MBIs have not been shown to be more effective than the traditional intervention for insomnia, Cognitive-Based Therapy for Insomnia (CBT-I). However, an advantage of utilizing MBIs over CBT-I is that it does not require the employment of sleep restriction, which can lead to residual sleepiness. Additionally, MBIs have a comparable or more effective outcome than many medications utilized to decrease the delay of sleep onset and increase sleep quality. It also removes the risk of side effects that may occur when taking these medications. 

How Do Mindfulness Based Interventions Compare To The Traditional Treatments for Insomnia?

In general, Mindfulness Based Interventions have the strongest effects on self-reported sleep quality and on decreasing total wake time in people with insomnia. Additionally, it has been shown to positively affect the severity of insomnia as well. These benefits are achieved because through the the targeting of arousal in mindfulness practices, a mindful stance can be achieved, thus decreasing sleep arousal and allowing for normal sleep patterns to emerge. 

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Practicing mindfulness can target arousal by targeting secondary arousal, which in turn has effects on primary arousal. Specifically, it can lead to increased awareness of one’s mental states in addition to their physical states, which in turn allows for the shift of their response to these symptoms through their mental processes with mindfulness practices. 

How Can Mindfulness Target Arousal in Insomnia?

There are various populations that can benefit from the use of mindfulness-based interventions, and these populations can differ in age, gender, race, orientations, etc. 

- Children and youth
- Parents
- Those Suffering From Addiction
- Patients with anxiety or depression
- Patients with eating disorders
- Those suffering from minority stress
- Traumatic Brain Injury patients
- Healthcare workers
- Adult Survivors of Childhood Trauma 
- Athletes
- People Who Have Insomnia
- War veterans who suffer from PTSD
- Incarcerated Individuals

Populations that Benefit from Mindfulness Interventions

This list includes different types of methods for treating and/or managing different sleep-wake disorders. These include:
-	Narcolepsy Treatment 
-	Mindfulness and Effects on Insomnia
-	Insomnia Treatment Differences Between CBT-I & MBTI

Treatment & Management Methods for Sleep-Wake Disorders

Ong, J. C., & Moore, C. (2020). What do we really know about mindfulness and sleep health? Current Opinion in Psychology, 34, 18–22. https://doi.org/10.1016/j.copsyc.2019.08.020

What do we really know about mindfulness and sleep health?

Mindfulness and Effects on Insomnia

It is noted that there are possible benefits for children participating in different mindfulness-related activities, such as yoga and meditation. However, it should be noted that more in-depth research is needed to measure change over time.

Mindfulness in Children and Youth

Mindfulness has been studied for its usage in those suffering from addiction to substances. Mindfulness has been shown in some scenarios to be effective in decreasing addictive behaviors in people addicted to substances such as opioids, heroin, cocaine, drinking, and smoking. 

Mindfulness for those suffering from substance use disorder

Cognitive Behavioral Therapy (CBT) was one of the original treatments for mental disorders like depression and anxiety.  While CBT is still a very popular treatment, mindfulness-based interventions like Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) have been shown to be as effective as CBT, creating the "new" types of treatment.

Mindfulness Interventions in Patients with Depression and Anxiety

- Hypothesis which states that internalized stigma contributes to existing mental health disparities in marginalized communities

Minority Stress Hypothesis

Mindfulness has been shown to be effective in reducing depression and anxiety symptoms in adults who had  (ACE) adverse childhood experiences that led to trauma.

Mindfulness in Adult Survivors of Childhood Trauma 

There are possible benefits for people who suffering from addiction from mindfulness-related activities.

Those Suffering From Addiction

Mindfulness interventions have been shown to be beneficial for those suffering with eating disorders including anorexia nervosa, binge eating disorder, and bulimia nervosa.

Mindfulness for patients with eating disorders

It has been proven that mindfulness-based interventions have been successful in reducing anxiety, symptoms of stress, improving well-being, and cognitive ability in athletes. Mindfulness-based interventions allow athletes to separate themselves from their feelings, thoughts, and perceptions by taking on a role as an "external observer."

Mindfulness-Based Interventions for Athletes

It has been supported by mutliple studies that MBI's such as Mindfulness Meditations and Vipassana Meditation help those involved in the justice system reduce stress, anger, substance use and improve emotional regulations.

Mindfulness-Based Interventions for Incarcerated Individuals

Through mindfulness practices, parents are able to not only improve their own health and deal with the stress of being a parent but also improve their relationship with their children.  With their parents learning mindfulness practices, children are able to form more secure attachment styles and improve their own behavior.

Mindfulness in Parents

 Mindfulness-based therapies combines the use of mindfulness principles and practices with behavioral strategies for insomnia. Mindfulness-based therapies can provide an alternative treatment to Cognitive Behavioral Therapy (CBT) by addressing hyper-arousal symptoms of insomnia. With the development of a conscious awareness through mindfulness meditation, there is a reduction in cognitive and physiological hyper-arousal, which targets chronic insomnia.

Mindfulness and Behavior Therapy for Insomnia

A disorder that results from experiencing or witnessing something that makes one feel afraid, terrified, or powerless and makes them think that their life, bodily integrity, or safety are in danger. It manifests as painful and intrusive memories of the stressful event, jitteriness, ongoing negative emotional states, social distancing, violent outbursts, and avoiding reminders of the incident.

Post-Traumatic Stress Disorder (PTSD)

Cognitive Behavior Therapy for Insomnia is the most widely used and recommended psychological treatment for chronic insomnia. CBT-I uses interventions involving sleep hygiene, stimulus control, sleep restriction, and cognitive therapy. CBT-I is moderately effective, but may not address hyper-arousal, which is known as a perpetuating factor for insomnia. If CBT-I is not effective in reducing hyper-arousal, then Mindfulness-Based Therapy should be used as treatment for chronic insomnia. MBTI uses the development of a metacognitive process and meditation practice to reduce cognitive and physiological hyper-arousal.Through the improvement of maladaptive thinking instead of challenging content directly, MBTI is ideal to improve sleep for those who do not respond to CBT-I.

Insomnia: The Difference in Treatment between Cognitive Behavior Therapy (CBT-I) and Mindfulness-Based Therapy for Chronic Insomnia (MBTI)

People with narcolepsy can differ substantially in how their symptoms appear and in how well available treatments work. McCarty's case study illustrates this variability: a 50-year-old woman had excessive sleepiness during waking hours, unusual right-sided cataplexy, no dream-like hallucinations, little improvement with a stimulant alone, and major improvement when the stimulant was paired with an antidepressant.

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