the beginning (baseline) including greater levels of negative emotions, lower health related quality of life, and greater fatigue. One interpretive difficulty here is a phenomenon called regression to the mean. This occurs when extremes are selected. On retest they are almost always significantly better. It is possible that the observed effects were not due to the treatment but to people who were struggling getting spontaneously better.

 

These results, however, suggest that MBCT training is best suited to older individuals who have existing mental health issues and is little value to those who are relatively stable psychologically. This makes sense and implies that MBCT training is not particularly useful for psychologically healthy individuals but can help those with difficulties.

 

So, improve mental health in older adults with mental health problems with mindfulness.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.” – Kelle Walsh

 

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

 

Oken, B. S., Goodrich, E., Klee, D., Memmott, T., & Proulx, J. (2018). Predictors of Improvements in Mental Health From Mindfulness Meditation in Stressed Older Adults. Alternative therapies in health and medicine, 24(1), 48-55.

 

Abstract

Context

The benefits of a mindfulness meditation (MM) intervention are most often evidenced by improvements in self-rated stress and mental health. Given the physiological complexity of the psychological stress system, it is likely that some people benefit significantly, while others do not. Clinicians and researchers could benefit from further exploration to determine which baseline factors can predict clinically significant improvements from MM.

Objectives

The study intended to determine: (1) if the baseline measures for participants who significantly benefitted from MM training were different from the baseline measures of participants who did not and (2) whether a classification analysis using a decision-tree, machine-learning approach could be useful in predicting which individuals would be most likely to improve.

Design

The research team performed a secondary analysis of a previously completed randomized, controlled clinical trial.

Setting

Oregon Health & Science University and participants’ homes.

Participants

Participants were 134 stressed, generally healthy adults from the metropolitan area of Portland, Oregon, who were 50 to 85 years old.

Intervention

Participants were randomly assigned either to a six-week MM intervention group or to a waitlist control group, who received the same MM intervention after the waitlist period.

Outcome Measures

Outcome measures were assessed at baseline and at two-month follow-up intervals. A responder was defined as someone who demonstrated a moderate, clinically significant improvement on the Mental Health Component (MHC) of the SF-36, Short Form Health-related Quality of Life (SF-36), ie, a change ≥4. The MHC had demonstrated the greatest effect size in the primary analysis of the above-mentioned randomized, controlled clinical trial. Potential predictors were demographic information and baseline measures related to stress and affect. Univariate statistical analyses were performed to compare the values of predictors in the responder and nonresponder groups. In addition, predictors were chosen for a classification analysis using a decision tree approach.

Results

Of the 134 original participants, 121 completed the MM intervention. As defined above, 61 were responders and 60 were nonresponders. Analyses of the baseline measures demonstrated significant differences between the 2 groups in several measures: (1) the Positive and Negative Affect Schedule negative sub-scale (PANAS-neg), (2) the SF-36 MHC, and (3) the SF-36 Energy/Fatigue, with clinically worse scores being associated with greater likelihood of being a responder. Disappointingly, the decision-tree analyses were unable to achieve a classification rate of better than 65%.

Conclusions

The differences in predictor variables between responders and nonresponders to an MM intervention suggested that those with worse mental health at baseline were more likely to improve. Decision-tree analysis was unable to usefully predict who would respond to the intervention.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5802968/

 

Decrease Hypertension with Yoga Practice

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Decrease Hypertension with Yoga Practice

 

By John M. de Castro, Ph.D.

 

“Yoga, when performed mindfully, can reduce this type of stress-induced hypertension, while addressing its underlying causes. It pacifies the sympathetic nervous system and slows down the heart, while teaching the muscles and mind to relax deeply.” – Marla Apt

 

High Blood Pressure (Hypertension) is an insidious disease because there are no overt symptoms. The individual feels fine. But it can be deadly as more than 360,000 American deaths, roughly 1,000 deaths each day, had high blood pressure as a primary or contributing cause. In addition, hypertension markedly increases the risk heart attack, stroke, heart failure, and kidney disease.  It is also a very common disorder with about 70 million American adults (29%) having high blood pressure and only about half (52%) of people with high blood pressure have their condition under control.

 

High blood pressure, because it doesn’t have any primary symptoms, is usually only diagnosed by direct measurement of blood pressure usually by a health care professional. When hypertension is chronically present over three quarters of patients are treated with antihypertensive drugs. But these medications often have adverse side effects. So, patients feel lousy when taking the drugs, but fine when they’re not. So, compliance is a major issue with many patients not taking the drugs regularly or stopping entirely.

 

Obviously, there is a need for alternative to drug treatments for hypertension. Mindfulness practices have been shown to aid in controlling hypertension. Exercise is also known to help. So, yoga practice, which combines mindfulness practice with exercise would seem to be a good candidate practice for the treatment of hypertension. Indeed, yoga practice appears to lower blood pressure in hypertension. But yoga practices can contain a number of components including meditation, breathing exercises, postures, chanting, and mantras. It is not known, whether the postures included in the practice are necessary for the beneficial effects of yoga practice on hypertension.

 

In today’s Research News article “Yoga in Arterial Hypertension.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375068/ ), Cramer and colleagues recruited adult patients with primary arterial hypertension receiving antihypertensive medication. They were randomly assigned to receive either yoga training that either included postures or without postures, or a wait-list control condition. The yoga practice consisted of 90 minutes, once a week, for 12 weeks of meditation, relaxation techniques, and postures for the yoga with postures group. The participants were encouraged and provided materials to practice daily at home. They were measured before and after training and 26 weeks later for systolic and diastolic blood pressure.

