Review Article

The Effect of Mind-Body Therapies on Insomnia: A Systematic Review and Meta-Analysis

Table 1

Characteristics of included studies.

Study (year)ParticipantsN, ageIntervention type 
Duration, frequency
Control  
condition
Sleep related outcome measuresDropouts 
(%)
Study type

Part 1 Studies used active control conditions
Gross 2011Chronic primary insomnia30, 21-65Meditation-MBSRPCTPSQI, ISI, Actigraphy, sleep diary10%RCT
2.5hr/wk, 8wk
Boettcher 2014Anxiety disorder91, 38(10.3)MeditationOnline discussion forumISI11%RCT
1 module/wk, 8wk
Garland 2014Insomnia comorbid with cancer111, 58.89(11.08)Meditation-MBSRCBT-IPSQI, ISI, Actigraphy, sleep diary50%RCT
90min/wk, 8wk
Ong 2014Chronic insomnia35, 42.9(12.2)Meditation-MBSR&MBTISelf-monitoring conditionISI, PSAS, PSG, Actigraphy, sleep diary31.58%RCT
2.5hr/wk&6hr retreat between 5-7wk, 8wk
Black 2015Older adults49, 66.34(7.4)Meditation-MAPsSHE programPSQI; Athens Insomnia Scale12.5%RCT
2hr/wk, 6wk
Alder 2017Adults with obesity194, 47(12.49)Meditation-MBWLIPMRPSQI20%RCT
2-2.5hr ×16, 5.5 mons
Gordon 2017Fibromyalgia148, 46.88(9.43)Meditation-MATCBTGPSQI27%RCT
2hr/wk, 8wk
Wong 2017Adults with chronic primary insomnia216, 56.09(9.4)Meditation-MBCTPEECISI; sleep diary9%RCT
2.5hr/wk, 8wk
Larkey 2015Breast cancer survivors101, 58.8(8.94)Qigong/Tai Chi-QG/TCESham QigongPSQI12.24%RCT
60min/wk, 12wk
Li 2004Older adults with sleep complaints118, 75.37(7.77)Tai Chi-Easy Tai ChiLow-impact exercisePSQI, ESS32.26%RCT
60min×3/wk, 24wk
Irwin 2008Older adults52, 70.12(6.68)Tai Chi-TCCHealth educationPSQI11.86%RCT
40min×3/wk, 16wk
WANG 2010Elderly with cerebrovascular disorder34, 77.06(10.95)Tai Chi-Simplified Yang-styleRehabilitation programPSQI5.88%RCT
50min/wk, 12wk
Jones 2012Fibromyalgia101, 54.04Tai Chi-Modified Yang-styleEducationPSQI0%RCT
1.5 hr×2/wk, 12wk
Irwin 2014Older adults with chronic and primary insomnia73, 66.33(7.45)Tai ChiSleep seminar education controlPSQI, Athens Insomnia Scale, ESS, PSG, sleep diary16.67%RCT
2hr/wk, 4months
Bongi 2016Fibromyalgia44, 52.24(12.19)Tai Chi-Tai Ji Quan  
60min×2/wk, 16wk
Educational course about FMSPSQINRRCT
Irwin 2017Breast cancer survivors90, 59.8(8.58)Tai Chi-Tai Chi ChihCBT-IPSQI, AISI, ESS, PSG, sleep diary15.56%RCT
2hr×8wk+1month skill consolidation
Lü 2017Knee osteoarthritis women46, 64.57(3.38)Tai Chi-Tai Ji Quan  
60min×3/wk, 24wk
Wellness education classesPSQI, sleep latency, total sleep time, sleep efficiency8.70%RCT
Innes 2012Older Women with Restless Legs Syndrome20, 58.7(8.1)Yoga-lyengar yoga program  
90min×2/wk, 8wk
Education film interventionPSQI20%RCT

