Improve Smoking Abstinence with Mindfulness

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Improve Smoking Abstinence with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness training (MT) may decouple the association between craving and smoking, thus facilitating smoking cessation.” – J. Kim Pemberthy

 

“Tobacco use remains the single largest preventable cause of death and disease in the United States.” (Centers for Disease Control and Prevention). So, treating nicotine addiction and producing smoking cessation could greatly improve health. But smoking has proved devilishly difficult to treat. There are a wide variety of methods and strategies to quit smoking which are to only a very limited extent effective. According to the National Institutes of Health, about 40% of smokers who want to quit make a serious attempt to do so each year, but fewer than 5% actually succeed. Most people require three or four failed attempts before being successful.

 

One problem is that nicotine is one of the most addictive substances known and withdrawal from nicotine is very stressful, producing many physical and psychological problems, including negative emotional states and depression. In essence, the addict feels miserable without the nicotine. This promotes relapse to relieve the discomfort. Better methods to quit which can not only promote quitting but also prevent relapse are badly needed. Mindfulness practices have been found to be helpful in treating addictions, including nicotine addiction, and reducing the risk of relapse.

 

In today’s Research News article “Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/), Spears and colleagues recruited adult smokers desiring to quit and provided them with “six smoking cessation counseling sessions (10–20 minutes each).” They completed questionnaires on demographics and mindfulness. They were also asked to complete assessments at baseline and for 4 weeks after cessation of smoking on a smartphone of positive and negative emotions, smoking urges, and expectancy of regulating emotions whenever they had an urge to smoke, smoked a cigarette, and 4 randomly selected times per day prompted on their smartphone.

 

Of the participants 63% achieved smoking abstinence after treatment and 41% remained abstinent 7 days later. They found that on the day of smoking cessation and 7 days later, the higher the levels of mindfulness the lower the levels of negative emotions, stress, smoking urges, and expectancies that smoking would improve mood and the higher the levels of positive emotions. They also found that lower smoking urges were associated with higher levels of abstinence when the participants were low in mindfulness but not when they were high in mindfulness. In addition, the higher the levels of mindfulness, the higher the levels of positive emotions and the lower the levels of negative emotions which were in turn associated with higher levels of smoking abstinence.

 

Even though the smoking cessation therapy did not include a mindfulness component, the participant’s level of mindfulness was an important contributor to successful smoking abstinence. Mindfulness appeared to be associated with improved mood and lower stress levels and urges to smoke which were in turn associated with improved outcomes. Hence, mood and stress appear to mediate the association of mindfulness with successfully quitting smoking. Mindful people appear to have more positive moods which works to improve the likelihood of quitting smoking.

 

So, improve smoking abstinence with mindfulness.

 

“stress is caused by craving. If you can let go of that craving, then your stress will dissolve, and practicing mindfulness is the way to do that.” – Judson Brewer

 

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

 

Spears, C. A., Li, L., Wu, C., Vinci, C., Heppner, W. L., Hoover, D. S., Lam, C., & Wetter, D. W. (2019). Mechanisms linking mindfulness and early smoking abstinence: An ecological momentary assessment study. Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors, 33(3), 197–207. https://doi.org/10.1037/adb0000451

 

Abstract

Research suggests that individuals with greater dispositional mindfulness (i.e., non-judgmental, present-focused attention) are more likely to quit smoking, but the underlying mechanisms are unclear. This study investigated mechanisms linking mindfulness and early smoking abstinence using ecological momentary assessment (EMA). Participants were 355 smokers (33% Caucasian, 33% African American, 32% Latino; 55% female) receiving smoking cessation treatment. Mindfulness was assessed at baseline and on the quit date. For 4 days pre-quit and 1 week post-quit, participants completed up to 4 EMAs per day indicating levels of negative affect (NA), positive affect (PA), smoking urges, and affect regulation expectancies. Mean, slope, and volatility were calculated for each pre-quit and post-quit EMA variable. Associations among mindfulness, EMA parameters, and abstinence on the quit day and 7 days post-quit, as well as indirect effects of mindfulness on abstinence through EMA parameters were examined. Mindfulness predicted higher odds of abstinence in unadjusted but not covariate-adjusted models. Mindfulness predicted lower NA, higher PA, and lower affective volatility. Lower stress mediated the association between mindfulness and quit-day abstinence. Higher ratings of happy and relaxed, and lower ratings of bored, sad and angry, mediated the association between mindfulness and post-quit abstinence. Mindfulness appeared to weaken the association between craving and post-quit abstinence. This study elucidates real-time, real-life mechanisms underlying dispositional mindfulness and smoking abstinence. During the early process of quitting smoking, more mindful individuals appear to have more favorable emotional profiles, which predicts higher likelihood of achieving abstinence 1 week after the quit date.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483850/

 

The Relationship between Cravings and Mindfulness in Patients Recovering from Substance Abuse

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Mindfulness, doi:10.1007/s12671-018-1023-z

The Relationship between Cravings and Mindfulness in Patients Recovering from Substance Abuse

 

By John M. de Castro, Ph.D.

 

“when people cultivate mindfulness, they’re developing a tool to become aware of that inclination to want only pleasurable things and escape uncomfortable things.” – Sarah Bowen

 

Substance abuse is a major health and social problem. There are estimated 22.2 million people in the U.S. with substance dependence. It is estimated that worldwide there are nearly ¼ million deaths yearly as a result of illicit drug use which includes unintentional overdoses, suicides, HIV and AIDS, and trauma. Obviously, there is a need to find effective methods to prevent and treat substance abuse. There are a number of programs that are successful at stopping the drug abuse, including the classic 12-step program emblematic of Alcoholics Anonymous. Unfortunately, the majority of drug and/or alcohol abusers relapse and return to substance abuse. Hence, it is important to find an effective method to treat substance abuse and prevent relapse.

