Improving sleep with mindfulness and acceptance: A metacognitive model of insomnia

Abstract

While there is accumulating evidence to suggest that therapies using mindfulness and acceptance-based approaches have benefits for improving the symptoms of insomnia, it is unclear how these treatments work. The goal of this paper is to present a conceptual framework for the cognitive mechanisms of insomnia based upon mindfulness and acceptance approaches. The existing cognitive and behavioral models of insomnia are first reviewed and a two-level model of cognitive (primary) and metacognitive (secondary) arousal is presented in the context of insomnia. We then focus on the role of metacognition in mindfulness and acceptance-based therapies, followed by a review of these therapies in the treatment of insomnia. A conceptual framework is presented detailing the mechanisms of metacognition in the context of insomnia treatments. This model proposes that increasing awareness of the mental and physical states that are present when experiencing insomnia symptoms and then learning how to shift mental processes can promote an adaptive stance to one’s response to these symptoms. These metacognitive processes are characterized by balanced appraisals, cognitive flexibility, equanimity, and re-commitment to values and are posited to reduce sleep-related arousal, leading to remission from insomnia. We hope that this model will further the understanding and impact of mindfulness and acceptance-based approaches to insomnia.

The power of presence: The role of mindfulness at work for daily levels and change trajectories of psychological detachment and sleep quality.

“…First, while these studies established the link between mindfulness and sleep quality, they did not provide any insights into the mechanisms driving this relationship in the working population. Extant work on the mindfulness-sleep quality relationship in the clinical area has highlighted the role of sleep-related arousal (Ong et al, 2012) and dysfunctional sleep-related cognitions and beliefs (Heidenreich et al, 2006). The mechanisms underlying the mindfulness-sleep quality relationship in nonclinical, working populations are, however, likely to differ from the mechanisms driving the relationship in clinical populations with clinical levels of insomnia.…”

A Predictive Model of Occupational and Lifestyle Risk Factors and Pain Management Strategies for Participants in a Wellness Program Diagnosed with Chronic Low Back Pain

“…Sleep restriction and selected antidepressant medications have been found to diminish the burden of chronic insomnia and prevent major depression [84,85]. Furthermore, several studies have recently provided evidence to support mindfulness-based treatment programs as being effective in treating clinical levels of insomnia [86][87][88] and alleviate sleep-related problems that often go along with other physical and psychological illnesses [89,90]. These findings may have significant implications on those that experience as CLBP and associated sleep disturbance.…”

Evaluating and Managing Insomnia: Non-pharmacological Treatments

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