Improve Sleep in People with Sleep Disturbance with a Meditation App

Improve Sleep in People with Sleep Disturbance with a Meditation App

 

By John M. de Castro, Ph.D.

 

“Sufficient sleep heals our bodies and minds, but for many reasons sleep doesn’t always come easily. Mindfulness practices and habits can help us fall asleep and stay asleep.” – Mindful

 

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.

 

Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia. The vast majority of the mindfulness training techniques, however, require a trained therapist. 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. But the question arises as to the effectiveness of these Apps in improving sleep in patients with sleep disturbance.

 

In today’s Research News article “Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790277/ ) Huberty and colleagues recruited online, adults with moderate sleep disorder, insomnia, and randomly assigned them to a wait-list control condition or to use the “Calm” meditation app for 10 minutes per day for 8 weeks. They were measured before, during, and after for fatigue, daytime sleepiness, pre-sleep arousal, sleep quality, and use of the app.

 

They found that there was high adherence to app use, with an average of 6.36 uses per week that remained steady over the 8-week intervention period. They found that in comparison to baseline and the wait-list control group, the group that used the “Calm” app had greater reductions in fatigue, daytime sleepiness, and cognitive and somatic pre-sleep arousal. In addition, the group that used the “Calm” app had significant improvements in sleep quality, including falling asleep faster and sleeping longer.

 

The results of this study suggest that using the “Calm” app improves the sleep of individuals with insomnia and also reduces daytime fatigue and sleepiness, and pre-sleep arousal. The results of this study suggest that using the “Calm” app improves the sleep of individuals with insomnia and also reduces daytime fatigue and sleepiness, and pre-sleep arousal. The results are not surprising as mindfulness training has been shown repeatedly to improve sleep and reduce fatigue. But demonstrating these improvements with an app that is widely available, inexpensive, and convenient to use, is important as the app makes treatment more readily available for a wider group of patients. Hence, the Calm” app would seem to be an excellent treatment for the moderate sleep disorder of insomnia.

 

So, improve sleep in people with sleep disturbance with a meditation app.

 

The idea is to create a reflex to more easily bring forth a sense of relaxation. That way, it’s easier to evoke the relaxation response at night when you can’t sleep. In fact, the relaxation response is so, well, relaxing that your daytime practice should be done sitting up or moving (as in yoga or tai chi) so as to avoid nodding off.” – Julie Corliss

 

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

 

Huberty, J. L., Green, J., Puzia, M. E., Larkey, L., Laird, B., Vranceanu, A. M., Vlisides-Henry, R., & Irwin, M. R. (2021). Testing a mindfulness meditation mobile app for the treatment of sleep-related symptoms in adults with sleep disturbance: A randomized controlled trial. PloS one, 16(1), e0244717. https://doi.org/10.1371/journal.pone.0244717

 

Abstract

The objective of this randomized controlled trial was to test whether a commercially available, mindfulness meditation mobile app, (i.e., Calm app), was effective in reducing fatigue (primary outcome), pre-sleep arousal, and daytime sleepiness (secondary outcomes) in adults with sleep disturbance (Insomnia Severity Index Score >10) as compared to a wait-list control group. Associations between the use of the Calm app (i.e., adherence to the intervention) and changes in sleep quality was also explored in the intervention group only. Adults with sleep disturbance were recruited (N = 640). Eligible and consenting participants (N = 263) were randomly assigned to the intervention (n = 124) or a wait-list control (n = 139) group. Intervention participants were asked to meditate using the Calm app ≥10 minutes/day for eight weeks. Fatigue, daytime sleepiness, and pre-sleep arousal were assessed at baseline, mid- (4-weeks) and post-intervention (8-weeks) in both groups, whereas sleep quality was evaluated only in the intervention group. Findings from intent-to-treat analyses suggest the use of the Calm app for eight weeks significantly decreased daytime fatigue (p = .018) as well as daytime sleepiness (p = .003) and cognitive (p = .005) and somatic (p < .001) pre-sleep arousal as compared to the wait-list control group. Within the intervention group, use of the Calm app was associated with improvements in sleep quality (p < .001). This randomized controlled trial demonstrates that the Calm app can be used to treat fatigue, daytime sleepiness, and pre-sleep arousal in adults with sleep disturbance. Given that the Calm app is affordable and widely accessible, these data have implications for community level dissemination of a mobile app to improve sleep-related symptoms associated with sleep disturbance.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7790277/

 

Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

Improve the Psychological Well-Being of Breast Cancer Survivors with Mindfulness

 

By John M. de Castro, Ph.D.

 

“Mindfulness is a good resource for dealing with the physical and psychological symptoms of metastatic disease. Women who were more mindful tended to have lower symptoms of metastatic breast cancer, including pain severity and interference, fatigue, psychological distress, and sleep disturbance.” – Lauren Zimmaro

 

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 stress,  sleep disturbance, and anxiety and depression. The Mindfulness-Based Stress Reduction (MBSR) program is a mindfulness training program that includes meditation practice, body scan, yoga, and discussion along with daily home practice. MBSR has been shown to be beneficial for cancer patients in general and also specifically for the symptoms of breast cancer survivors. So, it makes sense to further explore the effectiveness of MBSR training for the treatment of breast cancer survivors.

 

In today’s Research News article “Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/ ) Reich and colleagues recruited breast cancer survivors and randomly assigned them to either usual care or to receive a 6-week, once a week for 2-hours, Mindfulness-Based Stress Reduction (MBSR) modified for breast cancer survivors. They were measured before and after training and 6 weeks later for worry, fear of cancer recurrence, anxiety, depression, perceived stress, mindfulness, symptom severity, sleep quality, fatigue, pain, cognition, and health-related quality of life.

 

They found with factor analysis that the measures fit into 4 clusters; pain, cognition, fatigue, and psychological. They found that in comparison to baseline the usual care, Mindfulness-Based Stress Reduction (MBSR) produced significant improvement in the psychological and fatigue clusters, but not the cognitive or pain clusters. These effects were still present 6 weeks later.