 

An effective treatment for addiction has been elusive. Most programs and therapies to treat addictions have poor success rates. Recent research is indicating that mindfulness has been found to be effective in treating addictions. One way that mindfulness may produce these benefits is by reducing cravings. Mindfulness-based Relapse Prevention (MBRP) has been developed to specifically assist in relapse prevention and has been shown to be effective. “MBRP integrates mindfulness practices with cognitive-behavioral Relapse Prevention therapy and aims to help participants increase awareness and acceptance of difficult thoughts, feelings, and sensations to create changes in patterns of reactive behavior that commonly lead to relapse. Mindfulness training in MBRP provides clients with a new way of processing situational cues and monitoring internal reactions to contingencies, and this awareness supports proactive behavioral choices in the face of high-risk relapse situation.” – Grow et al. 2015.

 

In a previous study it was reported that Mindfulness-based Relapse Prevention (MBRP) improved mindfulness which in turn resulted in reduced cravings. In today’s Research News article “The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435335/), Hsiao and colleagues attempted to replicate their previous findings of mindfulness as a mediator between MBRP and reduced cravings. They recruited adults who had completed intensive treatment for cessation of alcohol or drug abuse in the prior 2 weeks. The patients were randomly assigned to receive either treatment as usual or 8 weekly 2-hour sessions of Mindfulness-based Relapse Prevention (MBRP). They were measured before and after training and 2 and 4 months later for acceptance, mindfulness and drug or alcohol cravings.

 

In a previous, virtually identical study, they had found that in comparison to baseline and treatment as usual Mindfulness-based Relapse Prevention (MBRP) resulted in significantly increased mindfulness and acceptance and decreased cravings. They also found that mindfulness mediated the effect of MBRP on cravings such that MBRP increased mindfulness which in turn decreased cravings. But in the present study MBRP did not increase mindfulness and acceptance and did not decrease cravings and there was no significant mediation.

 

These were surprising results. The previous study was highly significant with moderate effect sizes. They hypothesized that part of the failure to replicate the prior results may have been due to the increased acceptance of mindfulness in the therapeutic community over the years. They speculated that mindfulness may have been incorporated in the therapy included in treatment as usual in the present study whereas it wasn’t in the prior study. More research is needed to examine this possibility.

 

It should be noted that the effectiveness of mindfulness in producing benefits has been replicated multiple times in other domains. Thus, the results underline the need for replication of published results in the studies of mindfulness and addiction. They may be more fragile than thought.

 

“One of the biggest challenges of recovering from addiction is dealing with cravings. . . Being mindful in a craving means seeing the craving for what it really is and really experiencing it. . . Once you can accept that a craving is just a feeling and the object of the craving will never deliver on that promise, you will be able to regain some control.” – Recovery Ways

 

CMCS – Center for Mindfulness and Contemplative Studies

 

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

 

Study Summary

 

Hsiao, Y. Y., Tofighi, D., Kruger, E. S., Lee Van Horn, M., MacKinnon, D. P., & Witkiewitz, K. (2019). The (Lack of) Replication of Self-Reported Mindfulness as a Mechanism of Change in Mindfulness-Based Relapse Prevention for Substance Use Disorders. Mindfulness, 10(4), 724–736. https://doi.org/10.1007/s12671-018-1023-z

 

Abstract

The development and evaluation of mindfulness-based interventions for a variety of psychological and medical disorders has grown exponentially over the past 20 years. Yet, calls for increasing the rigor of mindfulness research and recognition of the difficulties of conducting research on the topic of mindfulness have also increased. One of the major difficulties is the measurement of mindfulness, with varying definitions across studies and ambiguity with respect to the meaning of mindfulness. There is also concern about the reproducibility of findings given few attempts at replication. The current secondary analysis addressed the issue of reproducibility and robustness of the construct of self-reported mindfulness across two separate randomized clinical trials of mindfulness-based relapse prevention (MBRP), as an aftercare treatment for substance use disorder. Specifically, we tested the robustness of our previously published findings, which identified a latent construct of mindfulness as a significant mediator of the effect of MBRP on reducing craving following treatment. First, we attempted to replicate the findings in a separate randomized clinical trial of MBRP. Second, we conducted sensitivity analyses to test the assumption of the no-omitted confounder bias in a mediation model. The effect of MBRP on self-reported mindfulness and overall mediation effect failed to replicate in a new sample. The effect of self-reported mindfulness in predicting craving following treatment did replicate and was robust to the no-omitted confounder bias. The results of this work shine a light on the difficulties in the measurement of mindfulness and the importance of examining the robustness of findings.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6435335/

 

Improve Mothers and Children with Autism with Mindfulness

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Improve Mothers and Children with Autism with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Parents of children with autism spectrum disorder (ASD) often experience high stress in the form of psychological problems, marital strain, and/or family interaction difficulties. . . Mindfulness-based interventions have been found to be beneficial for these parents in many ways, such as decreasing their levels of depression, stress, and emotional reactivity . . . Additionally, many parents of children with ASD who engage in a mindfulness-based practice see a decrease in their child’s aggression and challenging behaviors and an improvement in the child’s overall functioning.” – Katy Oberle

 

Autism spectrum disorder (ASD) is a developmental disability that tends to appear during early childhood and affect the individual throughout their lifetime. It affects a person’s ability to communicate, and interact with others, delays learning of language, makes eye contact or holding a conversation difficult, impairs reasoning and planning, narrows and intensifies interests, produces poor motor skills and sensory sensitivities, and is frequently associated with sleep and gastrointestinal problems. ASD is a serious disorder that impairs the individual’s ability to lead independent lives including complete an education, enter into relationships or find and hold employment. Mindfulness training has been shown to be helpful in treating ASD.

