9
AASM Membership Sections Newsletter
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Issue #7
American Academy of
Sleep Medicine
Twenty-five percent of US adults report insufficient sleep at
least 15 out of 30 days
3
. The Centers of Disease Control and
Prevention (CDC) have declared insufficient sleep as a public
health epidemic (
). The US
Department of Health and Human Services unveiled in 2010
a program called Healthy People 2020, setting 10-year goals
for health promotion and disease prevention, including sleep
health among the topics
)
. The goal
assigned to the topic sleep health in this program is “increase
public knowledge of how adequate sleep and treatment of
sleep disorders improve health, productivity, wellness, quality
of life, and safety on roads and in the workplace”.
Despite these very important efforts, the general population
is not yet aware of the importance of healthy sleep. Neither
are the companies and employers, nor the political authorities.
We, as the sleep medicine community have a very important
challenge ahead. We cannot only produce data but have to
be able to effectively reach the people and help them make
a healthy change in their lives in sleep terms. However, this
is not a person-by-person effort, but a whole-society effort.
Personal behaviors and ideas about sleep need to be changed,
but also work and leisure schedules need to be retuned to
pave the way for healthy sleep, among other measures. The
sleep medicine community has a pivotal role in the needed
transformation toward a healthy sleep society.
1.
Daley M et al (2009) The economic burden of insomnia:
direct and indirect costs for individuals with insomnia
syndrome, insomnia symptoms, and good sleepers.
Sleep 32: 55-64.
2.
Buysse DJ (2014) Sleep Health: Can We Define It? Does
It Matter? Sleep 37 (1): 9-17.
3.
Centers for Disease Control and Prevention,
Epidemiology Program Office. Perceived insufficient rest
or sleep among adults: United States, 2008. MMWR.
2009 Oct 30;58(42):1175-9.
MINDFULNESS AND INSOMNIA
IMRAN KHAWAJA, MD
In order to be able to sleep, we have to be able to relax and
let go of the tension and stress. It is hard to force ourselves
to sleep; we can only let ourselves fall asleep. Trying to
force ourselves to sleep only results in greater difficulty
initiating sleep and if this becomes a nightly pattern we start
complaining of insomnia.
Insomniacs associate bedtime with more anxiety and stress.
Any approach, which can induce a state of relaxation or reduce
anxiety at bedtime, can make it easier to fall asleep.
Mindfulness practice is found to reduce anxiety and stress
in several studies
1
. It is moment-to-moment awareness and
is cultivated by purposefully paying attention to things we
ordinarily do not give a moment’s thought to.
Mindfulness meditation is based on meditations that are used
in Buddhism to help improve mental focus. Jon Kaba-Zinn
(1990) described the use of mindfulness to help with insomnia
in his book “Full Catastrophic Living.” He described the basic
attitudes underlying successful practice of mindfulness as:
non-judging, patience, beginners mind, trust, non-striving,
accepting and letting go. All these attitudes can be helpful
when we consider that falling asleep requires relaxing and
“letting go.”
Mindfulness based approach provides a conceptual framework
for targeting bedtime sleep related arousals that could
potentially enhance the behavioral component of Cognitive
Behavioral Therapy for Insomnia (CBT-I). Mindfulness based
approach encourages participants to observe their thoughts
rather than challenging beliefs and attitudes, which is the case
in CBT-I. For this reason this might be more appealing to some
patients.
Mindfulness based meditation as a single intervention has not
yielded strong effects on sleep, but Ong et al
2
showed that
combining mindfulness and CBT-I in group setting is feasible
and acceptable for individuals with insomnia. There was
statistically and clinically significant improvement in pre-sleep
arousal, sleep effort and dysfunction. In addition, a correlation
was noted between number of meditation sessions and
changes in trait measures of arousal.
More recently, Black at el
3
showed that a standardized
mindfulness practice intervention was superior to sleep