 

They found that at the end of training the yoga group without postures had a greater reduction in systolic blood pressure than either the control group or the group with yoga postures. But, at follow-up, 26 weeks later, the yoga group that included postures had a greater reduction in systolic blood pressure than either the control group or the group without yoga postures. Diastolic blood pressure was not affected. It should be noted that these benefits were obtained in patients taking antihypertensive medications. So, the yoga practice benefits supplemented those of the drugs.

 

These are interesting results that suggest that on the short-term yoga practice without postures is best for blood pressure reduction in patients with hypertension while for the long-term yoga with postures is best. The relaxation produced by practicing meditation and relaxation may have the immediate consequence of decreasing blood pressure but doesn’t appear to be sustained while the exercise involved in postures, like occurs with other aerobic exercises, may have more long-term benefits for the cardiovascular system.

 

These benefits are important as reducing blood pressure in patients with hypertension is important for their health, longevity, and well-being. Yoga appears to be a safe, effective, and relatively inexpensive treatment. In addition, yoga practice has psychological and social benefits that can help to maintain practice over the long-term.

 

So, decrease hypertension with yoga practice.

 

“Yoga, along with deep breathing exercises, meditation and inner reflection, is a good adjunctive and integrative cardiovascular approach to better health, including lowering blood pressure, as this data suggests,” – David Friedman

 

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

 

Cramer, H., Sellin, C., Schumann, D., & Dobos, G. (2018). Yoga in Arterial Hypertension. Deutsches Arzteblatt international, 115(50), 833-839. DOI: 10.3238/arztebl.2018.0833

 

Abstract

Background

Yoga seems to exert its effect against arterial hypertension mainly through the associated breathing and meditation techniques, and less so through yoga postures. The goal of this trial was to compare the blood pressure–lowering effect of yoga interventions with and without yoga postures in patients with arterial hypertension.

Methods

75 patients taking medications for arterial hypertension (72% women, mean age 58.7 ± 9.5 years) were randomized into three groups: a yoga intervention group with yoga postures (25 patients, of whom 5 dropped out of the trial before its end), a yoga intervention group without yoga postures (25 patients, 3 dropouts), and a wait list control group (25 patients, one dropout). The interventions consisted of 90 minutes of yoga practice per week for twelve weeks. The data collectors, who were blinded to the intervention received, assessed the primary outcome measures “systolic 24-hour blood pressure” and “diastolic 24-hour blood pressure” before and after the intervention. In this report, we also present the findings on secondary outcome measures, including follow-up data.

Results

After the intervention, the systolic 24-hour blood pressure in the yoga intervention group without yoga postures was significantly lower than in the control group (group difference [?]= -3.8 mmHg; [95% confidence interval (CI): (-0.3; -7.4) p = 0.035]); it was also significantly lower than in the yoga intervention group with yoga postures (? = -3.2 mmHg; 95% CI: [-6.3; -0.8]; p = 0.045). Diastolic blood pressures did not differ significantly across groups. No serious adverse events were encountered in the course of the trial.

Conclusion

In accordance with the findings of earlier studies, we found that only yoga without yoga postures induced a short-term lowering of ambulatory systolic blood pressure. Yoga is safe and effective in patients taking medications for arterial hypertension and thus can be recommended as an additional treatment option for persons in this category.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6375068/

 

Social Mindfulness is Reduced in Patients with Psychosis

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Social Mindfulness is Reduced in Patients with Psychosis

 

By John M. de Castro, Ph.D.

 

“There is increasing evidence that specially adapted mindfulness techniques can be used safely and effectively in the management and treatment of severe mental health problems, such as psychosis.” – Carly Samson

 

Psychoses are mental health problems that cause people to perceive or interpret things differently from those around them. This might involve hallucinations; seeing and, in some cases, feeling, smelling or tasting things that aren’t objectively there, or delusions; unshakable beliefs that, when examined rationally, are obviously untrue. The combination of hallucinations and delusional thinking can often severely disrupt perception, thinking, emotion, and behavior, making it difficult if not impossible to function in society without treatment. Psychoses appear to be highly heritable and involves changes in the brain. The symptoms of psychoses usually do not appear until late adolescence or early adulthood. There are, however, usually early signs of the onset of psychoses which present as cognitive impairments.

 

Mindfulness training has been shown to be beneficial for patients with psychosis. Individuals with psychosis almost always have difficulties with social functioning. It is reasonable then to investigate the social mindfulness of patients having their first psychotic episode. In today’s Research News article “). Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381043/ ), Lemmers-Jansen and colleagues recruited patients having their first psychotic episode aged 16 to 22 years, individuals at high clinical risk for developing psychosis, and healthy control participants..

 

The participants were measured for social mindfulness, intelligence, and positive and negative symptoms of psychosis. In the social mindfulness task, the participants made a choice that would either enhance (socially mindful) or decrease (socially unmindful) choices for another unseen participant. They performed the task initially without instruction and again after being instructed “to keep the other’s best interest in mind.” The participants performed the social mindfulness task while undergoing functional Magnetic Resonance Scans (f-MRI) of their brains.

 

They found that the patients with their first psychotic episode tended to make less socially mindful choices both before and after instruction than either the individuals at high clinical risk for developing psychosis, and healthy control participants. In addition, the patients with psychosis showed less activation of the caudate during mindful choices and less activation of the medial and dorsal prefrontal cortex and the cingulate cortex during unmindful choices that the other groups.

 

The neural findings suggest that the psychotic patients used less higher-level thinking when making socially unmindful choices (prefrontal cortex) and received less reward for making socially mindful choices (caudate). This suggests that the psychotic patients are less mindful because they’re responding with less thought and with less reinforcement for making socially mindful choices. Regardless, it is clear that a laboratory test confirms what is reported in the patients that they respond less well to social situations.