 

Providing care for children with autism can be particularly challenging. These children’s behavior is characterized, in varying degrees, by difficulties in social interaction, verbal and nonverbal communication and repetitive behaviors. These make it difficult to relate to the child and receive the kind of positive feelings that often help to support caregiving. The challenges of caring for a child with autism require that the parent be able to deal with stress, to regulate their own emotions, and to be sensitive and attentive to their child. These skills are exactly those that are developed in mindfulness training. It improves the psychological and physiological responses to stress. It improves emotion regulation. And it improves the ability to maintain attention and focus in the face of high levels of distraction.

 

In today’s Research News article “A Component Analysis of the Mindfulness-Based Positive Behavior Support (MBPBS) Program for Mindful Parenting by Mothers of Children with Autism Spectrum Disorder.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223597/), Singh and colleagues examine the ability of mindful parenting to improve children with autism and their parents. They recruited mothers of children with Autism spectrum disorder (ASD). After a 10-week preintervention control period the mothers were randomly assigned to receive training for 3 days followed by 30 weeks of practice of either Mindfulness-Based Positive Behavior Support (MBPBS), mindfulness and meditation, or Positive Behavior Support (PBS). PBS involved instruction on how to positively manage their children’s behavior. They were measured before and after the intervention and yearly for 3 years following the intervention for perceived stress and amount of meditation practice and the children’s’ aggressive behaviors, disruptive behaviors, and compliance with mothers’ instructions.

 

They found that in comparison to baseline all groups had significant decreases in the mothers, perceived stress and the children’s aggressive behaviors and disruptive behaviors and significant increases in the children’ compliance with mothers’ instructions that was maintained over the 3-year follow-up period. But the group receiving Mindfulness-Based Positive Behavior Support (MBPBS) had significantly greater improvements in these measures than the mindfulness only group which in turn had significantly greater improvements than the Positive Behavior Support (PBS) group.

 

Dealing with a child with autism spectrum disorder is difficult, challenging and stressful. The results of the present study suggest that training in mindfulness and positive behavior support produces long lasting improvements in the children’s behaviors and the mother’s stress levels. The results further suggest that both mindfulness training and positive behavior support training produce significant benefits with mindfulness training superior. But the combination of the trainings produces maximum effects. Hence, the benefits of mindfulness training and positive behavior support training appear to be additive.

 

The levels of effectiveness of the combined Mindfulness-Based Positive Behavior Support (MBPBS) were quite remarkable with the children’s aggressive and disruptive behaviors almost reduced to zero and this compliance with the mothers’ instructions nearly doubled. The fact that these benefits last over 3 years is quite remarkable. As such MBPBS training should be recommended for mothers of children with autism spectrum disorder.

 

So, improve mothers and children with autism with mindfulness.

 

“mindful parenting can affect not just you and reduce your own stress, but it can also help your children, as well.” – A. Stout

 

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

 

Singh, N. N., Lancioni, G. E., Medvedev, O. N., Hwang, Y. S., & Myers, R. E. (2020). A Component Analysis of the Mindfulness-Based Positive Behavior Support (MBPBS) Program for Mindful Parenting by Mothers of Children with Autism Spectrum Disorder. Mindfulness, 1–13. Advance online publication. https://doi.org/10.1007/s12671-020-01376-9

 

Abstract

Objectives

Mindfulness-Based Positive Behavior Support (MBPBS) has been shown to be effective in reducing stress and burnout in parents and professional caregivers of children and adolescents with intellectual and developmental disabilities (IDD) and autism spectrum disorder (ASD). The aim of this study was to assess the comparative effects of the mindfulness (MB) and positive behavior support (PBS) components against the MBPBS program for mindful parenting.

Methods

The study utilized a three-arm randomized controlled trial design, with a 10-week pre-treatment control condition, 30 weeks of intervention, and 3 years of post-intervention follow-up. Mothers of children with ASD were randomly assigned to the MB, PBS, and MBPBS conditions and provided 3 days of training specific to each condition. The effects of these programs were assessed on the mothers (i.e., training attendance, meditation time, perceived psychological stress) and spillover effects were assessed on their children with ASD (i.e., aggression, disruptive behavior, compliance with mothers’ requests).

Results

Mothers in the MBPBS condition reported greater reductions in perceived psychological stress, followed by those in the MB condition, and with no significant changes reported by those in the PBS condition. Reduction in the children’s aggression and disruptive behavior followed a similar pattern, with most to least significant reductions being in MBPBS, MB, and PBS condition, respectively. Significant increases in compliance (i.e., responsiveness to mothers’ requests) were largest in the MBPBS condition, followed by MB, and then PBS. Changes across all variables for both mothers and their children were maintained for 3 years post-intervention. After time and training type were controlled for, meditation time was a significant predictor in reducing aggressive and disruptive behaviors, and in enhancing compliance of the children with mothers’ requests.

Conclusions

Positive outcomes for mothers and their children with ASD were significantly greater in the MBPBS condition, followed by the MB condition, and least in the PBS condition. MBPBS appears to be an effective mindful parenting program on the assessed variables.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223597/

 

Reduce Inflammation in Psychiatric Patients with Mindfulness

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Reduce Inflammation in Psychiatric Patients with Mindfulness

 

By John M. de Castro, Ph.D.

