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Mindfulness-based interventions (MBI) have been shown to improve sleep quality among people with insomnia. However, much less is known about the effects of MBIs on other aspects of insomnia such as daytime symptoms and cognitive-emotional arousal. The purpose of this study was to examine the treatment effects on these domains for adults with chronic insomnia disorder who were randomized to mindfulness-based stress reduction (MBSR), mindfulness-based therapy for insomnia (MBTI), or a delayed-treatment control consisting of sleep diary self-monitoring (SM) followed by behavior therapy (BT). Analyses were conducted on baseline to post-treatment changes with superiority comparisons for each MBI to SM followed by non-inferiority comparisons for each MBI to BT. The results revealed significant reductions from baseline in the MBTI group with large effect sizes on sleep effort, maladaptive sleep-related cognitions, and hyperarousal which were superior to the SM control (p

The development of psychological and behavioral therapies over the past several decades has led to what is termed the third wave of psychotherapy, a collection of treatments that adopt a new approach to maladaptive cognitions and target broad, contextualistic goals. Within the field of behavioral sleep medicine, treatments for insomnia have followed a similar evolution, and several emerging therapies, including mindfulness and acceptance-based therapies, have begun to accumulate evidence as effective treatments for this sleep disorder over the past several decades. This paper discusses the historical background of the third wave of psychotherapy, introduces each of the third-wave therapies that have been applied to the treatment of insomnia, and reviews the recent literature to critique the effectiveness of these treatments. Relevant controversies with the third-wave therapies are discussed to inform future directions in insomnia research.

Background Previous work has shown that purpose in life can be protective against numerous negative health outcomes including sleep disturbances. Given that sleep disturbances are common among older adults and African Americans, the aim of the present study was to examine the relationship between purpose in life, overall sleep quality, and the presence of sleep disorders in a community-based bi-racial sample of older adults. Methods Participants were 825 non-demented older African Americans (n = 428) and Whites (n = 397) from two cohort studies, the Minority Aging Research Study (MARS) and the Rush Memory and Aging Project (MAP). Participants completed a 32-item questionnaire assessing sleep quality and symptoms of Sleep Apnea, Restless Leg Syndrome (RLS) and REM Behavior Disorder (RBD). Purpose in life was assessed with a 10-item measure modified from Ryff & Keyes’s scales of Psychological Well Being. Results In a series of hierarchical multiple linear regressions controlling for the demographic covariates of age, sex, race, and education, higher levels of purpose in life were associated with better sleep quality at baseline. Using longitudinal follow-up data, higher levels of purpose in life was associated with lower risk of sleep apnea at baseline, 1-year follow-up, and 2-year follow-up, as well as reduced symptoms of RLS at 1-year and 2-year follow-up. Conclusions These findings provide support for the hypothesis that a higher level of meaning and purpose in life among older adults is related to better sleep quality and appears to be protective against symptoms of sleep apnea and RLS.

This study explored cognitive predictors of multiple symptoms of insomnia (difficulty with sleep initiation, maintenance, and early morning awakenings) among a sample of individuals seeking cognitive-behavior therapy for insomnia.Participants consisted of 146 clinical patients with insomnia of which 67 (45.89%) were classified as Single Symptoms subgroup and 79 (54.11%) as Combined subgroup. A receiver operating curve (ROC) analysis was conducted to identify predictors of Combined versus Single Symptom subgroups. The set of predictor variables included demographics, sleep-related cognitions, circadian preferences, depression symptoms, and self-report sleep parameters with insomnia subgroups (Combined versus Single Symptom only) as the dependent variable.The ROC analysis identified two significant predictors: Self Efficacy Scale (SES)23 and a 3-item subscale of the Glasgow Content of Thoughts Inventory (GCTI) assessing "thoughts about the environment" with scores ≥ 5. Post-hoc comparisons revealed that individuals with combined symptoms who had SES score23 had significantly longer sleep onset latency (SOL) and more number of nights with SOL30 minutes, poorer sleep quality, higher insomnia severity, less morningness tendency, higher depression symptom severity, and more anxiety about anxiety and about sleep compared to individuals with SES score ≥ 23.These findings indicate that low self-efficacy and increased thoughts about the environment are associated with having multiple symptoms of insomnia. Further research should examine the specific role of self-efficacy and thought content in the etiology of individuals who suffer from multiple symptoms of insomnia.

Previous research has shown that patients with facial pain exhibit a pattern of physiological and behavioral reactivity to scheduled-waiting tasks that may help account for the development of facial pain. The present study extended this line of research by examining the psychophysiological reactivity of headache sufferers in a similar task. A total of 34 frequent headache sufferers screened by International Headache Society (IHS) criteria and 13 painfree controls completed a psychophysiological assessment consisting of 4 phases (adaptation, free-play, scheduled-play, and recovery) that included a scheduled-waiting condition (scheduled-play) designed to produce adjunctive behavior. Masseter and frontalis EMG were measured continuously during each phase and self-reported oral habits and pain ratings were collected following each phase. A significant interaction and group effect was found on frontalis EMG, with the headache group exhibiting elevated EMG levels across the phases, whereas the control group exhibited increasing EMG levels that peaked during the scheduled-play phase. Only a significant phase effect was found on masseter EMG, with the highest EMG levels recorded during the scheduled-play phase for both groups. In addition, a significant phase effect was found on self-reported oral habits data. Overall, these results provide general support for the adjunctive behavior effect, but the predicted difference in magnitude between the groups was not found.