 

“Fears about meditation triggering psychosis were holding back progress in this area, despite growing evidence that a specially adapted form of mindfulness training could prove safe and very beneficial for these patients.” – Plastic Brain

 

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

 

Lemmers-Jansen, I., Fett, A. J., Van Doesum, N. J., Van Lange, P., Veltman, D. J., & Krabbendam, L. (2019). Social Mindfulness and Psychosis: Neural Response to Socially Mindful Behavior in First-Episode Psychosis and Patients at Clinical High-Risk. Frontiers in human neuroscience, 13, 47. doi:10.3389/fnhum.2019.00047

 

Abstract

Background: Psychosis is characterized by problems in social functioning and trust, the assumed glue to positive social relations. But what helps building trust? A prime candidate could be social mindfulness: the ability and willingness to see and consider another person’s needs and wishes during social decision making. We investigated whether first-episode psychosis patients (FEP) and patients at clinical high-risk (CHR) show reduced social mindfulness, and examined the underlying neural mechanisms.

Methods: Twenty FEP, 17 CHR and 46 healthy controls, aged 16–31, performed the social mindfulness task (SoMi) during fMRI scanning, spontaneously and after the instruction “to keep the other’s best interest in mind.” As first of two people, participants had to choose one out of four products, of which three were identical and one was unique, differing in a single aspect (e.g., color).

Results: FEP tended to choose the unique item (unmindful choice) more often than controls. After instruction, all groups significantly increased the number of mindful choices compared to the spontaneous condition. FEP showed reduced activation of the caudate and medial prefrontal cortex (mPFC) during mindful, and of the anterior cingulate cortex (ACC), mPFC, and left dorsolateral prefrontal cortex (dlPFC) during unmindful decisions. CHR showed reduced activation of the ACC compared to controls.

Discussion: FEP showed a trend toward more unmindful choices. A similar increase of mindful choices after instruction indicated the ability for social mindfulness when prompted. Results suggested reduced sensitivity to the rewarding aspects of social mindfulness in FEP, and reduced consideration for the other player. FEP (and CHR to a lesser extent) might perceive unmindful choices as less incongruent with the automatic mindful responses than controls. Reduced socially mindful behavior in FEP may hinder the building of trust and cooperative interactions.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6381043/

 

Mindful Birthday

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Mindful Birthday

 

By John M. de Castro, Ph.D.

 

“I had always thought a birthday was a day for me, but I believe it’s a day for everyone that is around me. It is a day where everyone shows you love; it’s a day where people want to make you happy. It is a day where smiles and laughter are ubiquitous. My special day brings out the very best in others.” – Anand

 

Birthdays are a special time, one day a year set aside to celebrate the existence of a particular person. It is fairly arbitrary day other than the person was born on a day when the Earth was at the same point in its orbit of the sun. It’s also fairly arbitrary as it is a single point in an ongoing developmental sequence ranging from conception to death; the point of emergence from the mother’s womb. So, it should be seen simply as an annual remembrance and celebration of the individual’s life and growth. As such, it is a worthwhile yearly reflection on life’s continuous changes, as Thich Nhat Hahn likes to say “Happy Continuation Day.”

 

The celebration of a birthday can be special. It’s a time when the individual is recognized by other humans, particularly family and friends. Expressions of love and caring that may be unspoken the rest of the year come out into the open. It’s an opportunity to revel in this recognition, caring, and connection. It is best to do so mindfully; to be sensitive and aware of each present moment, to look deeply at the feelings of the moment, and to listen carefully to everyone involved, hearing not only what is said but the nonverbal expressions. These are usually positive but sometimes they’re negative, but regardless should simply be experienced mindfully without judgement.

 

It is important to be mindful to experience the joy and happiness of the day. It should be fully experienced looking mindfully at the internal feelings and sensations that constitute this joy. But, it needs to be recognized that this, like everything, is impermanent and will briefly arise and fall away. It should not be clung to and attempted to be held onto. That is a prescription for unsatisfactoriness and unhappiness. It should be simply enjoyed as it is when it is present, appreciating the gift of the moment and having no regrets when it vanishes. That is the truly mindful way, that leads to satisfaction with life as it is.

 

So, enjoy your special day. If you focus on appreciating and savoring, but not clinging to, the happy moments in life your entire life will become happier. Enjoying them fully, mindfully, reinforces and strengthens these feelings making them more likely to reappear in the future. Similarly, letting go of regret that the good feelings have gone away and any negative emotions occurring makes them less likely to reappear. It’s simply watering the seeds of happiness so they’ll grow and flourish and allowing negatives to wither. Birthdays are opportunities to do just that.

 

If we reflect, though, it will become apparent that we are constantly being reborn. In fact, every moment we a reborn anew, different than we were, physically, mentally, and spiritually. In fact, awakening in the morning each day is a daily reminder of rebirth. This rebirth is subtle, though, and hard to detect on a moment to moment basis. That is one reason that the birthday celebration is so important. A year passing produces highly detectable changes in our bodies, our minds, and our life situations, greatly emphasizing this continual rebirth. Looking at it mindfully and carefully we can see the impermanence of everything, including ourselves. Some things have gone away, some new things have entered, and the rest has changed to some degree or another. This can lead to and appreciation, wonder, and celebration of the ongoing, ever changing, experience of life. What a wonderful opportunity to see ourselves and life as it truly is.

