Effect of mindfulness-based stress reduction on sleep quality: Results of a randomized trial among Danish breast cancer patients

Danish Cancer Society Research Center , Survivorship, Copenhagen , Denmark.
Acta oncologica (Stockholm, Sweden) (Impact Factor: 3). 01/2013; 52(2). DOI: 10.3109/0284186X.2012.745948
Source: PubMed


The prevalence of sleep disturbance is high among cancer patients, and the sleep problems tend to last for years after the end of treatment. As part of a large randomized controlled clinical trial (the MICA trial, NCT00990977) of the effect of mindfulness-based stress reduction (MBSR) on psychological and somatic symptoms among breast cancer patients, the aim of the current study was to evaluate the effect of MBSR on the secondary outcome, 'sleep quality'.

Material and methods:
A total of 336 women operated on for breast cancer stage I-III 3-18 months previously were randomized to MBSR (n = 168) or treatment as usual (n = 168); both groups received standard clinical care. The intervention consisted of an eight-week MBSR program (psycho-education, meditation and gentle yoga). Sleep quality was assessed on the Medical Outcome Study sleep scale at baseline, after the intervention and at six- and 12-months' follow-up.

The mean sleep problem scores were significantly lower in the MBSR group than in controls immediately after the intervention. Quantile regression analyses showed that the effect was statistically significant only for the participants represented by the lower percentile of change between baseline and post-intervention, i.e. those who had more sleep problems; the MBSR group had a significantly smaller increase in sleep problems than the control group. After the 12-month follow-up, there was no significant between-group effect of MBSR on sleep quality in intention-to-treat analyses.

MBSR had a statistically significant effect on sleep quality just after the intervention but no long-term effect among breast cancer patients. Future trials in which participation is restricted to patients with significant sleep problems are recommended for evaluating the effect of MBSR on sleep quality.

Download full-text


Available from: Christoffer Johansen, Dec 22, 2013
  • Source
    • "Data on other outcomes from individual studies of mindfulness-based treatments have found improvements in sleep (S. R. Andersen et al., 2013; Garland et al., 2014), fatigue (Carlson & Garland, 2005), and energy levels (Lengacher et al., 2009). "
    [Show abstract] [Hide abstract]
    ABSTRACT: Objective: Psychological interventions can attenuate distress and enhance coping for those with an initial diagnosis of cancer, but there are few intervention options for individuals with cancer recurrence. To address this gap, we developed and tested a novel treatment combining Mindfulness, Hope Therapy, and biobehavioral components. Method: An uncontrolled, repeated measures design was used. Women (N = 32) with recurrent breast or gynecologic cancers were provided 20 treatment sessions in individual (n = 12) or group (n = 20) formats. On average, participants were middle aged (M = 58) and Caucasian (81%). Independent variables (i.e., hope and mindfulness) and psychological outcomes (i.e., depression, negative mood, worry, and symptoms of generalized anxiety disorder) were assessed pre-treatment and 2, 4, and 7 months later. Session-by-session therapy process (positive and negative affect, quality-of-life) and mechanism (use of intervention-specific skills) measures were also included. Results: Distress, anxiety, and negative affect decreased, whereas positive affect and mental-health-related quality-of-life increased over the course of treatment, as demonstrated in mixed-effects models with the intent-to-treat sample. Both hope and mindfulness increased, and use of mindfulness skills was related to decreased anxiety. Conclusions: This treatment was feasible to deliver and was acceptable to patients. The trial serves as preliminary evidence for a multi-component intervention tailored to treat difficulties specific to recurrent cancer. The blending of the components was novel as well as theoretically and practically consistent. A gap in the literature is addressed, providing directions for testing interventions designed for patients coping with the continuing stressors and challenges of cancer recurrence.
    Full-text · Article · Jun 2014 · Journal of Consulting and Clinical Psychology
  • Source

    Full-text · Article · Feb 2013 · Acta oncologica (Stockholm, Sweden)

  • No preview · Article · Sep 2013 · Sleep Medicine Clinics
Show more