miércoles, 22 de abril de 2015

Meditación Mindfulness para mejorar el sueño de los ancianos

Las tazas de té. Juan Gris



Desde el año pasado  llevo adelante un proyecto que me ilusiona mucho, se trata de talleres de meditación Mindfulness con ancianos junto a Antonio Gamonal, psicólogo del Ayuntamiento de Villalba. Hemos terminado el primer ciclo con buenos resultados y estamos con el segundo. Uno de los aspectos que nos comenta alguno de los participantes es que duermen mejor por la noche cuando practican.

La meditación Midfulness (atención plena),  es muy sencilla, se trata de dedicar un tiempo a mantener plena atención centrada en la respiración, el propio cuerpo, un pensamiento o un objeto. Algo que muchas tradiciones culturales llevan siglos proponiendo. El método MBSR se ha popularizado desde que Jon Kabat Zinn lo desarrollara para aliviar el stress de enfermos de cáncer hospitalizados. Hay mucho escrito sobre el tema, si tienes interés te dejo una lista de recursos aquí.

Hoy aporto una investigación que señala que el sueño de los ancianos mejora más con un programa de meditación basado en Mindfulness que con otro estandard de higiene del sueño.

Todo lo que sea buscar alternativas a las omiprentes pastillas me parece digno de valor. ¿Nos atreveremos los médicos a prescribir conciencia plena para ayudar a los ancianos?



Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep DisturbancesA Randomized Clinical Trial

David S. Black, PhD, MPH1; Gillian A. O’Reilly, BS1; Richard Olmstead, PhD2; Elizabeth C. Breen, PhD2; Michael R. Irwin, MD2
Importance  Sleep disturbances are most prevalent among older adults and often go untreated. Treatment options for sleep disturbances remain limited, and there is a need for community-accessible programs that can improve sleep.
Objective  To determine the efficacy of a mind-body medicine intervention, called mindfulness meditation, to promote sleep quality in older adults with moderate sleep disturbances.
Design, Setting, and Participants  Randomized clinical trial with 2 parallel groups conducted from January 1 to December 31, 2012, at a medical research center among an older adult sample (mean [SD] age, 66.3 [7.4] years) with moderate sleep disturbances (Pittsburgh Sleep Quality Index [PSQI] >5).
Interventions  A standardized mindful awareness practices (MAPs) intervention (n = 24) or a sleep hygiene education (SHE) intervention (n = 25) was randomized to participants, who received a 6-week intervention (2 hours per week) with assigned homework.
Main Outcomes and Measures  The study was powered to detect between-group differences in moderate sleep disturbance measured via the PSQI at postintervention. Secondary outcomes pertained to sleep-related daytime impairment and included validated measures of insomnia symptoms, depression, anxiety, stress, and fatigue, as well as inflammatory signaling via nuclear factor (NF)–κB.
Results  Using an intent-to-treat analysis, participants in the MAPs group showed significant improvement relative to those in the SHE group on the PSQI. With the MAPs intervention, the mean (SD) PSQIs were 10.2 (1.7) at baseline and 7.4 (1.9) at postintervention. With the SHE intervention, the mean (SD) PSQIs were 10.2 (1.8) at baseline and 9.1 (2.0) at postintervention. The between-group mean difference was 1.8 (95% CI, 0.6-2.9), with an effect size of 0.89. The MAPs group showed significant improvement relative to the SHE group on secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity (P < .05 for all). Between-group differences were not observed for anxiety, stress, or NF-κB, although NF-κB concentrations significantly declined over time in both groups (P < .05).
Conclusions and Relevance  The use of a community-accessible MAPs intervention resulted in improvements in sleep quality at immediate postintervention, which was superior to a highly structured SHE intervention. Formalized mindfulness-based interventions have clinical importance by possibly serving to remediate sleep problems among older adults in the short term, and this effect appears to carry over into reducing sleep-related daytime impairment that has implications for quality of life.
 
Puedes acceder a la investigación completa aquí.
Agradezco a Enrique Gavilán haberme compartido la referencia en twitter.