 

Birthdays are also wonderful times for mindful deep reflections on what has happened to us over the year and what was responsible for it. If we look deeply, we can readily see how much has happened and how interconnected we are to others. Our experiences were not produced by ourselves alone but were contributed to in very fundamental ways by a vast array of people, people close to us and only remotely connected. The individual may have a significant achievement or event during the year; a graduation, a promotion, a marriage, a birth of a child. A little mindful reflection will show how this occurred as a result of the confluence of efforts by a large number of others, our teachers and support group, our coworkers and family, our spouse and their family, in fact, our entire society and those who have gone before. Mindfulness can reveal that nothing occurs in isolation, but rather is the result of an almost infinite matrix of interconnected people and phenomenon. The Birthday is an excellent opportunity to reflect upon and deeply understand this truth of the interdependence of our existences.

 

We can equally benefit from celebrating the birthdays of others. Mindfully reveling in, sensing, and appreciating the good feelings we have toward them is another chance to experience the joys in life. Sensing the love in ourselves toward another is best done mindfully, observing the internal feelings and sensations that constitute this love. Enjoying the feelings of love for another makes it more likely that we’ll express love toward others, increasing the love in the world and our own personal happiness. Seeing the changes in them over the years is another lesson in impermanence. We are not the only one constantly changing and being reborn. It’s happening to everyone. Seeing this helps us to understand in an unvarnished experiential way the true nature of existence.

 

Birthdays are an opportunity to grow, understand, and become happier. Take advantage of that opportunity. But, do so mindfully. Have a mindful Happy Birthday.

 

“You also were inside before you were outside. That means that before you were born, you already existed—inside your mother. The fact is that if something is already there, it does not need to be born. To be born means from nothing you become something. If you are already something, what is the use of being born? So, your so-called birthday is really your continuation day. The next time you celebrate, you can say, “Happy Continuation Day.” – Thich Nhat Hahn

“Chogyam Trungpa always had everyone sing “Cheerful Birthday,” not “Happy Birthday,” saying that Happiness was a state of mind that had Sadness or Unhappiness on its flip side. Cheerfulness, he said, better described a fundamental way or attitude of being. So, growing up in the Buddhist tradition, we always sang Cheerful Birthday to you… .” –  Waylon Lewis

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

Improve Osteopenia and Osteoporosis with Tai Chi

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Improve Osteopenia and Osteoporosis with Tai Chi

 

By John M. de Castro, Ph.D.

 

“There are many ways that tai chi helps people with osteoporosis. An excellent study showed tai chi slowed down the loss of bone density approximately three fold.” – Paul Lam

 

Bone is living tissue that, like all living tissues, is constantly being broken down and replaced. Osteopenia and Osteoporosis occur when the creation of new bone doesn’t keep up with the removal of old bone. This results in a loss of bone mass, causing bones to become weak and brittle. It can become so brittle that a fall or even mild stresses like bending over or coughing can cause a fracture. These fractures most commonly occur in the hip, wrist or spine. Osteoporosis is estimated to affect 200 million women worldwide. In the United States 54 million adults over 50 are affected by osteoporosis and low bone mass. Osteoporosis takes a huge personal and economic toll. The disability due to osteoporosis is greater than that caused by cancers and is comparable or greater than that lost to a variety of chronic diseases, such as arthritis, asthma and high blood pressure related heart disease.

 

The most common treatments for osteoporosis are drugs which slow down the breakdown of bone, combined with exercise. The side effects of the drugs are mild, including upset stomach and heartburn. But there is a major compliance problem as the drugs must be taken over very long periods of time. In fact, only about a third of patients continue to take their medications for at least a year. Even when drugs are taken, exercise is recommended to improve bone growth. Indeed the mindful movement exercise of yoga has been shown to improve osteoporosis. The ancient mindful movement technique Tai Chi is a very safe form of gentle exercise that is beneficial for the prevention and treatment of osteoporosis. With accumulating evidence it is a good idea to step back and summarize what is known about the application of Tai Chi practice for the treatment of osteoporosis.

 

In today’s Research News article “Tai chi for treating osteopenia and primary osteoporosis: a meta-analysis and trial sequential analysis. Clinical interventions in aging.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322510/ ), Zhang and colleagues review, summarize and perform a meta-analysis of the published research literature regarding the application of Tai Chi practice for the treatment of osteopenia and osteoporosis. They discovered 15 published randomized controlled trials.

 

They found that the research studies reported that Tai Chi practice produced a significant increase in bone mineral density and bone gla protein. In addition, Tai Chi practice produced a significant reduction in pain from osteoporosis. These are positive and encouraging results but the authors caution that the quality of the studies was not high and that larger better controlled trials are needed.

 

Tai Chi is gentle and safe mindfulness practice. It is appropriate for all ages including the elderly and for individuals with illnesses that limit their activities or range of motion. It is inexpensive to administer, can be performed in groups or alone, at home or in a facility, and can be quickly learned. In addition, it can be practiced in social groups. This can make it fun, improving the likelihood of long-term engagement in the practice. So, Tai Chi practice would appear to be an excellent gentle mindfulness training and light exercise to improve bone density in patients with osteopenia and osteoporosis.

 

So, improve osteopenia and osteoporosis with Tai Chi.

 

“Tai chi has lots of potential benefits that are well-proven. Even if its direct effects on bone strength and quality are limited, it can still help prevent fractures because it improves balance, neuromuscular coordination and postural stability, thus reducing the risk of falls.” – Berkeley Wellness

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Zhang, Y., Chai, Y., Pan, X., Shen, H., Wei, X., & Xie, Y. (2019). Tai chi for treating osteopenia and primary osteoporosis: a meta-analysis and trial sequential analysis. Clinical interventions in aging, 14, 91-104. doi:10.2147/CIA.S187588

 

Abstract

Purpose

The aim of this meta-analysis was to evaluate the efficacy of Tai chi (TC) as an adjuvant treatment for osteopenia and primary osteoporosis.