 

These findings suggest that Mindfulness-Based Stress Reduction (MBSR) is an effective treatment to relieve the psychological and fatigue symptoms of breast cancer survivors. This corresponds with prior findings that mindfulness improves the symptoms of breast cancer survivors and reduces anxiety, depression, and perceived stress, and improves emotional well-being and also reduces fatigue and improves sleep quality.

 

The observed improvements produced by Mindfulness-Based Stress Reduction (MBSR) markedly improves the quality of life and reduces the suffering of these cancer patients. These are clinically significant. It has been shown that an improved psychological outlook is associated with better physical recovery. Hence, these findings suggest that MBSR or other mindfulness training programs, should be incorporated into the routine care of breast cancer survivors.

 

So, improve the psychological well-being of breast cancer survivors with mindfulness.

 

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

 

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

 

Reich, R. R., Lengacher, C. A., Alinat, C. B., Kip, K. E., Paterson, C., Ramesar, S., Han, H. S., Ismail-Khan, R., Johnson-Mallard, V., Moscoso, M., Budhrani-Shani, P., Shivers, S., Cox, C. E., Goodman, M., & Park, J. (2017). Mindfulness-Based Stress Reduction in Post-treatment Breast Cancer Patients: Immediate and Sustained Effects Across Multiple Symptom Clusters. Journal of pain and symptom management, 53(1), 85–95. https://doi.org/10.1016/j.jpainsymman.2016.08.005

 

Abstract

Context.

Breast cancer survivors (BCS) face adverse physical and psychological symptoms, often co-occurring. Biologic and psychological factors may link symptoms within clusters, distinguishable by prevalence and/or severity. Few studies have examined the effects of behavioral interventions or treatment of symptom clusters.

Objectives.

The aim of this study was to identify symptom clusters among post-treatment BCS and determine symptom cluster improvement following the Mindfulness-Based Stress Reduction for Breast Cancer (MBSR(BC)) program.

Methods.

Three hundred twenty-two Stage 0–III post-treatment BCS were randomly assigned to either a six-week MBSR(BC) program or usual care. Psychological (depression, anxiety, stress, and fear of recurrence), physical (fatigue, pain, sleep, and drowsiness), and cognitive symptoms and quality of life were assessed at baseline, six, and 12 weeks, along with demographic and clinical history data at baseline. A three-step analytic process included the error-accounting models offactor analysis and structural equation modeling.

Results.

Four symptom clusters emerged at baseline: pain, psychological, fatigue, and cognitive. From baseline to six weeks, the model demonstrated evidence of MBSR(BC) effectiveness in both the psychological (anxiety, depression, perceived stress and QOL, emotional well-being) (P = 0.007) and fatigue (fatigue, sleep, and drowsiness) (P < 0.001) clusters. Results between six and 12 weeks showed sustained effects, but further improvement was not observed.

Conclusion.

Our results provide clinical effectiveness evidence that MBSR(BC) works to improve symptom clusters, particularly for psychological and fatigue symptom clusters, with the greatest improvement occurring during the six-week program with sustained effects for several weeks after MBSR(BC) training.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7771358/

 

Movement-Based Therapies are Affective for Rehabilitation from Disease

Movement-Based Therapies are Affective for Rehabilitation from Disease

 

By John M. de Castro, Ph.D.

 

Tai chi is often described as “meditation in motion,” but it might well be called “medication in motion.” There is growing evidence that this mind-body practice, which originated in China as a martial art, has value in treating or preventing many health problems.” – Havard Health

 

Mindful movement practices such as yoga and Tai Chi and Qigong have been used for centuries to improve the physical and mental health and well-being of practitioners. But only recently has the effects of these practices come under scientific scrutiny. This research has been accumulating. So, it makes sense to pause and examine what has been learned about the effectiveness of these practice for rehabilitation from disease.

 

In today’s Research News article “Movement-Based Therapies in Rehabilitation.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/ ) Phuphanich and colleagues review and summarize the published research studies of the effects of mindful movement practices on rehabilitation from disease.

 

They report that published research has found that yoga practice reduces fatigue, sleep disturbances, depression, and anxiety and improves the immune system in cancer patients. Yoga has been found to be an effective treatment for mental health issues such as anxiety, depression, and post-traumatic stress disorder (PTSD). Yoga has been found to reduce pain levels, fear avoidance, stress, and sleep disturbance and increases self-efficacy and quality of life in chronic pain patients. Yoga has been found to improve the symptoms of traumatic brain injury, stroke, spinal cord injury, Parkinson disease, dementia, multiple sclerosis, epilepsy, and neuropathies. In addition, yoga has been found to improve systolic and diastolic blood pressures, heart rate, respiratory rate, waist circumference, waist/hip ratio, cholesterol, triglycerides, hemoglobin A1c, and insulin resistance in cardiopulmonary diseases.

 

They report that the published research has found that Tai Chi and Qigong practices reduce falls in the elderly. Tai Chi and Qigong has been found to reduce pain levels and increase quality of life in chronic pain patients. In addition, there is evidence that Tai Chi and Qigong practices improves depression, anxiety, posttraumatic stress disorder, sleep disturbance, schizophrenia, rheumatoid arthritis, spinal cord injury, traumatic brain injury, and immune disorders.

 

These are remarkable findings. The range of disorders that are positively affected by yoga, Tai Chi, and Qigong practices is breathtaking. These practices are also safe and can be widely implemented at relatively low cost and can be performed alone or in groups and at home or in a therapeutic setting. This suggests that these practices should be routinely implemented for rehabilitation from disease.

 

So,  movement-based therapies are affective for rehabilitation from disease.

 

Being mindful through any physical activity can not only improve performance in the activity such as yoga, tennis, swimming, etc, but it can also increase flexibility, confidence in movement and generate a sense of body and mind connection that has the potential for improving your overall sense of well-being.“- Anupama Kommu

 

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

 

Phuphanich, M. E., Droessler, J., Altman, L., & Eapen, B. C. (2020). Movement-Based Therapies in Rehabilitation. Physical medicine and rehabilitation clinics of North America, 31(4), 577–591. https://doi.org/10.1016/j.pmr.2020.07.002

 

Abstract

Movement therapy refers to a broad range of Eastern and Western mindful movement-based practices used to treat the mind, body, and spirit concurrently. Forms of movement practice are universal across human culture and exist in ancient history. Research demonstrates forms of movement therapy, such as dance, existed in the common ancestor shared by humans and chimpanzees, approximately 6 million years ago. Movement-based therapies innately promote health and wellness by encouraging proactive participation in one’s own health, creating community support and accountability, and so building a foundation for successful, permanent, positive change.