 

“mindfulness practice was not directly linked to lower inflammation levels, but that it may have bolstered stress resilience among at-risk adults by preventing an increase in inflammatory biomarker levels.” – Grace Bullock

 

The immune system is designed to protect the body from threats like stress, infection, injury, and toxic chemicals. One of its tools is the Inflammatory response. This response works quite well for short-term infections and injuries. But when inflammation is protracted and becomes chronic, it can itself become a threat to health. It can produce autoimmune diseases such as colitis, Chron’s disease, arthritis, heart disease, increased cancer risk, lung disease, sleep disruption, gum disease, decreased bone health, psoriasis, and depression. In the elderly it is associated with the onset of dementia.

 

Needless to say, chronic inflammation can create major health problems. Indeed, the presence of chronic inflammation is associated with reduced longevity. So, it is important for health to control the inflammatory response, allowing it to do its job in fighting off infection but reducing its activity when no external threat is apparent. Of course, it is far better to prevent chronic inflammation in the first place than to treat it later. Mind-body techniques such as yoga, Tai Chi and meditation have been shown to adaptively reduce the inflammatory response. In addition, mindfulness training, has been shown to be effective in treating psychiatric disorders. It is possible that mindfulness acts, in part, to improve psychiatric disorders by decreasing inflammation in these patients.

 

In today’s Research News article “Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/), Sanada and colleagues review, summarize, and perform a meta-analysis of the effectiveness of mindfulness-based interventions in reducing biomarkers of the inflammatory response in psychiatric patients. They discovered 10 published research studies with a total of 998 participants. They included patients diagnosed with anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD.

 

They report that the published research studies found that mindfulness-based interventions improved the levels of a variety of biomarkers of inflammation with a variety of psychiatric problems. These included event-related potentials, methylation of serotonin transporter genes, IL-6, TNF-α, and adrenocorticotropic hormone. These biomarkers suggest that psychiatric disorders are associated with mild levels of inflammation and that mindfulness-based interventions reduce the levels of these biomarkers.

 

Hence the published research literature suggests that mindfulness-based interventions are effective in reducing the levels of inflammation in psychiatric patients and improving their health status. These results provide an explanation for the effectiveness of mindfulness for the improvement of anxiety disorders, depression, alcohol abuse, sleep disorders, PTSD, and ADHD. They did not report on the mechanisms by which mindfulness reduces inflammation. But high on the list of possibilities has to be the ability of mindfulness training to reduce the physiological and psychological responses to stress as stress can increase inflammatory responses.

 

So, reduce inflammation in psychiatric patients with mindfulness.

 

“mindfulness techniques may be more effective in relieving inflammatory symptoms than other activities that promote well-being.” – ScienceDaily

 

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

 

Sanada, K., Montero-Marin, J., Barceló-Soler, A., Ikuse, D., Ota, M., Hirata, A., Yoshizawa, A., Hatanaka, R., Valero, M. S., Demarzo, M., Campayo, J. G., & Iwanami, A. (2020). Effects of Mindfulness-Based Interventions on Biomarkers and Low-Grade Inflammation in Patients with Psychiatric Disorders: A Meta-Analytic Review. International journal of molecular sciences, 21(7), 2484. https://doi.org/10.3390/ijms21072484

 

Abstract

Mindfulness-Based Interventions (MBIs) present positive effects on mental health in diverse populations. However, the detailed associations between MBIs and biomarkers in patients with psychiatric disorders remain poorly understood. The aim of this study was to examine the effects of MBIs on biomarkers in psychiatric illness used to summarise the effects of low-grade inflammation. A systematic review of PubMed, EMBASE, PsycINFO, and the Cochrane Library was conducted. Effect sizes (ESs) were determined by Hedges’ g and the number needed to treat (NNT). Heterogeneity was evaluated. A total of 10 trials with 998 participants were included. MBIs showed significant improvements in the event-related potential amplitudes in attention-deficit hyperactivity disorder, the methylation of serotonin transporter genes in post-traumatic stress disorder, the salivary levels of interleukin 6 (IL-6) and tumour necrosis factor alpha (TNF-α) in depression, and the blood levels of adrenocorticotropic hormone (ACTH), IL-6, and TNF-α in generalised anxiety disorder. MBIs showed low but significant effects on health status related to biomarkers of low-grade inflammation (g = −0.21; 95% confidence interval (CI) –0.41 to −0.01; NNT = 8.47), with no heterogeneity (I2 = 0; 95% CI 0 to 79). More trials are needed to establish the impact of MBIs on biomarkers in psychiatric illness.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7177919/

 

Improve Health Care Professional Self-Compassion with Mindfulness

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Improve Health Care Professional Self-Compassion with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is especially suited to physicians, because it can help counteract the worrying, perfectionism and self-judgment that are so common among doctors.” – WellMD

 

Stress is epidemic in the western workplace with almost two thirds of workers reporting high levels of stress at work. In high stress occupations, like healthcare, burnout is all too prevalent. Burnout is the fatigue, cynicism, emotional exhaustion, sleep disruption, and professional inefficacy that comes with work-related stress. It is estimated that over 45% of healthcare workers experience burnout. It not only affects the healthcare providers personally, but also the patients, as it produces a loss of empathy and compassion. Burnout, in fact, it is a threat to the entire healthcare system. Currently, over a third of healthcare workers report that they are looking for a new job. Hence, burnout contributes to the shortage of doctors and nurses.

