Insomnia can be a frustrating cycle of sleeplessness to break. For many people, insomnia leads not only to daytime fatigue, sleepiness, and irritability, but also to anxiety about sleep itself. Feeling stress about one's ability to sleep can make falling asleep even more difficult. This kind of negative thinking about sleep is common among people with insomnia, part of the cycles that can feel debilitating.
Recent research shows that mind-body practices can be one effective way to treat insomnia and some of its symptoms.
One group of researchers studied the effects of the meditative exercise practice Tai Chi in treating insomnia and found improvements to several insomnia symptoms, including overall sleep quality. Another recent study evaluated the effects of mindfulness meditation therapies on chronic insomnia. Researchers concluded that meditation can be successful in relieving insomnia that has become chronic. Both studies suggest that mind-body practices may have an important place in the constellation of therapies used to treat this common sleep disorder.
Before we look more closely at this latest research, let's get clear on what we mean when we talk about insomnia. Often people think insomnia is equivalent to a general difficulty sleeping. Insomnia is a sleep disorder with specific characteristics. Insomnia is a pattern of trouble with any one or more of the following symptoms:
• Difficulty falling asleep
• Difficulty staying asleep throughout the night
• Waking very early in the morning
• Experiencing un-refreshing and non-restorative sleep
One or more of these symptoms may be present in an episode of insomnia. Insomnia also takes on different forms. Sometimes insomnia is acute -- it comes on suddenly and lasts for a relatively short and well defined period of time. Acute insomnia is often associated with stress or changes in life. It is possible to experience a bout of acute insomnia only once. Sometimes episodes of acute insomnia recur throughout a person's life. Other times, insomnia comes on and persists for longer periods of time. When insomnia has persisted several nights a week for three months or more, it is considered chronic.
Insomnia is an extremely common sleep problem. Research indicates that most U.S. adults experience an episode of insomnia at least once in their lives. For approximately 10 percent or more of the adult population, insomnia may be chronic. Finding ways to alleviate insomnia and reduce the impact of its symptoms is an important goal for sleep science, one that can have a significant impact on millions of people.
In one new study, researchers evaluated the effects of two different therapies for insomnia in a group of older adults. Among a group of 54 participants with insomnia, researchers compared Tai Chi as a treatment to cognitive behavioral therapy (CBT), a standard treatment for the sleep disorder. Researchers divided participants into three groups, each to receive a different form of treatment for their insomnia. Over a four-month period, one group received CBT for insomnia, and a second group practiced Tai Chi as an insomnia treatment. The third group -- which functioned as a control group for the study -- participated in regular sleep education sessions. Treatment within the study concluded at the four-month mark, and researchers evaluated all participants' sleep again at seven and 16 months. Results of their analysis showed CBT most effective at alleviating insomnia and its symptoms. But Tai Chi also demonstrated effectiveness in improving some symptoms of insomnia. Participants who practiced Tai Chi saw greater improvements to sleep quality, diminished fatigue, and relief from depressive symptoms, compared to the sleep-education control group.
It's not surprising that CBT performed so well in treating insomnia, as it is considered among the most effective treatments for the sleep disorder. It is encouraging to see Tai Chi show a positive impact on insomnia symptoms. A proven stress reducer, Tai Chi is a gentle and meditative form of exercise that incorporates slow, deliberate movements and deep breathing. Other research has demonstrated that Tai Chi may help improve sleep quality and increase total sleep amounts. Studies have also shown Tai Chi may improve daytime function, improving concentration and reducing fatigue.
In a separate study, another group of researchers examined the effects of meditation treatment for chronic insomnia. Fifty-four adults suffering from chronic insomnia were divided into three groups. For eight weeks, two groups received different forms of meditation therapy and a third group participated in a self-monitoring program. Participants kept sleep diaries, and researchers measured sleep using polysomnography and wrist sensors. Both forms of mediation therapy -- mindfulness-based stress reduction (MBSR) and mindfulness-based therapy for insomnia (MBTI) -- appeared to have a positive effect on relieving chronic insomnia:
• Both MBSR and MBTI groups experienced significant improvements in sleep quality, compared to the self-monitoring group.
• MBTI showed the highest rates of remission from chronic insomnia at six months after treatment concluded.
This study adds to the compelling body of scientific research indicating that meditation can play a role in improving sleep. Other recent studies show that meditation may stimulate nighttime levels of the sleep hormone melatonin, and may increase time spent in deep sleep and REM sleep, which are critically important to mental and physical rejuvenation.
Mind-body therapies including Tai Chi and meditation ought to be considered as possible treatment options for sleep problems including insomnia. Science is increasingly showing these gentle, restorative practices to be helpful in alleviating the frustrating cycle of insomnia.
Michael J. Breus, PhD
The Sleep Doctor™