Key Points – Movement-based therapies

  • Decrease fear avoidance and empower individuals to take a proactive role in their own health and wellness.
  • Can benefit patients of any ability; practices are customizable to the individual’s needs and health.
  • Are safe, cost-effective, and potent adjunct treatments used to supplement (not replace) standard care.
  • Deliver patient-centered, integrative care that accounts for the physical, psychological, social, and spiritual aspects of health and illness.
  • Have diverse, evidence-based benefits, including reduction in pain, stress, and debility, and improvements in range of motion, strength, balance, coordination, cardiovascular health, physical fitness, mood, and cognition.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7476461/

 

Yoga Practice Improves the Symptoms of Restless Legs Syndrome

Yoga Practice Improves the Symptoms of Restless Legs Syndrome

 

By John M. de Castro, Ph.D.

 

“regular yoga poses and stretches can help ease those restless legs syndrome symptoms and help you sleep better, feel less stressed, and even lower blood pressure.” – Everyday Health

 

Restless legs syndrome, also known as Willis-Ekbom disease, is characterized by an urge to move the legs after rest. This occurs particularly at night but also after extended sitting such as in a car, airplane, or movie theatre. It produces unpleasant sensations in the legs or feet including crawling, creeping, pulling, throbbing, aching, itching, and electric sensations. It can involve twitching and kicking, possibly throughout the night, while you sleep. It is estimated that about 7% of the population experiences restless legs syndrome.

 

There is no known cause or cures for restless leg syndrome. The only treatments that seem to help are movements such as stretching, jiggling the legs, walking, or pacing. Yoga is a mindfulness practice and an exercise that involves stretching and movement. Hence, it would make sense to explore the ability of yoga practice to improve the symptoms of restless leg syndrome.

 

In today’s Research News article “Effects of a 12-week yoga versus a 12-week educational film intervention on symptoms of restless legs syndrome and related outcomes: an exploratory randomized controlled trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053002/ ) Innes and colleagues recruited adult patients with restless legs syndrome and randomly assigned them to receive a 12-week program of either yoga training or to watch educational films on restless legs syndrome. Yoga training occurred for 75 minutes, 2 times per week for 4 weeks and then once a week for four more weeks. Participants were asked to practice at home for 30 minutes daily. The education class met once a week. The participants were measured before and after training for frequency, intensity, and impact of restless legs syndrome symptoms, sleep quality, health-related quality of life, mood, perceived stress, blood pressure, heart rate, social support, and physical activity.

 

They found that both the yoga and education groups had significant improvements in restless legs syndrome symptoms, and most secondary outcomes. The yoga group, however, had significantly greater reductions in restless legs syndrome symptoms, perceived stress, sleep quality, and mood. Additionally, the more yoga sessions attended and the greater the amount of home practice the greater the improvement in restless legs syndrome symptoms. This was not true for the education group.

 

The results suggest that yoga practice produced symptom relief for restless legs syndrome patients to a significantly greater extent than education about restless legs syndrome. Yoga provides exercise and stretching and it is not clear whether the benefits for restless legs syndrome are a result of the exercise or are specific to yoga practice. Future research should compare the effective of yoga practice relative to other exercises for restless legs syndrome. Regardless, it is clear from this study that practicing yoga is a safe, effective, and relatively inexpensive treatment for restless legs syndrome. It should be routinely recommended to relieve the suffering of these patients.

 

So, yoga practice improves the symptoms of restless legs syndrome.

 

When restless legs syndrome keeps you up all night, yoga is a treatment option that helps both your mind and body relax.” – Diana Rodriguez

 

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

 

Innes, K. E., Selfe, T. K., Montgomery, C., Hollingshead, N., Huysmans, Z., Srinivasan, R., Wen, S., Hausmann, M. J., Sherman, K., & Klatt, M. (2020). Effects of a 12-week yoga versus a 12-week educational film intervention on symptoms of restless legs syndrome and related outcomes: an exploratory randomized controlled trial. Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine, 16(1), 107–119. https://doi.org/10.5664/jcsm.8134

 

Abstract

Study Objectives:

To assess the effects of a yoga versus educational film (EF) program on restless legs syndrome (RLS) symptoms and related outcomes in adults with RLS.

Methods:

Forty-one community-dwelling, ambulatory nonpregnant adults with moderate to severe RLS were randomized to a 12-week yoga (n = 19) or EF program (n = 22). In addition to attending classes, all participants completed practice/treatment logs. Yoga group participants were asked to practice at home 30 minutes per day on nonclass days; EF participants were instructed to record any RLS treatments used on their daily logs. Core outcomes assessed pretreatment and posttreatment were RLS symptoms and symptom severity (International RLS Study Group Scale (IRLS) and RLS ordinal scale), sleep quality, mood, perceived stress, and quality of life (QOL).

Results:

Thirty adults (13 yoga, 17 EF), aged 24 to 73 (mean = 50.4 ± 2.4 years), completed the 12-week study (78% female, 80.5% white). Post-intervention, both groups showed significant improvement in RLS symptoms and severity, perceived stress, mood, and QOL-mental health (P ≤ .04). Relative to the EF group, yoga participants demonstrated significantly greater reductions in RLS symptoms and symptom severity (P ≤ .01), and greater improvements in perceived stress and mood (P ≤ .04), as well as sleep quality (P = .09); RLS symptoms decreased to minimal/mild in 77% of yoga group participants, with none scoring in the severe range by week 12, versus 24% and 12%, respectively, in EF participants. In the yoga group, IRLS and RLS severity scores declined with increasing minutes of homework practice (r = .7, P = .009 and r = .6, P = .03, respectively), suggesting a possible dose-response relationship.

