Background Information

As people age, sleep problems become increasingly common. Nearly half of adults over 55 report some form of sleep disturbance, often struggling with falling or staying asleep. These issues don’t just affect nighttime rest—they also impact mood, cognitive function, and overall quality of life during the day. Yet despite their prevalence, moderate sleep issues in older adults are frequently left untreated. While medications and cognitive behavioral therapies are available for more severe cases like insomnia, there’s a growing need for accessible, low-cost, and non-pharmacological approaches that can help prevent sleep issues from worsening.

Mindfulness meditation, a practice rooted in cultivating non-judgmental present-moment awareness, has been gaining traction as one such option. Previous research suggested it might help with sleep, but studies often used mixed-age groups or targeted populations already suffering from severe insomnia or other illnesses. This study set out to explore something more targeted: Can a structured mindfulness meditation program help older adults with moderate—but not yet clinically severe—sleep disturbances?

What They Did

In a randomized clinical trial, 49 older adults (average age 66) with moderate sleep issues were assigned to one of two six-week programs. One group received mindfulness training through a standardized “Mindful Awareness Practices” (MAPs) course, which included techniques like sitting meditation, mindful walking, and loving-kindness practice. The other group participated in an active control condition: a sleep hygiene education (SHE) course designed to match the meditation program in time, attention, and group support.

Participants in both groups attended weekly two-hour classes for six weeks and were assigned daily homework. Outcomes were assessed both before and after the intervention, focusing on sleep quality (via the Pittsburgh Sleep Quality Index), as well as other measures like depression, fatigue, anxiety, and inflammatory Inflammation is a biological response of the immune system to injury, infection, or stress, characterized by the release of signaling molecules called cytokines. Chronic inflammation is linked to impaired cognitive function, increased risk of disease, and accelerated aging.

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View in glossary markers (specifically NF-κB, a signaling molecule linked to inflammation and sleep disruption).

One Big Result

The MAPs mindfulness group showed significantly greater improvements in sleep quality than the sleep hygiene education group. On average, participants in the mindfulness group improved their Pittsburgh Sleep Quality Index (PSQI) scores by 2.8 points, compared to just 1.1 points in the SHE group—a between-group difference of 1.8 points with a large effect size Effect size is a statistical concept that quantifies the magnitude or strength of a relationship, difference, or intervention outcome. Unlike p-values which only indicate statistical significance, effect sizes measure how meaningful a result is in practical terms. Common measures include Cohen’s d (standardized mean difference), correlation coefficients (r), and odds ratios. In meditation research, effect sizes help quantify the practical impact of different meditation practices on psychological or physiological outcomes.

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View in glossary of 0.89.

Mindfulness meditation appears to have a role in addressing the prevalent burden of sleep problems among older adults by remediating their moderate sleep disturbances and deficits in daytime functioning.

For context, the PSQI ranges from 0 to 21, with higher scores indicating worse sleep. A score above 5 is considered poor sleep quality; thus, participants in this study—starting at an average PSQI of 10.2—fell well into the “poor sleep” range. A reduction of nearly 3 points moved many participants closer to, or just below, the clinical threshold for poor sleep.

Effect size matters here: an effect size of 0.89 is considered large and clinically meaningful, on par with or even exceeding many pharmacological or cognitive-behavioral treatments for sleep issues.

The effect size of 0.89 for improvement in sleep quality was large and of clinical relevance.

In practical terms, a 0.89-point improvement on the PSQI is roughly the same magnitude of change seen with prescription sleep medications like benzodiazepines. While that might seem like a small number, PSQI is a composite score—improvements here often reflect better sleep latency, duration, and reduced disturbances. It’s a meaningful shift in sleep experience and day-to-day functioning, especially for older adults.

Miscellaneous Interesting Takeaways

Reductions in Daytime Impairment

Participants in the mindfulness group also saw improvements in related daytime issues. They reported less fatigue, reduced depressive symptoms, and fewer signs of insomnia. These benefits did not appear in the control group, despite both receiving substantial psychoeducational support.

Mindfulness Improved—And It Mattered

Only the MAPs group showed significant increases in mindfulness as measured by the Five Facet Mindfulness Questionnaire. In this group, improvements in sleep were correlated with increases in mindfulness, particularly the ability to remain non-reactive to inner experiences.

Inflammation Declined, But Equally in Both Groups

Both groups showed decreases in NF-κB, a marker of inflammatory signaling, over the course of the intervention. However, there was no significant difference between the groups, suggesting that while inflammation may be sensitive to behavioral interventions generally, the superior sleep outcomes were specific to mindfulness training.

Final Reflection

This study adds weight to the growing view that mindfulness meditation offers tangible health benefits beyond stress reduction.

Mindfulness meditation significantly improves sleep quality and daytime well-being in older adults with moderate sleep disturbances, offering a scalable alternative to more intensive clinical treatments.

Citation

Black, D. S., O’Reilly, G. A., Olmstead, R., Breen, E. C., & Irwin, M. R. (2015). Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances. JAMA Internal Medicine, 175(4), 494. 10.1001/jamainternmed.2014.8081