 

Preventing burnout has to be a priority. Unfortunately, it is beyond the ability of the individual to change the environment to reduce stress and prevent burnout. So, it is important that methods be found to reduce the individual’s responses to stress; to make the individual more resilient when high levels of stress occur. Contemplative practices have been shown to reduce the psychological and physiological responses to stress and improve well-being. Indeed, mindfulness has been shown to be helpful in treating and preventing burnout, increasing resilience, and improving sleep.

 

One way that mindfulness may help reduce burnout is by improving self-compassion. Self-compassion is “treating oneself with kindness and understanding when facing suffering, seeing one’s failures as part of the human condition, and having a balanced awareness of painful thoughts and emotions” (Kristin Neff). This may reduce the perfectionism and self-judgement that is common among physicians and thereby reduce burnout.

 

In today’s Research News article “Effects of Mindfulness-Based Interventions on Self-compassion in Health Care Professionals: a Meta-analysis.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223423/), Wasson and colleagues review summarize and perform a meta-analysis of the effectiveness of mindfulness training in improving self-compassion in physicians. They identified 28 published research studies.

 

They found that the published research reports that mindfulness-based interventions produced significant improvements in self-compassion in a variety of health care professionals. The effects sizes were moderate and there were no indications of publication bias. These results are important as having compassion for oneself is a prerequisite to having true compassion for others and this is essential for patient treatment. In addition, self-compassion may inoculate the health care worker from burnout. Hence, mindfulness training is important for health care professionals.

 

So, improve health care professional self-compassion with mindfulness.

 

“Mindfulness is growing in popularity as a way of promoting self-compassion among physicians. “This is all about being aware and in tune with yourself, learning to listen to your body and your mind so you know what you need and can give that to yourself.” – Kevin Teoh

 

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

 

Rachel S. Wasson, Clare Barratt, William H. O’Brien, Effects of Mindfulness-Based Interventions on Self-compassion in Health Care Professionals: a Meta-analysis. Mindfulness (N Y) 2020 Mar 5 : 1–21. doi: 10.1007/s12671-020-01342-5

 

Abstract

Objectives

Health care professionals have elevated rates of burnout and compassion fatigue which are correlated with poorer quality of life and patient care, and inversely correlated with self-compassion. Primary studies have evaluated the extent to which mindfulness-based interventions increase self-compassion with contradictory findings. A meta-analytic review of the literature was conducted to quantitatively synthesize the effects of mindfulness-based interventions on self-compassion among health care professionals.

Methods

Twenty-eight treatment outcome studies were identified eligible for inclusion. Five cumulative effect sizes were calculated using random-effects models to evaluate differences of changes in self-compassion for treatment and control groups. Within and between group comparisons were evaluated. Sub-group and moderator analyses were conducted to explore potential moderating variables.

Results

Twenty-seven articles (k = 29, N = 1020) were utilized in the pre-post-treatment meta-analysis. Fifteen samples (52%) included health care professionals and fourteen (48%) professional health care students. Results showed a moderate effect size between pre-post-treatment comparisons (g = .61, 95% CI = .47 to .76) for self-compassion and a strong effect size for pre-treatment to follow-up (g = .76, 95% CI = .41 to 1.12). The effect size comparing post-treatment versus post-control was moderate. One exploratory moderator analysis was significant, with stronger effects for interventions with a retreat component.

Conclusions

Findings suggest mindfulness-based interventions improve self-compassion in health care professionals. Additionally, a variety of mindfulness-based programs may be useful for employees and trainees. Future studies with rigorous methodology evaluating effects on self-compassion and patient care from mindfulness-based interventions are warranted to extend findings and explore moderators.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223423/

 

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/

 

Spirituality is Associated with Better Decision Making and Well-Being at End of Life

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Spirituality is Associated with Better Decision Making and Well-Being at End of Life

 

By John M. de Castro, Ph.D.

 

“spirituality is an important component of quality of life and may be a key factor in how people cope with illness, experience healing, and achieve a sense of coherence.” – Christina Puchalski

 

Death in inevitable, but that does not mean that it has to be difficult. Suzuki Roshi at the end of his life was in excruciating pain from cancer yet he told everyone around him “Don’t worry, It’s just Buddha suffering”. He passed with a smile on his face. Augustus Montague Toplady, the preacher author of the hymn “Rock of Ages” dying from tuberculosis said “Oh, what delights! Who can fathom the joy of the third heaven? The sky is clear, there is no cloud; come Lord Jesus, come quickly!” These stories exemplify how spirituality can influence the quality of life at the end of life.

 

Spirituality becomes much more important to people when they’re approaching the end of life. It is thought that people take comfort in the spiritual when facing mortality. But, spiritual concerns, such as feelings of being abandoned by god or needing forgiveness for actions in their lives might lead to anxiety and worry rather than comfort and can exacerbate the psychological burdens at the end of life. Hence, there is a need to study the relationship of spirituality to a palliative care patient’s well-being at the approach of the end of life.

 

In today’s Research News article “The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035674/), Rego and colleagues recruited adult outpatients from cancer palliative care institutes who had terminal illnesses. They were asked to complete measures of decision conflict and health related quality of life including spiritual well-being and undergo a semi-structured interviews addressing “spirituality, the importance of spirituality during illness, spiritual care, the influence of illness in the sense/meaning of life and the ability to make decisions related to health.”

 

They found that patients who indicated that spirituality was important in dealing with their illness and had a sense of meaning in their lives reported significantly higher levels of spiritual well-being, quality of life, and significantly lower levels of decisional conflict. In addition, they found that higher levels of spiritual wellbeing were associated with higher levels of physical, emotional and functional wellbeing, meaning/peace and faith, and quality of life. Also, spiritual well-being was significantly associated with lower levels of uncertainty and decisional conflict and higher levels of being informed and supported, and satisfaction with decisions. Finally, the patients indicated that spiritual care was important but there was little provided.