Conclusions:

Findings of this exploratory RCT suggest that yoga may be effective in reducing RLS symptoms and symptom severity, decreasing perceived stress, and improving mood and sleep in adults with RLS.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053002/

 

Improve Stress Responding, Health, and Well-Being with Qigong

Improve Stress Responding, Health, and Well-Being with Qigong

 

By John M. de Castro, Ph.D.

 

Qigong is an extraordinary tool for reducing the harmful effects of stress. The three pillars of qigong practice are body, breath, and mind. If your body is relaxed your breathing will slow down. When your breath is slow, you feel more centered, more calm, and more in touch with yourself” – Kenneth Cohen

 

Tai Chi and Qigong are ancient mindfulness practices involving slow prescribed movements. They are gentle and completely safe, can be used with the elderly and sickly, are inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, they can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice.

 

Tai Chi and Qigong are both mindfulness practices and gentle exercises. They have been shown to be beneficial for the health and well-being of individuals of a variety of ages, but particularly the elderly. They also improve the symptoms of a variety of diseases. One way that these practices may improve health and well-being is by reducing stress. The studies of the benefits for health of Tai Chi and Qigong are accumulating and so it makes sense to take a moment to summarize what has been learned about the benefits of Qigong practice.

 

In today’s Research News article “Individual Stress Prevention through Qigong.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579037/ )  van Dam reviews and summarizes the published research studies of the effects of Qigong practice on stress. She reports that the published studies found that Qigong practice improves the cardiovascular system including a significant reduction in blood pressure and an increase in heartrate variability, an indicator of parasympathetic relaxation. It improves the respiratory system including increased lung capacity, oxygen intake and breathing patterns. It improves immune function and reduces inflammatory responses. It improves both psychological and physiological responses to stress. It improves sleep quality and reduces fatigue. It reduces depression and both acute and chronic anxiety.

 

These findings are remarkable and suggest that this gentle safe practice markedly improves the physical and mental well-being and health of the practitioners. Many of these benefits may result from the ability of Qigong practice to improve stress responding. Stress impairs health and well-being and Qigong practice appears to counteract these effects.

 

So, improve stress responding, health, and well-being with Qigong.

 

Qi Gong helps you develop a crystal clear mind as you connect with the present moment, letting go of the stress of daily life and relaxing deeply.”- Nick Jankel

 

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

 

van Dam K. (2020). Individual Stress Prevention through Qigong. International journal of environmental research and public health, 17(19), 7342. https://doi.org/10.3390/ijerph17197342

 

Abstract

Owing to work intensification and an accelerated pace of life in general, individuals in many Western countries are often overactivated and find it difficult to switch off. However, recovery from physiological and mental activation is critical to prevent stress symptoms and maintain one’s physiological and mental well-being. Extensive research evidence indicates that Qigong, a traditional Chinese movement practice for promoting health, provides an effective means to recover from work and off-work demands. The main objective of this paper is to offer a comprehensive, narrative review of the effects of Qigong and its core components. Attention is first paid to the outcomes of work and off-work demands and stress, and the role of recovery for individuals’ well-being. Then, Qigong and its components are explained, followed by the results of scientific research. Finally, limitations and implications for research and practiced are discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579037/

 

Improve Autonomic Nervous System Function Reducing Stress with Online Mindfulness Training

Improve Autonomic Nervous System Function Reducing Stress with Online Mindfulness Training

 

By John M. de Castro, Ph.D.

 

“Research has found that meditation can positively affect a measure of heart health known as heart rate variability (HRV). HRV reflects how quickly your heart makes small changes in the time interval between each heartbeat. A high HRV is a sign of healthier heart. . . With regular meditation, you may be able to raise your HRV. – Harvard Mens Health

 

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. Indeed, mindfulness practice improves Heart Rate Variability (HRV). It makes sense to explore the ability of real world mindfulness training with an online app to improve autonomic nervous system function as measured by heart rate variability.

 

In today’s Research News article “Heart rate variability is enhanced during mindfulness practice: A randomized controlled trial involving a 10-day online-based mindfulness intervention.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746169/ ) Kirk and Axelsen recruited healthy adults online and randomly assigned them to either a mindfulness, music, or no treatment control group. The mindfulness group received mindfulness training with a smartphone app (Headspace) while the music group listened to music also with a smartphone app for 10 days. Before and after training they were measured for mindfulness, sleep quality, perceived stress, and respiration rate and had their electrocardiogram measured to determine heart rate and heart rate variability.

 

They found that in comparison to baseline and the no-treatment control group, the mindfulness training group had significantly greater mindfulness and sleep quality and significantly lower perceived stress. Although the music group also had a reduction in perceive stress, the mindfulness group had a significantly greater reduction.

 

They found that during the mindfulness and music sessions there were significant increases in heart rate variability but only during the mindfulness sessions was there a significant reduction in respiration rate. Outside of the sessions, they found that the mindfulness group and not the music or control groups had significant increases in heart rate variability during the daytime, nighttime, and during sleep.

 

This was a well-controlled study in that an active as well as passive control conditions were present. So, clear conclusions about causation can be reached. The results suggest that mindfulness trained with a smartphone app increases heart rate variability both acutely, during the sessions, and chronically, outside of the training sessions across the day including during sleep. These increases in heart rate variability suggest an increase in parasympathetic activity and a decrease in sympathetic activity. These reflect an improved balance and relaxation in the autonomic nervous system. These increases in heart rate variability are physiological measures reflecting the psychological measures of decreased perceived stress and improved sleep quality. Hence, online mindfulness training of relatively short duration is capable of improving both physiological and psychological indicators of stress and improving sleep.

 

So, improve autonomic nervous system function reducing stress with online mindfulness training.