Methods

We went through eight databases to identify relevant randomized controlled trials that compared TC with a control group. The primary outcome was osteoporosis-related fractures (fracture incidence). Meta-analyses and trial sequential analyses (TSA) were conducted using RevMan 5.3 and TSA 0.9.

Results

Fifteen randomized controlled trials involving a total of 857 patients were included in the analyses. No trials reported primary outcome; however, bone mineral density (BMD) values differed significantly in subgroup 1 (TC vs no treatment; weighted mean difference [WMD] =0.05 g/cm2, 95% CI 0.03 to 0.07; P<0.00001; P for heterogeneity =0.22, I2=22%) and subgroup 2 (TC vs conventional treatments; WMD =0.16 g/cm2, 95% CI 0.11 to 0.21; P<0.00001; P for heterogeneity =0.008, I2=75%). In addition, two trials compared TC with conventional treatments, which found a significant difference in bone gla protein (standardized mean difference =−1.18, 95% CI −1.66 to −0.70; P<0.00001; P for heterogeneity =0.58, I2=75%). The results of the BMD were confirmed by TSA. Also, TC may have a certain effect on the relief of osteoporotic pain (WMD = −2.61, 95% CI −3.51 to −1.71; WMD = −1.39, 95% CI −2.01 to −0.77). However, it did not promote the quality of life, level of serum calcium, serum phosphorus, and also had no effect on bone turnover markers.

Conclusion

Although there is no study monitoring fracture incidence, TC may be beneficial for patients in improving BMD values, level of bone gla protein, and relieving osteoporotic pain. However, due to the low methodological quality, current evidence for treating osteopenia and primary osteoporosis through TC is insufficient.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6322510/

 

Students and Military who are High in All Facets of Mindfulness Have Better Psychological Health

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Students and Military who are High in All Facets of Mindfulness Have Better Psychological Health

 

By John M. de Castro, Ph.D.

 

“The research is strong for mindfulness’ positive impact in certain areas of mental health, including stress reduction, emotion and attention regulation, reduced rumination, for reducing mild to moderate depression and anxiety, and preventing depressive relapse.“ – Kelle Walsh

 

Mindfulness training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, mindfulness training has been called the third wave of therapies.

 

One of the premiere measurement tools for mindfulness is the Five Factors of Mindfulness Questionnaire. It measures overall mindfulness and also five facets; observing, describing, acting with awareness, non-judgement, and non-reactivity. People differ and an individual can be high or low on any of these facets and any combination of facets. It is not known what pattern of mindfulness facets are most predictive of good mental health.

 

In today’s Research News article “Mindfulness and Psychological Health Outcomes: A Latent Profile Analysis among Military Personnel and College Students.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800780/ ), Bravo and colleagues recruited active and retired military personnel and college students. They were measured online for mindfulness, depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms.

 

They found that overall, the greater the levels of mindfulness, the better the mental health of the participants including lower depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms. The military personnel were higher on all measures except rumination than the college students.

 

For the college students latent profile analysis revealed 4 mindfulness profiles ““high mindfulness” group (i.e., moderately high on all facets of mindfulness), a “low mindfulness” group (i.e., relatively low-to-average on all facets of mindfulness), a “judgmentally observing” group (i.e., high on observing facet, low on non-judging of inner experience and acting with awareness) and a “non-judgmentally aware” group (i.e., low on observing, high on non-judging of inner experience and acting with awareness).” For the military personnel latent profile analysis revealed 3 mindfulness profiles “high mindfulness” group (i.e., moderately high on all facets of mindfulness), a “low mindfulness/ judgmentally observing” group (i.e., relatively low-to-average on describing, and non-reacting facets of mindfulness and  high on observing facet, low on non-judging of inner experience and acting with awareness) and a “non-judgmentally aware” group (i.e., low on observing, high on non-judging of inner experience and acting with awareness).

 

For both the military personnel and the students, the participants with the “high mindfulness” profile had significantly better mental health than those with the other profiles including lower depression, anxiety, rumination, suicidality, post-traumatic stress disorder, alcohol and drug abuse symptoms. It is important to note that the results were similar in very different participant populations, suggesting that the results are generalizable.

 

The results further suggest that with mindfulness there are very different types of people, expressing mindfulness in different ways and this makes a difference in the relationship of mindfulness to mental health. The results suggest that overall being mindful is associated with good mental health. They further suggest that being generally high on all facets of mindfulness is an even better predictor of good mental health. It may make sense in future research to pay more attention to these different mindfulness profile groups in investigating mindfulness relationships with mental and physical well-being.

 

It is clear that mindfulness is associated with better mental health.

 

“We’ve seen this in the clinical domain for many years. People, in concert with their physicians… actually going off their medications for pain, for anxiety, for depression, as they begin to learn the self-regulatory elements of mindfulness. They discover that the things that used to be symptomatically problematic for them are no longer arising at the same level.” – Jon Kabat-Zinn

 

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

 

Bravo, A. J., Pearson, M. R., & Kelley, M. L. (2017). Mindfulness and Psychological Health Outcomes: A Latent Profile Analysis among Military Personnel and College Students. Mindfulness, 9(1), 258-270.