 

It should be noted that this study was correlative and as such conclusions about causation cannot be definitively made. But the results suggest that there are clear relationships between spirituality and the ability to cope with end of life issues. Spirituality was related to many components of well-being, suggesting that while approaching end of life having deeper sense of meaning is important in dealing with mortality. In addition, spirituality appears to be associated with better capacity to make decisions, suggesting that it aids in having a clear mind in dealing with the issues associated with the remainder of their lives.

 

It is interesting that as important spirituality appears to be for dealing with the end of life the patients reported that there was very little spiritual care available. This suggests that palliative care should include greater spiritual care. The results suggest that if there was greater spiritual care it would help ease the burden of being terminally ill and improve the quality of their remaining life.

 

Hence, spirituality is associated with better decision making and well-being at end of life.

 

“Spirituality is too important and too impactful to ignore. We must work together as palliative care advocates to ensure that patients get comprehensive, person-centered care that addresses all aspects of their quality of life.” – Coalition for Compassionate Care

 

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

 

Rego, F., Gonçalves, F., Moutinho, S., Castro, L., & Nunes, R. (2020). The influence of spirituality on decision-making in palliative care outpatients: a cross-sectional study. BMC palliative care, 19(1), 22. https://doi.org/10.1186/s12904-020-0525-3

 

Abstract

Background

Decision-making in palliative care can be complex due to the uncertain prognosis and general fear surrounding decisions. Decision-making in palliative care may be influenced by spiritual and cultural beliefs or values. Determinants of the decision-making process are not completely understood, and spirituality is essential for coping with illness. Thus, this study aims to explore the influence of spirituality on the perception of healthcare decision-making in palliative care outpatients.

Methods

A cross-sectional study was developed. A battery of tests was administered to 95 palliative outpatients, namely: sociodemographic questionnaire (SQ), Decisional Conflict Scale (DCS), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being scale (FACIT-Sp), and a semi-structured interview (SSI) to study one’s perception of spirituality and autonomy in decision-making. Statistical analyses involved descriptive statistics for SQ and SSI. The Mann-Whitney test was used to compare scale scores between groups and correlations were used for all scales and subscales. The analysis of patients’ definitions of spirituality was based on the interpretative phenomenological process.

Results

Spiritual wellbeing significantly correlated with greater levels of physical, emotional and functional wellbeing and a better quality of life. Greater spiritual wellbeing was associated with less decisional conflict, decreased uncertainty, a feeling of being more informed and supported and greater satisfaction with one’s decision. Most patients successfully implemented their decision and identified themselves as capable of early decision-making. Patients who were able to implement their decision presented lower decisional conflict and higher levels of spiritual wellbeing and quality of life. Within the 16 themes identified, spirituality was mostly described through family. Patients who had received spiritual care displayed better scores of spiritual wellbeing, quality of life and exhibited less decisional conflict. Patients considered spirituality during illness important and believed that the need to receive spiritual support and specialised care could enable decision-making when taking into consideration ones’ values and beliefs.

Conclusion

The impact of spiritual wellbeing on decision-making is evident. Spirituality is a key component of overall wellbeing and it assumes multidimensional and unique functions. Individualised care that promotes engagement in decision-making and considers patients’ spiritual needs is essential for promoting patient empowerment, autonomy and dignity.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7035674/

 

Meditation Produces Mental Emptiness by Lowering Phasic Relationships in the EEG

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Meditation Produces Mental Emptiness by Lowering Phasic Relationships in the EEG

 

By John M. de Castro, Ph.D.

 

“Meditation research explores how the brain works when we refrain from concentration, rumination and intentional thinking. Electrical brain waves suggest that mental activity during meditation is wakeful and relaxed.” – ScienceDaily

 

Meditation 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. A characterizing feature of meditation is that it can produce periods of thoughtless awareness also known as mental emptiness where thinking is minimized. Little is known, however, about the underlying brain activity during thoughtless awareness relative to cognitive processing, thinking.

 

One way to observe the effects of meditation is to measure changes in the electroencephalogram (EEG), the rhythmic electrical activity that can be recorded from the scalp. The recorded activity can be separated into frequency bands. Delta activity consists of oscillations in the 0.5-3 cycles per second band. Theta activity in the EEG consists of oscillations in the 4-8 cycles per second band. Alpha activity consists of oscillations in the 8-12 cycles per second band. Beta activity consists of oscillations in the 13-30 cycles per second band while Gamma activity occurs in the 30-100 cycles per second band.

 

In today’s Research News article “From thoughtless awareness to effortful cognition: alpha – theta cross-frequency dynamics in experienced meditators during meditation, rest and arithmetic.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096392/), Rodriguez-Larios and colleagues recruited adult, highly experienced, meditators and recorded the electroencephalogram (EEG) while they were at rest, engaged in breath following focused meditation, and doing mental arithmetic (counting backward by 7. They analyzed the EEG signals for alpha and theta rhythms and investigated the phasic relationships between them.

 

They found that during meditation the phasic relationships between alpha and theta rhythms in the brain were at a minimum where they were at a maximum during mental arithmetic. Since during the cognitive task of mental arithmetic the phasic relationships were high, it appears that these phasic relationships between alpha and theta rhythms are associated with cognitive processes, thinking. The fact that they’re minimized during meditation suggests that during meditation cognition, thinking, is minimized. This suggests that awareness is occurring without thought; thoughtless awareness.