Part 2 Studies used inactive control conditions
Britton 2012Antidepressant users with sleep complaints26, 46.97(7.8)Meditation-MBCTWait-list control conditionPSG, sleep diary6.67%RCT
3hr/wk, 8wk
Johns 2015fatigued Cancer survivors35, 57.29(9.3)Meditation-MBSR-CRFWait-list control conditionISI0%RCT
2hr/wk, 7wk
Bower 2015Younger Breast Cancer survivors71, <50yearsMeditation-MAPsWait-list control conditionPSQI10.26%RCT
2hr/wk, 6wk
Lengacher 2015Breast cancer79, 57(9.7)Meditation-MBSRUsual carePSQI, Actigraphy, sleep diary0%RCT
2hr/wk, 6wk
Jensen 2015Stressed person with poor sleep quality72, 42(9)Meditation-Open and CalmUsual treatmentPSQI6%RCT
2.5hr/wk, 9wk
Zhang 2015Older adults with chronic insomnia60, 78.1(2.99)Meditation-MBSRWait-list control conditionPSQI3.33%RCT
2hr/wk, 8wk
Zhang 2017Leukemnia patients in chemotherapy76, 39.03(9.14)Meditation-MBPCConventional carePSQI13.16%RCT
30-40min/wk, 5wk
Chen 2012Older people56, 71.75(8.13)Qigong-Baduanjin QigongNo treatmentPSQI3.57%RCT
30min×3/wk, 12wk
Lynch 2012Fibromyalgia100, 52.49(8.71)Qigong-CFQWait-list control conditionPSQI16.98%RCT
40-60min/day, 8wk
Chen 2013Breast cancer96, 45(8.1)Qigong-Guo-lin New QigongWait-list control conditionPSQI0%RCT
40min×5/wk, 5 or 6wk
Chan 2014CFS patients150, 39(7.93)Qigong-Baduanjin QigongWait-list control conditionPSQI13.33%RCT
1.5hr×16sessions arranged over 9wk
McQuade 2017Prostate cancer patients undergoing radiotherapy50, 64.23(8.1)Qigong/Tai Chi-QGTCWait-list control conditionPSQI19.2%RCT
40min×4/wk, during radiotherapy
Frye 2007Older adults54, 69.2(9.26)Tai Chi-Yang-style tai chiNon-exercise controlPSQI25.8%RCT
60min×3/wk, 12wk
Hosseini 2011Older adult residents in nursing home62, 69.08(5.38)Tai Chi-Yang-style tai chiRoutine daily activityPSQI12.90%RCT
20-25min×3/wk, 12wk
Nguyen 2012Older adults96, 68.9(5.1)Tai ChiRoutine daily activityPSQI18.75%RCT
1hr×2/wk, 24wk
Taylor-Piliae 2014Community-dwelling survivors of stroke101, 69.9(10)Tai Chi-Yang-style tai chiUsual carePSQI9.43%RCT
60min×3/wk, 12wk
Cohen 2004Lymphoma patients38, 51Yoga-Tibetan yogaWait-list control conditionPSQINRRCT
Yoga session×1/wk, 7wk
Manjunath 2005geriatric population with self-reported sleep difficulty46, 71.2(7.85)YogaWait-list control conditionSleep rating questionnaire21.74%RCT
60min×6/wk, 24wk
Chen 2009Older adults with sleep complaints139, 68.98(6.18)Yoga-sliver yoga programWait-list control conditionPSQI7.46%RCT
70min×3/wk, 24wk
Afonso 2012Postmenopausal women with insomnia diagnosed40, 50-65yearsYogaWait-list control conditionISI37.50%RCT
1hr×2/wk, 4months
Hariprasad 2013Elderly with sleep disturbances120, 75.28(6.89)Yoga-yoga programWait-list control conditionPSQI29.03%RCT
60min×7/wk, 24wk
Köhn 2013Patients with stress-related symptoms or diagnoses39, 53.03(12.17)Yoga-medical yogaStandard careISI10%RCT
60min/wk, 12wk
Mustian 2013Cancer survivors410, 54.1(10.33)Yoga-YOCAS®Standard carePSQI, Actigraphy18.45%RCT
75min×2/wk, 4wk
Chandwani 2014Breast Cancer107, 52.24(9.79)YogaUsual carePSQI7.50%RCT
60min×3/wk, 6wk
Cheung 2014Older women with knee osteoarthritis36, 71.9Yoga-Hatha yogaWait-list control conditionPSQI0%RCT
60min/wk, 8wk
Newton 2014Women with menopausal vasomotor symptoms249, 54.24(3.67)YogaUsual activityPSQI, ISI1.87%RCT
90min/wk, 12wk
Fang 2015Nurse with poor sleep in China120, 35.58(10.43)YogaNon-yoga control groupPSQI11.48%RCT
50-60min×2/wk, 6months
Jindani 2015Adults with Posttraumatic Stress80, 41(18-64)Yoga-Kundalini yogaWait-list control conditionISI30%RCT
90min/wk, 8wk
Cramer 2016Colorectal cancer patients54, 68.3(9.7)Yoga-Hatha yogaWait-list control conditionPSQI22.22%RCT
90min/wk, 10wk
Buchanan 2017Menopausal Women with Hot Flashes132, 54.63(3.8)Yoga-based on ViniyogaUsual activityActigraphy40.38%RCT
90min/wk, 12wk
Chaoul 2018Breast cancer undergoing chemotherapy159, 49.23(9.93)Yoga-Tibetan yogaUsual carePSQI13.5%RCT
75-90minutes×4/wk, 12wk

Abbreviations. PSQI: Pittsburgh Sleep Quality Index; ISI: Insomnia Severity Index; PSAS: Presleep Arousal Scale; AISI: Athens Insomnia Severity Index; ESS: Epworth Sleepiness Scale; SWS: slow-wave sleep; PSG: polysomnography; MBSR: mindfulness-based stress reduction; MBCT: mindfulness-based cognitive therapy; MAPs: mindful awareness practices; MBTI: mindfulness-based therapy for insomnia; MBWLI: mindfulness-based weight loss intervention; MAT: meditation awareness training; MBPC: mindfulness-based psychological care; PMR: progressive muscle relaxation; PCT: pharmacotherapy; CBT-I: cognitive behavioral therapy for insomnia; CBTG: Cognitive behavioral theory for groups; SHE: sleep hygiene education; PEEC: psychoeducation with stretching exercise control; CFQ: Chaoyi Fanhuan Qigong; RCT: randomized controlled trials; NR: not report