 

Abstract

Previous research on trait mindfulness facets using person-centered analyses (e.g., latent profile analysis [LPA]) has identified four distinct mindfulness profiles among college students: a high mindfulness group (high on all facets of the Five-Factor Mindfulness Questionnaire [FFMQ]), a judgmentally observing group (highest on observing, but low on non-judging of inner experience and acting with awareness), a non-judgmentally aware group (high on non-judging of inner experience and acting with awareness, but very low on observing), and a low mindfulness group (low on all facets of the FFMQ). In the present study, we used LPA to identify distinct mindfulness profiles in a community based sample of U.S. military personnel (majority veterans; n = 407) and non-military college students (n = 310) and compare these profiles on symptoms of psychological health outcomes (e.g., suicidality, PTSD, anxiety, rumination) and percentage of participants exceeding clinically significant cut-offs for depressive symptoms, substance use, and alcohol use. In the subsample of college students, we replicated previous research and found four distinct mindfulness profiles; however, in the military subsample we found three distinct mindfulness profiles (a combined low mindfulness/judgmentally observing class). In both subsamples, we found that the most adaptive profile was the “high mindfulness” profile (i.e., demonstrated the lowest scores on all psychological symptoms and the lowest probability of exceeding clinical cut-offs). Based on these findings, we purport that the comprehensive examination of an individual’s mindfulness profile could help clinicians tailor interventions/treatments that capitalize on individual’s specific strengths and work to address their specific deficits.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800780/

 

Improve Quality of Life in Breast Cancer Survivors with Exercise or Yoga

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Improve Quality of Life in Breast Cancer Survivors with Exercise or Yoga

 

By John M. de Castro, Ph.D.

 

“In studies of women with breast cancer, yoga has been shown to reduce fatigue and improve quality of sleep, physical vitality, and overall quality of life.” – BreastCancer.org

 

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 alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients. But yoga practice is both a mindfulness practice and an exercise. It is unclear whether the benefits of yoga practice for cancer patients is due to its mindfulness or exercise components or both. The research has been accumulating. It is thus important to take a step back and summarize what has been learned.

 

In today’s Research News article “Yoga-Specific Enhancement of Quality of Life Among Women With Breast Cancer: Systematic Review and Exploratory 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/PMC6388460/ ), El-Hashimi and Gorey review, summarize and perform a meta-analysis of the effectiveness of yoga for improving the quality of life in survivors of breast cancer. They found and report on 8 randomized controlled trials that included a comparison to another exercise program.

 

They report that the research demonstrated that exercise practices including yoga produce significant improvements in quality of life for the breast cancer patients that are still present as much as a year later. But yoga practice was not significantly better than other exercise programs in improving the quality of life. It would appear that the fact that yoga practice is an exercise and not its mindfulness aspect is critical for the improvement in the quality of life of breast cancer patients.

 

So, improve quality of life in breast cancer survivors with exercise or yoga.

 

“Yoga, meditation, and breathing practices allow women with breast cancer to explore their emotions, foster mindful empathy, and cope with fatigue and tightness,” – Sierra Campbell

 

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

 

El-Hashimi, D., & Gorey, K. M. (2019). Yoga-Specific Enhancement of Quality of Life Among Women With Breast Cancer: Systematic Review and Exploratory Meta-Analysis of Randomized Controlled Trials. Journal of evidence-based integrative medicine, 24, 2515690X19828325.

 

Abstract

Physical activities during and after cancer treatment have favorable psychosocial effects. Increasingly, yoga has become a popular approach to improving the quality of life (QoL) of women with breast cancer. However, the extant synthetic evidence on yoga has not used other exercise comparison conditions. This meta-analysis aimed to systematically assess yoga-specific effects relative to any other physical exercise intervention (eg, aerobics) for women with breast cancer. QoL was the primary outcome of interest. Eight randomized controlled trials with 545 participants were included. The sample-weighted synthesis at immediate postintervention revealed marginally statistically and modest practically significant differences suggesting yoga’s potentially greater effectiveness: d = 0.14, P = .10. However, at longer term follow-up, no statistically or practically significant between-group difference was observed. This meta-analysis preliminarily demonstrated that yoga is probably as effective as other exercise modalities in improving the QoL of women with breast cancer. Both interventions were associated with clinically significant improvements in QoL. Nearly all of the yoga intervention programs, however, were very poorly resourced. Larger and better controlled trials of well-endowed yoga programs are needed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388460/

 

Trait Mindfulness is Only Loosely Associated with State Mindfulness

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Trait Mindfulness is Only Loosely Associated with State Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a “state” of mind that I can practice when I sit, but it is also a “trait” of mind, an “enduring characteristic,” that can become a part of my basic temperament.” – James Walsh

 

Mindfulness training has been shown to improve health and well-being. It has also been found to be effective for a large array of medical and psychiatric conditions, either stand-alone or in combination with more traditional therapies. As a result, mindfulness training has been called the third wave of therapies. One problem with understanding mindfulness effects is that there are, a wide variety of methods to measure mindfulness.

 

There two basic forms of mindfulness, trait and state mindfulness. Trait mindfulness is an enduring characteristic that is a long-term proclivity to be mindful. It remains relatively stable over time. On the other hand, state mindfulness is a short-term characteristic that is dependent upon circumstances and can change from moment to moment. The relationship between trait and state mindfulness has not been systematically explored.

 

In today’s Research News article “When Traits Match States: Examining the Associations between Self-Report Trait and State Mindfulness following a State Mindfulness Induction.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800747/ ), Bravo and colleagues recruited college students 31% of which had previous meditation experience. They were randomly assigned to receive a brief (8 minute) recorded guided mindfulness meditation induction focused on body sensations and the breath or a control condition consisting of an 8-minute recorded educational presentation on fruit flies. They were measured before and after the induction for state mindfulness including mindfulness of mind and mindfulness of body, and trait mindfulness including observing, describing, acting with awareness, non-judging, non-reactivity.

 

They found that at baseline there were few, weak, and small relationships between trait mindfulness facets and state mindfulness of either mind or body. This makes sense as trait mindfulness is fairly stable while state mindfulness can be highly variable, high one moment and low another. After the brief body focused meditation there was a significant increase in the participants state of mindfulness of their body but not mind which also is to be expected. They also found that “the association between observing trait mindfulness and state mindfulness of mind and body strengthened with more frequent mindfulness meditation practice.”