 

Generally speaking, a low and irregular HRV indicates a stressed state and a high and regular HRV indicates a relaxed state such as mindfulness.” – Mindfio

 

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

 

Kirk, U., & Axelsen, J. L. (2020). Heart rate variability is enhanced during mindfulness practice: A randomized controlled trial involving a 10-day online-based mindfulness intervention. PloS one, 15(12), e0243488. https://doi.org/10.1371/journal.pone.0243488

 

Abstract

Objectives

The goal of the present study was to probe the effects of mindfulness practice in a naturalistic setting as opposed to a lab-based environment in the presence of continuous heart rate variability (HRV) measurements. The specific experimental goals were to examine the effects of a brief 10-day online-based mindfulness intervention on both chronic and acute HRV responses.

Method

We conducted a fully randomized 10-day longitudinal trial of mindfulness practice, explicitly controlling for practice effects with an active-control group (music listening) and a non-intervention control group. To assess chronic cardiovascular effects, we asked participants in the 3 groups to complete 2-day HRV pre- and post-intervention measurement sessions. Using this experimental setup enabled us to address training effects arising from mindfulness practice to assess physiological impact on daytime as well as nighttime (i.e. assessing sleep quality) on the underlying HRV response. To assess acute cardiovascular effects, we measured HRV in the 2 active intervention groups during each of the 10 daily mindfulness or music sessions. This allowed us to track the development of purported training effects arising from mindfulness practice relative to the active-control intervention in terms of changes in the HRV slope over the 10-day time-course.

Results

Firstly, for the acute phase we found increased HRV during the daily practice sessions in both the mindfulness and active-control group indicating that both interventions were effective in decreasing acute physiological stress. Secondly, for the chronic phase we found increased HRV in both the day- and nighttime indicating increased sleep quality, specifically in the mindfulness group.

Conclusion

These results suggest causal effects in both chronic and acute phases of mindfulness practice in formerly naïve subjects and provides support for the argument that brief online-based mindfulness interventions exert positive impact on HRV.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7746169/

 

Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

Ethnicity Modulates Improvements in Sleep in Prehypertensive Patients with a Smartphone Meditation App

 

Several practices that help calm the mind can also lower blood pressure. All are types of meditation.” – Harvard Health

 

By John M. de Castro, Ph.D.

 

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 “Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/ ) Sieverdes and colleagues recruited patients diagnosed with prehypertension. They had the participants use a smartphone app, “Tension Tamer” for 6 months. The app provided focused breath following meditation practice and also measured heart rate and blood pressure. The participants were randomized into 3 dosage groups, 5, 10, or 15 minutes of daily practice. They were measured before and after training and at 1 and 3-months during training for sleep with a self-reports and 7-days of wrist actigraphy which also measured activity levels.

 

They found that the 47% of the participants who were African American had significantly shorter sleep durations, poorer sleep quality, and greater sleep disturbance at baseline both in the self-report and actigraphy measures than non-Hispanic white participants. They also found that the effects of the meditation app on sleep varied according to ethnic group. For the Non-Hispanic White participants, the 5-minute per day dose of “Tension timer” use produced significantly greater improvements in sleep efficiency and quality, lower fragmentation, and longer sleep duration than the 10 or 15-minute doses. For the African American participants, the 5-minute dose produced significantly less sleep fragmentation and duration than the 10 or 15-minute doses. In comparing the ethnic groups, they found that the Non-Hispanic White participants had significantly greater improvements in sleep efficiency, reduced fragmentation, and longer sleep duration than the African American participants.

 

These results are interesting and suggest that smartphone app guided meditation practice improves sleep in patients diagnosed as prehypertensive. But the effects are less positive for African American participants than Non-Hispanic White participants. This is a bit surprising as African American participants appear to have more problematic sleep to start with and hence had greater room for improvement. It is also surprising that the lower amount of meditation practice, 5-minutes per day, was more beneficial that the longer daily meditations. It appears that the 5-minute practice participants tended to use the app more often and to use it more often just prior to going to bed than the other dose participants and this may have led to the differences.

 

Improving sleep is important in promoting relaxation and reducing the likelihood that prehypertension will progress to patent hypertension. So, the use of the app may be helpful in maintaining the health of prehypertensive patients. The ethnic differences, however, suggest that app usage may be more beneficial for white as opposed to black participant. The results also suggest that brief daily practice, 5-minutes, may promote more frequent use that improves effectiveness.

 

So, ethnicity modulates improvements in sleep in prehypertensive patients with a smartphone meditation app.

 

If you struggle with “turning your brain off”, you may find yourself feeling restless and unable to sleep. Fortunately, meditation is one way to quiet your thoughts and fight insomnia. Meditation has been shown to help people who struggle with insomnia and other sleep disturbances.“ – Florida Medical Clinic

 

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

 

Sieverdes, J. C., Treiber, F. A., Kline, C. E., Mueller, M., Brunner-Jackson, B., Sox, L., Cain, M., Swem, M., Diaz, V., & Chandler, J. (2020). Ethnicity Differences in Sleep Changes Among Prehypertensive Adults Using a Smartphone Meditation App: Dose-Response Trial. JMIR formative research, 4(10), e20501. https://doi.org/10.2196/20501

 

Abstract

Background

African Americans (AAs) experience greater sleep quality problems than non-Hispanic Whites (NHWs). Meditation may aid in addressing this disparity, although the dosage levels needed to achieve such benefits have not been adequately studied. Smartphone apps present a novel modality for delivering, monitoring, and measuring adherence to meditation protocols.

Objective

This 6-month dose-response feasibility trial investigated the effects of a breathing awareness meditation (BAM) app, Tension Tamer, on the secondary outcomes of self-reported and actigraphy measures of sleep quality and the modulating effects of ethnicity of AAs and NHWs.

Methods

A total of 64 prehypertensive adults (systolic blood pressure <139 mm Hg; 31 AAs and 33 NHWs) were randomized into 3 different Tension Tamer dosage conditions (5,10, or 15 min twice daily). Sleep quality was assessed at baseline and at 1, 3, and 6 months using the Pittsburgh Sleep Quality Index (PSQI) and 1-week bouts of continuous wrist actigraphy monitoring. The study was conducted between August 2014 and October 2016 (IRB #Pro00020894).