 

These results make sense in that the goal of breath following meditation is to relax the mind and focus it on simple sensory signals and thereby minimize thinking. Meditation focuses the mind on the present moment and the sensory experiences occurring in the moment. The deeper the focus, the less room there is for thought to occur. The present results indicate that this thoughtless awareness can be seen in the electrical activity of the brain during meditation.

 

So, meditation produces mental emptiness by lowering phasic relationships in the EEG.

 

“A theta wave cycle lasts about as long as the human eye blinks, or about 4/10 of a second! They are also associated with deep meditation. . . Theta waves are associated with dreaming sleep, super learning, creativity, daydreaming, and deep meditation. And with emotional surges, self-reprogramming, and spiritual experiences.” – Mindvalley

 

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

 

Rodriguez-Larios, J., Faber, P., Achermann, P., Tei, S., & Alaerts, K. (2020). From thoughtless awareness to effortful cognition: alpha – theta cross-frequency dynamics in experienced meditators during meditation, rest and arithmetic. Scientific reports, 10(1), 5419. https://doi.org/10.1038/s41598-020-62392-2

 

Abstract

Neural activity is known to oscillate within discrete frequency bands and the synchronization between these rhythms is hypothesized to underlie information integration in the brain. Since strict synchronization is only possible for harmonic frequencies, a recent theory proposes that the interaction between different brain rhythms is facilitated by transient harmonic frequency arrangements. In this line, it has been recently shown that the transient occurrence of 2:1 harmonic cross-frequency relationships between alpha and theta rhythms (i.e. falpha ≈ 12 Hz; ftheta ≈ 6 Hz) is enhanced during effortful cognition. In this study, we tested whether achieving a state of ‘mental emptiness’ during meditation is accompanied by a relative decrease in the occurrence of 2:1 harmonic cross-frequency relationships between alpha and theta rhythms. Continuous EEG recordings (19 electrodes) were obtained from 43 highly experienced meditators during meditation practice, rest and an arithmetic task. We show that the occurrence of transient alpha:theta 2:1 harmonic relationships increased linearly from a meditative to an active cognitive processing state (i.e. meditation < rest < arithmetic task). It is argued that transient EEG cross-frequency arrangements that prevent alpha:theta cross-frequency coupling could facilitate the experience of ‘mental emptiness’ by avoiding the interaction between the memory and executive components of cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7096392/

 

Lower Heart Rate and Increase its Variability with Meditation

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Lower Heart Rate and Increase its Variability with Meditation

 

By John M. de Castro, Ph.D.

 

“If a person’s system is in more of a fight-or-flight mode, the variation between subsequent heartbeats is low. If one is in a more relaxed state, the variation between beats is high. In other words, the healthier the ANS the faster you are able to switch gears, showing more resilience and flexibility. Over the past few decades, research has shown a relationship between low HRV and worsening depression or anxiety. A low HRV is even associated with an increased risk of death and cardiovascular disease.” – Marcelo Campos

 

In our lives we are confronted with a variety of situations and environments. In order to successfully navigate these differing situations, we must be able to adapt and self-regulate. The Autonomic Nervous System (ANS) is designed to adapt physiologically to the varying demands on us. It is composed of 2 divisions; the sympathetic division underlies activation, including increases in heart rate and blood pressure, while the parasympathetic division underlies relaxation, including decreases in heart rate and blood pressure. A measure of the balance between these systems is provided by the variability of the heart rate.

 

Heart Rate Variability (HRV) 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. Mindfulness has been associated with psychological flexibility and a greater ability to adapt appropriately to differing situations. It makes sense then to investigate the relationship of mindfulness to and Heart Rate Variability (HRV).

 

In today’s Research News article “Meditation Practice Improves Short-Term Changes in Heart Rate Variability.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142551/), Chang and colleagues performed 2 experiments. In the first, they recruited healthy meditation naïve adults and presented them with a 90-minute class on meditation including practice in a face to face setting once a week for 4 weeks. In the second experiment experienced meditators were recruited and received once a week for 4 weeks the 90-minute class on meditation including practice presented on video. The participants wore wrist heart rate monitors and were measured over the course of the study for heart rate, heart rate variability, and blood pressure.

 

They found that both the meditation naïve participants with face to face instruction and the experienced meditators with video instruction had significant decreases over the course of the study in heart rate and significant increases in heart rate variability. Increased heart rate variability signals greater relaxation in the autonomic nervous system with a predominance of parasympathetic (relaxation) activity over sympathetic (activation) activity. The results make sense as parasympathetic activity tends to decrease heart rate. This all signals greater physiological relaxation

 

There was no control condition in the present study. So, the experiment is open to confounding by demand characteristics, experimenter bias, expectancy (placebo) effect etc. But prior randomized controlled studies have also observed that mindfulness training reduces heart rate and increases heart rate variability. So, the present results are likely due to the meditation practice. This increase in parasympathetic activity produced by meditation training may explain why mindfulness training is effective in treating cardiovascular diseases, in overall reducing the deleterious effects of stress and producing increased relaxation.

 

So, lower heart rate and increase its variability with meditation.

