Choukas Nathaniel R, Woodworth Emily C, Manglani Heena R, Greenberg Jonathan, Mace Ryan A
Center for Health Outcomes and Interdisciplinary Research (CHOIR), Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
Behav Sleep Med. 2025 Jan-Feb;23(1):17-30. doi: 10.1080/15402002.2024.2401457. Epub 2024 Sep 16.
In this meta-regression, we aimed to explore associations between changes in psychosocial factors and changes in sleep disturbance during mindfulness-based interventions (MBIs). We also investigated participant-specific and methodological factors associated with sleep disturbance during MBIs.
We utilized data from a published meta-analysis of 40 randomized controlled trials of MBIs (published from inception to 2020) with a sleep disturbance outcome measure in healthy and clinical adult populations. We conducted meta-regressions to test associations between sleep improvements following MBIs and psychosocial factors, as well as demographic and methodological factors.
MBIs were associated with significant reductions in sleep disturbance (SMD = -0.523; 95% CI = -0.678 to -0.368) and psychosocial factors (SMD = -0.213 - -0.894). Reductions in sleep disturbance were associated with reductions in stress ( = 0.74, = .02) and depression ( = 0.90, < .001).
MBIs improve sleep disturbance across a wide range of healthy and clinical populations. Stress and depression may be important psychosocial factors associated with sleep disturbance. Future RCTs should include measures of additional factors and should investigate longitudinal associations between psychosocial, demographic, and methodological factors with changes in sleep disturbance to test mechanisms and to identify "active ingredients" of MBIs.
在这项元回归分析中，我们旨在探讨基于正念的干预措施（MBIs）期间心理社会因素的变化与睡眠障碍变化之间的关联。我们还研究了与MBIs期间睡眠障碍相关的参与者特定因素和方法学因素。
我们利用了一项已发表的对40项MBIs随机对照试验（从开始到2020年发表）的元分析数据，这些试验针对健康和临床成年人群有睡眠障碍结局测量。我们进行了元回归分析，以测试MBIs后睡眠改善与心理社会因素以及人口统计学和方法学因素之间的关联。
MBIs与睡眠障碍（标准化均数差[SMD]=-0.523；95%置信区间[CI]=-0.678至-0.368）和心理社会因素（SMD=-0.213至-0.894）的显著降低相关。睡眠障碍的降低与压力降低（r=0.74，p=0.02）和抑郁降低（r=0.90，p<0.001）相关。
MBIs在广泛的健康和临床人群中改善睡眠障碍。压力和抑郁可能是与睡眠障碍相关的重要心理社会因素。未来的随机对照试验应包括其他因素的测量，并应研究心理社会、人口统计学和方法学因素与睡眠障碍变化之间的纵向关联，以测试机制并确定MBIs的“有效成分”。