Results

At baseline, PSQI and actigraphy data indicated that AAs had shorter sleep duration, greater sleep disturbance, poorer efficiency, and worse quality of sleep (range P=.03 to P<.001). Longitudinal generalized linear mixed modeling revealed a dose effect modulated by ethnicity (P=.01). Multimethod assessment showed a consistent pattern of NHWs exhibiting the most favorable responses to the 5-min dose; they reported greater improvements in sleep efficiency and quality as well as the PSQI global value than with the 10-min and 15-min doses (range P=.04 to P<.001). Actigraphy findings revealed a consistent, but not statistically significant, pattern in the 5-min group, showing lower fragmentation, longer sleep duration, and higher efficiency than the other 2 dosage conditions. Among AAs, actigraphy indicated lower sleep fragmentation with the 5-min dose compared with the 10-min and 15-min doses (P=.03 and P<.001, respectively). The 10-min dose showed longer sleep duration than the 5-min and 15-min doses (P=.02 and P<.001, respectively). The 5-min dose also exhibited significantly longer average sleep than the 15-min dose (P=.03).

Conclusions

These findings indicate the need for further study of the potential modulating influence of ethnicity on the impact of BAM on sleep indices and user-centered exploration to ascertain the potential merits of refining the Tension Tamer app with attention to cultural tailoring among AAs and NHWs with pre-existing sleep complaints.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7576537/

 

Improve the Mental Health of Chronic Pain Patients with Mindfulness Training Over the Internet.

Improve the Mental Health of Chronic Pain Patients with Mindfulness Training Over the Internet.

 

 

By John M. de Castro, Ph.D.

 

“Daily mindfulness practice can be helpful for people living with chronic pain because sometimes there are negative or worrisome thoughts about the pain. These thoughts are normal, and can affect mood and increase pain. Being able to focus on relaxing the body, noticing the breath and body sensations as being there just as they are, can help manage pain, as well as reduce depression and anxiety symptoms.” – Amanda Necker

 

We all have to deal with pain. It’s inevitable, but hopefully it’s mild and short lived. For a wide swath of humanity, however, pain is a constant in their lives. At least 100 million adult Americans have chronic pain conditions. The most common treatment for chronic pain is drugs. These include over-the-counter analgesics and opioids. But opioids are dangerous and highly addictive. Prescription opioid overdoses kill more than 14,000 people annually. So, there is a great need to find safe and effective ways to lower the psychological distress and improve the individual’s ability to cope with the pain.

 

There is an accumulating volume of research findings that demonstrate that mindfulness practices, in general, are effective in treating pain. A therapeutic technique that contains mindfulness training and Cognitive Behavioral Therapy (CBT) is Acceptance and Commitment Therapy (ACT). It focuses on the individual’s thoughts, feelings, and behavior and how they interact to impact their psychological and physical well-being. It then works to change thinking to alter the interaction and produce greater life satisfaction. ACT employs mindfulness practices to increase awareness and develop an attitude of acceptance and compassion in the presence of painful thoughts and feelings. ACT teaches individuals to “just notice”, accept and embrace private experiences and focus on behavioral responses that produce more desirable outcomes.

 

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

 

In today’s Research News article “Internet-delivered acceptance and commitment therapy (iACT) for chronic pain-feasibility and preliminary effects in clinical and self-referred patients.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327284/ ) Rickardsson and colleagues recruited chronic pain patients and provided them with 10 weeks of 4 times per week 15 minute programmed Acceptance and Commitment Therapy (ACT) delivered via the internet. Therapists interacted with the individual participants via text once a week for 12 weeks. They were measured before and after training and at 3 and 12-month follow-ups for pain interference, psychological flexibility, value orientation, quality of life, pain intensity, insomnia, anxiety, and depression.

 

They found that following treatment there were significant improvements in pain interference, psychological inflexibility, value progress, value obstruction, QoL, depressive symptoms, pain intensity, anxiety and insomnia. These improvements were maintained at the 3 and 12-month follow-ups.

 

This was a pilot study without a comparison condition. As such, it must be interpreted with caution. But the results suggest that Acceptance and Commitment Therapy (ACT) can be effectively delivered via the internet with the suggestion that it produced lasting improvements in the psychological health of the chronic pain patients. The internet delivery is important as it allows for convenient, cost-effective, mass delivery of the program. This makes it a particularly desirable therapeutic method for the treatment of patients with chronic pain.

 

So, improve the mental health of chronic pain patients with mindfulness training over the internet.

 

Mindfulness can help you . . . to reduce the suffering associated with pain without necessarily reducing the severity of the pain itself. It can also help you approach your pain with less fear and more acceptance, allowing you to live life fully, even though you have pain.” – Andrea Uptmor

 

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

 

Rickardsson, J., Zetterqvist, V., Gentili, C., Andersson, E., Holmström, L., Lekander, M., Persson, M., Persson, J., Ljótsson, B., & Wicksell, R. K. (2020). Internet-delivered acceptance and commitment therapy (iACT) for chronic pain-feasibility and preliminary effects in clinical and self-referred patients. mHealth, 6, 27. https://doi.org/10.21037/mhealth.2020.02.02

 

Abstract

Background

Acceptance and commitment therapy (ACT) is an evidence-based treatment to improve functioning and quality of life (QoL) for chronic pain patients, but outreach of this treatment is unsatisfactory. Internet-delivery has been shown to increase treatment access but there is limited evidence regarding feasibility and effectiveness of web-based ACT for chronic pain. The aim of the study was to evaluate and iterate a novel internet-delivered ACT program, iACT, in a clinical and a self-referred sample of chronic pain patients. The intervention was developed in close collaboration with patients. To enhance learning, content was organized in short episodes to promote daily engagement in treatment. In both the clinical and self-referred samples, three critical domains were evaluated: (I) feasibility (acceptability, practicality and usage); (II) preliminary efficacy on pain interference, psychological inflexibility, value orientation, QoL, pain intensity, anxiety, insomnia and depressive symptoms; and (III) potential treatment mechanisms.