 

These are interesting but not surprising findings that the enduring tendency to be mindful is not necessarily related to the moment by moment state of mindfulness. This also tells us that these are independent characteristics that can be accurately measured with existing scales of mindfulness. This suggests that measures of both should be included in research studies of mindfulness as they reflect different components of mindfulness.

 

So, trait mindfulness is only loosely associated with state mindfulness.

 

“the trait-like propensity to be mindful in everyday life may be modifiable (for at least some individuals) through intentional practice of evoking the corresponding state during meditation.” – Laura Kiken

 

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

 

Bravo, A. J., Pearson, M. R., Wilson, A. D., & Witkiewitz, K. (2017). When Traits Match States: Examining the Associations between Self-Report Trait and State Mindfulness following a State Mindfulness Induction. Mindfulness, 9(1), 199-211.

 

Abstract

Previous research has found inconsistent relationships between trait mindfulness and state mindfulness. To extend previous research, we sought to examine the unique associations between self-report trait mindfulness and state mindfulness by levels of meditation experience (meditation-naïve vs. meditation-experienced) and by mindfulness induction (experimentally induced mindful state vs. control group). We recruited 299 college students (93 with previous mindfulness meditation experience) to participate in an experiment that involved the assessment of five facets of trait mindfulness (among other constructs), followed by a mindfulness induction (vs. control), followed by the assessment of state mindfulness of body and mind. Correlational analyses revealed limited associations between trait mindfulness facets and facets of state mindfulness, and demonstrated that a brief mindfulness exercise focused on bodily sensations and the breath elicited higher state mindfulness of body but not state mindfulness of mind. We found significant interactions such that individuals with previous meditation experience and higher scores on the observing facet of trait mindfulness had the highest levels of state mindfulness of body and mind. Among individuals with meditation experience, the strengths of the associations between observing trait mindfulness and the state mindfulness facets increased with frequency of meditation practice. Some other interactions ran counter to expectations. Overall, the relatively weak associations between trait and state mindfulness demonstrates the need to improve our operationalizations of mindfulness, advance our understanding of how to best cultivate mindfulness, and reappraise the ways in which mindfulness can manifest as a state and as a trait.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5800747/

 

Reduce Athletic Burnout with Mindfulness

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Reduce Athletic Burnout with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness training has the potential to prevent athlete burnout because of stress reduction and increased recovery.  It also has the potential to enhance performances.  Mindfulness exercises could be beneficial for athletes who struggle with demands from several sources.” – P. Furrer

 

Athletic performance requires the harmony of mind and body. Excellence is in part physical and in part psychological. Without inheriting an athletic body and without many hours of training the individual will never reach an elite level. But, once there, the difference between winning and losing is psychological. That is why an entire profession of Sports Psychology has developed. “In sport psychology, competitive athletes are taught psychological strategies to better cope with a number of demanding challenges related to psychological functioning.” They use a number of techniques to enhance performance including anxiety or energy management, attention and concentration control (focusing), communication, goal setting, imagery, visualization, mental practice, self-talk, controlling negative emotions, team building, time management/organization.

 

Mindfulness training has been shown to enhance a number of the characteristics that are taught by Sports Psychologists. Mindfulness training improves attention and concentration and emotion regulation and reduces anxiety and worry and rumination, and the physiological and psychological responses to stress. As a result, mindfulness training, including meditation and yoga practices, have been employed by elite athletes and even by entire teams to enhance their performance. It makes sense at this point to step back and take a look at the state of the research.

 

In today’s Research News article “Mindfulness and Athlete Burnout: 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/PMC6388258/ ), Li and colleagues review and summarize, and perform a meta-analysis of the published research literature on the effectiveness of mindfulness as an antidote to athletic burnout. They identified 10 studies including 2 controlled trials, 5 cross-sectional surveys, 1 prospective survey, and 2 qualitative studies.

 

They found that the literature in general reports that mindfulness training produces a reduction in burnout symptoms in athletes and that mindful individuals tend to have significantly lower levels of burnout symptoms. Meta-analysis revealed a significant association between mindfulness and lower burnout, particularly with the burnout symptoms of emotional and physical exhaustion.

 

Hence, the research suggests the mindfulness is a potential antidote to athletic burnout. But the reviewed studies were methodologically weak and larger, well controlled, randomized controlled trials, with long-term follow-up are needed. Thus, although the research has produced promising results, conclusions must be tempered pending more research.

 

So, reduce athletic burnout with mindfulness.

 

“Despite how physically ready athletes are for competition, their performances may suffer if they do not have control over their minds. Improving mindfulness, or participating in mindfulness-based interventions may help athletes monitor and cope with their sport related anxiety, help them focus during their competitions, and help boost their confidence. Athletes are looking for whatever will give them the advantage, so why not try mindfulness?” – Crystal Chariton

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Li, C., Zhu, Y., Zhang, M., Gustafsson, H., & Chen, T. (2019). Mindfulness and Athlete Burnout: A Systematic Review and Meta-Analysis. International journal of environmental research and public health, 16(3), 449. doi:10.3390/ijerph16030449

 

Abstract

Objective: This review aims to identify, appraise, and synthesize studies reporting the relationship between mindfulness and athlete burnout and the effects of mindfulness-based interventions (MBIs) on athlete burnout. Methods: Studies were identified through searching six electronic databases using combinations of three groups of keywords and manual search. Two independent reviewers screened the searched studies, extracted data of the included studies, and assessed the study quality. The extracted data were synthesized qualitatively and quantitatively. Results: Ten studies consisting of two controlled trials, six surveys, and two interview studies met the inclusion criteria. The two controlled trials had weak methodological quality, and the remaining studies were of moderate to high research quality. Results of controlled trials and interview research generally showed that MBIs had positive effects in burnout prevention. Meta-analytic results indicated a negative association between mindfulness and burnout. Conclusions: There is some evidence showing that mindfulness was negatively associated with athlete burnout. However, given the small number of interventions and qualitative studies, there is limited evidence on whether MBIs are useful in preventing athlete burnout. More studies are needed to corroborate these findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6388258/

 

Improve Sleep in Breast Cancer Patients Undergoing Chemotherapy with Yoga

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Improve Sleep in Breast Cancer Patients Undergoing Chemotherapy with Yoga

 

By John M. de Castro, Ph.D.

