Thomas Roth Sleep Research & Disorders Center, Henry Ford Health, Detroit, MI, USA; Department of Obstetrics, Gynecology, and Reproductive Biology, Michigan State University College of Human Medicine, East Lansing, MI, USA. Electronic address: dkalmba1@hfhs.org.
3 papers in the library · 40 citations · publishing 2023-2024
A mindfulness-based sleep program for pregnant women with insomnia appears to work by reducing nighttime cognitive arousal and the effort invested in trying to sleep. In a small trial of 12 pregnant women with insomnia disorder, 75% reported high cognitive arousal before treatment, dropping to 8.3% after treatment. All women whose insomnia remitted had low cognitive arousal afterward, while half of non-remitters still had high arousal. Lower cognitive arousal and less sleep effort predicted same-week improvements in insomnia and later reductions in depression. The findings suggest that quieting a racing mind and decreasing sleep effort are key mechanisms through which mindfulness-based insomnia therapy alleviates both insomnia and depression during pregnancy.
A proof-of-concept trial of a treatment combining mindfulness with behavioral sleep strategies (PUMAS) for pregnant women with insomnia found large reductions in insomnia, depression, and cognitive arousal. Among 12 participants with insomnia disorder (five also had depression), 83.3% achieved insomnia remission after six telemedicine sessions. All five depressed patients remitted from depression. Nocturnal cognitive arousal, perinatal-focused rumination, and sleep effort all showed large improvements. Patients rated sleep restriction and guided meditations as most helpful and were highly satisfied with the telemedicine format and meditation app.
A mindfulness sleep program for pregnant women with insomnia, combining behavioral sleep strategies and meditation, led to large increases in everyday mindfulness and medium-large increases in maternal-fetal attachment. Participants also reported large reductions in anxiety, repetitive thinking, insomnia-focused rumination, and sleep-related daytime impairment. These preliminary results from a small trial of 11 women suggest that such a program may benefit multiple aspects of maternal wellbeing beyond sleep and depressed mood.