Methods

This was an open pilot study with two samples: 15 patients from a tertiary pain clinic and 24 self-referred chronic pain participants, recruited from October 2015 until January 2017. Data were collected via an online platform in free text and self-report measures, as well as through individual oral feedback. Group differences were analyzed with Chi square-, Mann-Whitney U- or t-test. Preliminary efficacy and treatment mechanism data were collected via self-report and analyzed with multilevel linear modeling for repeated measures.

Results

Feasibility: patient feedback guided modifications to refine the intervention and indicated that iACT was acceptable in both samples. User insights provided input for both immediate and future actions to improve feasibility. Comprehensiveness, workability and treatment credibility were adequate in both samples. Psychologists spent on average 13.5 minutes per week per clinical patient, and 8 minutes per self-referred patient (P=0.004). Recruitment rate was 24 times faster in the self-referred sample (24 patients in 1 month, compared to 15 patients in 15 months, P<0.001) and the median distance to the clinic was 40 km in the clinical sample, and 426 km in the self-referred sample (P<0.001). Preliminary effects: post-assessments were completed by 26 participants (67%). Significant effects of time were seen from pre- to post-treatment across all outcome variables. Within group effect sizes (Cohen’s d) at post-treatment ranged from small to large: pain interference (d=0.64, P<0.001), psychological inflexibility (d=1.43, P<0.001), value progress (d=0.72, P<0.001), value obstruction (d=0.42, P<0.001), physical QoL (d=0.41, P=0.005), mental QoL (d=0.67, P=0.005), insomnia (d=0.31, P<0.001), depressive symptoms (d=0.47, P<0.001), pain intensity (d=0.78, P=0.001) and anxiety (d=0.46, P<0.001). Improvements were sustained at 1-year follow-up. Psychological inflexibility and value progress were found to be potential treatment mechanisms.

Conclusions

The results from the present study suggests that iACT was feasible in both the clinical and the self-referred sample. Together with the positive preliminary results on all outcomes, the findings from this feasibility study pave the way for a subsequent large randomized efficacy trial.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7327284/

 

Improve Mental and Physical Health in Anxious, Depressed Patients with Mindfulness and Qigong

Improve Mental and Physical Health in Anxious, Depressed Patients with Mindfulness and Qigong

 

By John M. de Castro, Ph.D.

 

“You might think ‘I’m late, I might lose my job if I don’t get there on time, and it will be a disaster!’ Mindfulness teaches you to recognize, ‘Oh, there’s that thought again. I’ve been here before. But it’s just that—a thought, and not a part of my core self,’” – Elizabeth Hoge.

 

Anxiety disorders are the most common mental illness, affecting 40 million adults in the U.S., or 18% of the population. A characterizing feature of anxiety disorders is that the suffer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. Depression often co-occurs with anxiety disorders. Anxiety and depression are generally treated with drugs. But there are considerable side effects and these drugs are often abused. There are a number of psychological therapies for anxiety and depression. But, about 45% of the patients treated do not respond to the therapy. So, there is a need to develop alternative treatments.

 

Recently, it has been found that mindfulness training can be effective for anxiety disorders. Mindfulness has also been shown to be effective for depression. Mindfulness-Based Cognitive Therapy (MBCT) was specifically developed to treat depression and has been shown to be very effective. In addition, mind-body practices such as qigong have also been shown to be effective for anxiety and depression. Recently, qigong practice has been combined with Cognitive Behavioral Therapy (CBT) to treat anxiety and depression. The relative efficacy of MBCT and qigong-Based Cognitive Therapy has not been tested.

 

In today’s Research News article “A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734764/ ) Chan and colleagues recruited adults who had been diagnosed with either an anxiety disorder or depression and randomly assigned them to either a no-treatment control condition or to receive 8 weekly 2 hour sessions of either Mindfulness-Based Cognitive Therapy (MBCT) or Qigong-Based Cognitive Therapy (a combination of Qigong practice along with Cognitive Behavioral Therapy). They were measured before and after training and 8 weeks later for physical and mental health, anxiety, depression, perceived stress, sleep quality, and self-efficacy.

 

They found that in comparison to baseline and the no-treatment control, the participants who received either Mindfulness-Based Cognitive Therapy (MBCT) or Qigong-Based Cognitive Therapy had significantly reduced anxiety, depression, and perceived stress, and significantly increased sleep quality and self-efficacy. These improvements were either sustained or even greater still at the 8-week follow-up. The decreases in anxiety and depression were significantly greater in the Qigong group than in the MBCT group. But the MBCT group had significantly greater improvements in overall mental health than the Qigong group while the Qigong group had significantly greater improvements in physical health than the MBCT group.

 

These are interesting results and to my knowledge the first direct comparison of the effects of Mindfulness-Based Cognitive Therapy (MBCT) and Qigong-Based Cognitive Therapy on patients with anxiety and depression. MBCT has been previously established to significantly improve anxiety, depression, perceived stress, sleep, and self-efficacy and Qigong has similarly been established to significantly improve anxiety, depression, perceived stress, sleep, and self-efficacy. So, the improvements observed in the current study relative to the no-treatment group are expected. What is new is the findings that MBCT is superior for the improvement of mental health while Qigong is superior for the improvement of physical health in patients with diagnosed anxiety and depression.

 

So, improve mental and physical health in anxious, depressed patients with mindfulness and qigong.

 

depression and anxiety scores were significantly decreased after participation in an 8-week mindfulness group therapy for depressive and anxious people.” – Tora Takahashi

 

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

 

Chan, S., Chan, W., Chao, J., & Chan, P. (2020). A randomized controlled trial on the comparative effectiveness of mindfulness-based cognitive therapy and health qigong-based cognitive therapy among Chinese people with depression and anxiety disorders. BMC psychiatry, 20(1), 590. https://doi.org/10.1186/s12888-020-02994-2

 

Abstract

Background

The goal of this study was to investigate treatment outcome and related intervention processes of mindfulness-based cognitive therapy versus health qigong-based cognitive therapy versus waitlist control among individuals with mood disorders.