 

“Sleep disturbance is a common problem for women with breast cancer, and can have a variety of causes, from stress and depression related to the treatment or diagnosis, to a side effect of some of the drugs and anti-nausea medications used in chemotherapy regimens. Yoga not only produced benefits in the short term, it also produced benefits in sleep quality three months and six months after treatment.” – Paul Raeburn

 

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. Fatigue and insomnia are common symptoms in the aftermath of surviving breast cancer.

 

Mindfulness training has been shown to help with cancer recovery and help to alleviate many of the residual physical and psychological symptoms, including fatigue, stress,  sleep disturbance, and anxiety and depression. Yoga practice is a form of mindfulness training that has been shown to be beneficial for cancer patients.  In today’s Research News article “Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735004/ ), Chaoul and colleagues examine the ability of yoga practice to improve sleep in breast cancer patients.

 

They recruited patients with Stage 1 to 3 breast cancer scheduled to undergo chemotherapy. They were randomly assigned to usual care or to either receive a Tibetan Yoga Program or a stretching program. Participants met for 4, 75 to 90-minute, sessions during chemotherapy and 3 booster sessions over the next 6 months. The participants were also encouraged to practice at home. The Tibetan Yoga Program consisted of “1) mindfulness and focused attention through guided meditation with breathing and visualization; 2) an alternate nostril breathing practice and a breath retention exercise; 3) Tsa Lung movements; and 4) closing with a brief compassion-based meditation.” The participants were measured before and after the programs and 3, 6, and 12 months later for sleep quality, fatigue, and actigraph measured sleep patterns.

 

They found that all groups improved in sleep quality and fatigue over the 12-month measurement period. But the Tibetan Yoga group had significantly less daily sleep disturbances and fewer minutes awake before sleep onset. Hence, participation in the Tibetan Yoga Program had modest benefits for the quality of sleep for the patients. The Tibetan Yoga Program contains a number of different components including meditation, postures, and breathing exercises. It is impossible to determine in the current study which components or which combinations of components were necessary and sufficient for the benefits.

 

These results are encouraging but not clinically significant as the effects were very modest. But,

it should be kept in mind that yoga and meditation programs have been shown to improve a number of other impacts of breast cancer diagnosis and survival. So, the total impact of participation in yoga for breast cancer patients may be much greater than implied by the current results.

 

So, improve sleep in breast cancer patients undergoing chemotherapy with yoga.

 

“it is encouraging to see that the women who practiced yoga outside of class had improved sleep outcomes over time. Previous research has established that yoga effectively reduces sleep disturbances for cancer patients, but have not included active control groups or long-term follow-up.” – Lorenzo Cohen

 

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

 

Chaoul, A., Milbury, K., Spelman, A., Basen-Engquist, K., Hall, M. H., Wei, Q., Shih, Y. T., Arun, B., Valero, V., Perkins, G. H., Babiera, G. V., Wangyal, T., Engle, R., Harrison, C. A., Li, Y., … Cohen, L. (2017). Randomized trial of Tibetan yoga in patients with breast cancer undergoing chemotherapy. Cancer, 124(1), 36-45.

 

Abstract

BACKGROUND

This randomized trial examined the effects of a Tibetan yoga program (TYP) versus a stretching program (STP) and usual care (UC) on sleep and fatigue in women with breast cancer undergoing chemotherapy.

METHODS

Women with stage I–III breast cancer undergoing chemotherapy were randomized to TYP (n=74), STP (n=68), or UC (n=85) groups. Participants in the TYP and STP groups participated in 4 sessions during chemotherapy, followed by three booster sessions over the subsequent 6 months, and encouraged to practice at home. Self-report measures of sleep disturbances (Pittsburgh Sleep Quality Index) fatigue (Brief Fatigue Inventory), and actigraphy were collected at baseline, 1-week post-treatment, and 3, 6 and 12 months.

RESULTS

There were no group differences in total sleep disturbances or fatigue levels over time. However, patients in TYP reported fewer daily disturbances 1-week post-treatment than STP (difference=−0.43, 95% CI: −0.82, −0.04, P=0.03) and UC (difference=−0.41, 95.5% CI: −0.77, −0.05, P=0.02). Group differences at the other time points were maintained for TYP versus STP. Actigraphy data revealed greater minutes awake after sleep onset for STP 1-week post treatment versus TYP (difference=15.36, 95% CI: 7.25,23.48, P=0.0003) and UC (difference=14.48, 95% CI: 7.09,21.87, P=0.0002). Patients in TYP who practiced at least two times a week during follow-up reported better PSQI and actigraphy outcomes at 3 and 6 months post-treatment than those who did not and better than those in UC.

CONCLUSIONS

Participating in TYP during chemotherapy resulted in modest short-term benefits in sleep quality, with long-term benefits emerging over time for those who practiced TYP at least two times a week.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5735004/