Insomnia Clinical Trial
Official title:
Augmenting Behavior Therapy for Insomnia With Mindfulness Meditation
The overall goal of this project is to evaluate the evidence for the efficacy of two
mindfulness-based interventions, mindfulness-based therapy for insomnia (MBT-I) and
mindfulness-based stress reduction (MBSR), for reducing arousal and improving sleep among
individuals with psychophysiological insomnia.
Specific Aim 1: To obtain evidence for the relative effects of MBT-I and MBSR compared to a
delayed-treatment control condition followed by behavior therapy for insomnia (BT-I) on
arousal levels. It is hypothesized that MBSR and MBT-I will be superior to the control
condition at reducing arousal levels.
Specific Aim 2: To obtain evidence for the relative effects of MBT-I, MBSR, and the
delayed-treatment control on sleep. It is hypothesized that MBT-I will be superior to the
MBSR and control conditions at improving sleep parameters.
Specific Aim 3: To investigate the relationship between measures of arousal (self-report and
objective measures) and sleep (self-report and objective measures) to enhance the
understanding of the role of arousal in psychophysiological insomnia.
The conceptual model for this study identifies two possible targets of treatment: arousal
and sleep. In this model, BT for insomnia directly targets nighttime symptoms of insomnia
(BT pathway), which improves sleep by increasing the homeostatic drive for sleep. Although
BT is hypothesized to indirectly reduce arousal, no study has specifically investigated this
effect. In contrast, MBSR is an intervention that is hypothesized to target arousal and, as
preliminary findings suggest, also improves some symptoms of insomnia (MBSR pathway). It is
therefore hypothesized that a combination of BT and mindfulness is superior to each
treatment alone as it targets both nighttime symptoms and hyperarousal (Mindfulness + BT
pathway). Our preliminary data suggests that this combination treatment has effects on both
self-reported arousal and sleep. Conceptually, this novel approach would provide a set of
self-regulating skills that could potentially target a broader range of daytime and
nighttime symptoms that is characteristic of an insomnia disorder.
To test the conceptual model, this study employs a randomized clinical trial design with
three conditions: 1) Mindfulness-Based Therapy for insomnia (MBT-I), 2) mindfulness-based
stress reduction (MBSR), and 3) delayed-treatment condition followed by behavior therapy for
insomnia (BT-I). Each of the three treatments will be delivered in a group format with 8
weekly sessions spanning an 8-week period.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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