Methods

A total of 187 individuals with mood disorders were randomized and allocated into mindfulness-based cognitive therapy, health qigong-based cognitive therapy, or waitlist control groups. All participants were assessed at three time points with regard to depressive and anxiety symptoms, physical and mental health status, perceived stress, sleep quality, and self-efficacy. Linear mixed models analysis was used to test the individual growth model by studying the longitudinal data.

Results

Mindfulness-based cognitive therapy and health qigong-based cognitive therapy both produced greater improvements on all outcome measures as compared with waitlist control. Relatively, more reductions of mood symptoms were observed in the health qigong-based cognitive therapy group as compared with the mindfulness-based cognitive therapy group. Health qigong-based cognitive therapy is more conducive to physical health status whereas mindfulness-based cognitive therapy has more favorable mental health outcomes. Individual growth curve models indicated that alterations in perceived stress was the common predictor of mood changes in both intervention groups.

Conclusions

The predominant emphasis on physical health in health qigong-based cognitive therapy makes it more acceptable and effective than mindfulness-based cognitive therapy as applied in Chinese individuals with mood disorders. The influence of Chinese culture is discussed.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7734764/

 

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

Improve the Psychological Health of Cancer Patients with Mindfulness Taught over the Internet

 

By John M. de Castro, Ph.D.

 

“some of the most difficult elements of the cancer experience are very well-suited to a mindfulness practice.” – Linda Carlson

 

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 cancer. These symptoms markedly reduce the quality of life of the patients.

 

Mindfulness training has been shown to help with cancer recovery and help to relieve chronic pain. It can also help treat the residual physical and psychological symptoms, including stress,  sleep disturbancefear, and anxiety and depression. The vast majority of the mindfulness training techniques, however, require a trained therapist. This results in costs that many clients can’t afford. In addition, the participants must be available to attend multiple sessions at particular scheduled times that may or may not be compatible with their busy schedules and at locations that may not be convenient.

 

As an alternative, mindfulness training over the internet have been developed. These have tremendous advantages in decreasing costs, making training schedules much more flexible, and eliminating the need to go repeatedly to specific locations. In addition, research has indicated that mindfulness training online can be effective for improving the health and well-being of the participants. The research has been accumulating. So, it makes sense to step back and summarize what has been learned about the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients.

 

In today’s Research News article “Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/ ) Matis and colleagues review, summarize, and perform a meta-analysis on the published research studies on the effectiveness of mindfulness training over the internet in treating the psychological symptoms of cancer patients. They identified 24 published research studies including at least 4 weeks of mindfulness training delivered over the internet.

 

They report that the published research studies found that mindfulness training delivered over the internet to cancer patients produced significant decreases in stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. In the few studies where long-term follow-up measures were obtained the effects were maintained.

 

These are very promising results that suggest that mindfulness training over the internet is a safe and effective treatment for the psychological issues common in cancer survivors. Mindfulness training, in general, has been shown in a large number of previous studies o be effective in reducing stress, anxiety, depression, pain, fatigue, and sleep problems, and significant increases in mindfulness, posttraumatic growth, and some parameters of general health. So, the present study simply extends these findings to patients with cancer who receive mindfulness training over the internet.

 

These results are important as good mental health, particularly the ability to cope with stress, are predictors of good health outcomes. In addition, the fact that the interventions were provided over the internet allows for cost-effective and convenient delivery to patients. This makes participation and compliance more likely and effective. Hence, internet-based mindfulness training may help relieve the psychological suffering of patients diagnosed with cancer and should be included in their treatment plan.

 

So, improve the psychological health of cancer patients with mindfulness taught over the internet.

 

Both MBCT and eMBCT significantly reduced fear of cancer recurrence and rumination and increased mental health–related quality of life, mindfulness skills, and positive mental health.” – Matthew Stenger

 

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

 

Matis, J., Svetlak, M., Slezackova, A., Svoboda, M., & Šumec, R. (2020). Mindfulness-Based Programs for Patients With Cancer via eHealth and Mobile Health: Systematic Review and Synthesis of Quantitative Research. Journal of medical Internet research, 22(11), e20709. https://doi.org/10.2196/20709

 

Abstract

Background

eHealth mindfulness-based programs (eMBPs) are on the rise in complex oncology and palliative care. However, we are still at the beginning of answering the questions of how effective eMBPs are and for whom, and what kinds of delivery modes are the most efficient.

Objective

This systematic review aims to examine the feasibility and efficacy of eMBPs in improving the mental health and well-being of patients with cancer, to describe intervention characteristics and delivery modes of these programs, and to summarize the results of the included studies in terms of moderators, mediators, and predictors of efficacy, adherence, and attrition.

Methods

In total, 4 databases (PubMed, PsycINFO, Scopus, and Web of Knowledge) were searched using relevant search terms (eg, mindfulness, program, eHealth, neoplasm) and their variations. No restrictions were imposed on language or publication type. The results of the efficacy of eMBPs were synthesized through the summarizing effect estimates method.

Results

A total of 29 published papers describing 24 original studies were included in this review. In general, the results indicate that eMBPs have the potential to reduce the levels of stress, anxiety, depression, fatigue, sleep problems, and pain, and improve the levels of mindfulness, posttraumatic growth, and some parameters of general health. The largest median of Cohen d effect sizes were observed in reducing anxiety and depression (within-subject: median −0.38, IQR −0.62 to −0.27; between-group: median −0.42, IQR −0.58 to −0.22) and facilitating posttraumatic growth (within-subject: median 0.42, IQR 0.35 to 0.48; between-group: median 0.32, IQR 0.22 to 0.39). The efficacy of eMBP may be comparable with that of parallel, face-to-face MBPs in some cases. All studies that evaluated the feasibility of eMBPs reported that they are feasible for patients with cancer. Potential moderators, mediators, and predictors of the efficacy, attrition, and adherence of eMBPs are discussed.

Conclusions

Although the effects of the reviewed studies were highly heterogeneous, the review provides evidence that eMBPs are an appropriate way for mindfulness practice to be delivered to patients with cancer. Thus far, existing eMBPs have mostly attempted to convert proven face-to-face mindfulness programs to the eHealth mode. They have not yet fully exploited the potential of eHealth technology.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7704284/