 

“meditation may improve your heart’s recovery from stress as demonstrated by improved Heart Rate Variability (HRV).” – Sam Sly

 

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

 

Chang, K. M., Wu Chueh, M. T., & Lai, Y. J. (2020). Meditation Practice Improves Short-Term Changes in Heart Rate Variability. International journal of environmental research and public health, 17(6), 2128. https://doi.org/10.3390/ijerph17062128

 

Abstract

Background: It is well known that meditation improves the physical and psychological condition of its practitioners. This study investigated the heart rate variability response of meditation practitioners in two Chan master teaching environments, namely face-to-face and video classes. Methods: Experimental sessions were conducted, one featuring face-to-face classes and the other featuring video classes. The difference in participants’ physiological parameters (blood pressure and heart rate variability) between the two experimental sessions was determined. In the first session, physiological parameters were recorded twice, before and after one teaching course, and the second session took place one month after the first. The first and second sessions had 45 and 27 participants, respectively. Those involved in the first experiment had no experience with meditation, whereas participants in the second experiment had practiced meditation for an average of 9 years (range = 1 to 27 years). Both experiments were conducted once a week, with each session lasting 1.5 h. Results: For both experiments, both heart rate and heart rate variability by age significantly decreased after one teaching course. Conclusions: Chan meditation practitioners benefit from receiving both face-to-face and video class teaching from a Chan master.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142551/

 

Reduce Hypertension with a Mindfulness Smartphone App

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Reduce Hypertension with a Mindfulness Smartphone App

 

By John M. de Castro, Ph.D.

 

“Investigators found mindfulness was associated with a significant decrease in systolic blood pressure at 1 year and had other gains including better adherence to a recommended diet, lower salt intake, reduced alcohol consumption, and increased physical activity.” – Damian McNamara

 

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. Treatment frequently includes 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. The vast majority of the mindfulness training techniques, however, require a trained teacher. This results in costs that many patients 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, Apps for smartphones 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 today’s Research News article “Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143262/), Chandler and colleagues recruited adults with non-medicated stage 1 systolic hypertension; systolic blood pressure of 121–139 mmHg. They were randomly assigned to receive via smartphone app 3 months of either mindfulness training or health education. The mindfulness training app, Tension Tamer, employed twice daily practice of focused meditation for 10-15 minutes. The health education app, Runkeeper, delivered lifestyle health education messages focusing on exercise. They were measured before during and after training and 3 and 9 months later for systolic and diastolic blood pressure.

 

They found that the mindfulness trained group had greater reductions in systolic and diastolic blood pressure at the end of training and 9 months later. In addition, a greater proportion of mindfulness trained participants achieved reductions sufficient to remove them from being classified as having stage 1 systolic hypertension.

 

There were no significant differences found in perceived stress. Even though mindfulness training has been shown in prior studies to reduce perceived stress, it does not appear to be responsible for decrease blood pressure in the present study. Measures of heart rate during the meditation practice revealed significant decreases in heart rate over the session. This suggests that the mindfulness training was successful in reducing blood pressure by increasing relaxation perhaps by increasing the activity of the parasympathetic component of the autonomic nervous system.

 

So, reduce hypertension with a mindfulness smartphone app.

 

“mindfulness meditation in combination with conventional medication treatment reduces blood pressure and stress levels, while improving mindfulness and mood more than medication coupled with health education.” – goamra.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

 

Chandler, J., Sox, L., Diaz, V., Kellam, K., Neely, A., Nemeth, L., & Treiber, F. (2020). Impact of 12-Month Smartphone Breathing Meditation Program upon Systolic Blood Pressure among Non-Medicated Stage 1 Hypertensive Adults. International journal of environmental research and public health, 17(6), 1955. https://doi.org/10.3390/ijerph17061955

 

Abstract

(1) Background: Hypertension (HTN) affects ~50% of adults and is a major risk factor for stroke and cardiovascular disease. In 2017, the SPRINT trial outcomes led to lowering of HTN cutoffs by the American College of Cardiology (ACC) and American Heart Association (AHA). The Joint National Committee (JNC8) and National High BP Education Program recommend that lifestyle modifications be used as first-line HTN treatment. Chronic stress is a risk factor for HTN and cardiovascular disease. A recently completed 12 month randomized controlled trial (RCT) of a breathing meditation smart phone app (Tension Tamer, TT) involving JNC8 designated pre-HTN adults provided an opportunity to examine its impact upon individuals now classified as having stage 1 HTN. The TT app captures continuous real-time heart rate (HR) from a user’s fingertip placed over a video camera lens during sessions. Users receive immediate feedback graphs after each session, showing their HR changes. They also receive motivational and social reinforcement SMS text messages the following day based upon levels of adherence. We conducted ancillary analyses of a 2-arm, 12-month, small-scale efficacy RCT among a subgroup of our total sample of participants, who are now classified as having stage 1 non-medicated systolic HTN. Primary outcome was change in resting systolic blood pressure (SBP). Secondary outcomes were change in resting diastolic blood pressure, adherence to the TT protocol, and perceived stress levels. (2) Methods: 30 adults (mean age: 45.0 years; 15 males; 16 White; 14 Black) with ACC/AHA 2017 defined systolic HTN (130–139 mmHg) on 3 consecutive sessions (mean SBP: 132.6 mmHg) were randomly assigned to TT or lifestyle education program delivered via smartphone (SPCTL). Each group received a twice-daily dosage schedule of TT or walking (month 1: 15 min; months 2 and 3: 10 min; months 4–12: 5 min). (3) Results: Mixed modeling results revealed a significant group x time effect for SBP (p<.01). The TT group showed greater SBP reductions at months 3 (−8.0 vs. −1.9), 6 (−10.0 vs. −0.7), and 12: (−11.6 vs. −0.4 mmHg; all p-values <0.04). (4) Conclusion: The TT app was beneficial in reducing SBP levels among adults with stage 1 systolic HTN. The TT app may be a promising, scalable first-line tactic for stage 1 HTN. Preparations are underway for an efficacy RCT involving uncontrolled stage 1 HTN patients.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7143262/