A Chinese chan-based mind-body intervention improves sleep on patients with depression: a randomized controlled trial
Agnes S Chan, Queenie Y Wong, Sophia L Sze, Patrick P K Kwong, Yvonne M Y Han, Mei-chun Cheung, Agnes S Chan, Queenie Y Wong, Sophia L Sze, Patrick P K Kwong, Yvonne M Y Han, Mei-chun Cheung
Abstract
Sleep disturbance is a common problem associated with depression, and cognitive-behavioral therapy (CBT) is a more common behavioral intervention for sleep problems. The present study compares the effect of a newly developed Chinese Chan-based intervention, namely Dejian mind-body intervention (DMBI), with the CBT on improving sleep problems of patients with depression. Seventy-five participants diagnosed with major depressive disorder were randomly assigned to receive 10 weekly sessions of CBT or DMBI, or placed on a waitlist. Measurements included ratings by psychiatrists who were blinded to the experimental design, and a standardized questionnaire on sleep quantity and quality was obtained before and after the 10-week intervention. Results indicated that both the CBT and DMBI groups demonstrated significantly reduced sleep onset latency and wake time after sleep onset (effect size range = 0.46-1.0, P ≤ 0.05) as compared to nonsignificant changes in the waitlist group (P > 0.1). Furthermore, the DMBI group, but not the CBT or waitlist groups, demonstrated significantly reduced psychiatrist ratings on overall sleep problems (effect size = 1.0, P = 0.00) and improved total sleep time (effect size = 0.8, P = 0.05) after treatment. The present findings suggest that a Chinese Chan-based mind-body intervention has positive effects on improving sleep in individuals with depression.
References
- Weissman MM, Bland RC, Canino GJ, et al. Cross-national epidemiology of major depression and bipolar disorder. Journal of the American Medical Association. 1996;276(4):293–299.
- Ohayon MM, Shapiro CM, Kennedy SH. Differentiating DSM-IV anxiety and depressive disorders in the general population: comorbidity and treatment consequences. Canadian Journal of Psychiatry. 2000;45(2):166–172.
- Pigeon WR, Hegel M, Unützer J, et al. Is insomnia a perpetuating factor for late-life depression in the IMPACT cohort? Sleep. 2008;31(4):481–488.
- Lustberg L, Reynolds CF. Depression and insomnia: questions of cause and effect. Sleep Medicine Reviews. 2000;4(3):253–262.
- Scrandis DA, Sheikh TM, Niazi R, Tonelli LH, Postolache TT. Depression after delivery: risk factors, diagnostic and therapeutic considerations. The Scientific World Journal. 2007;7:1670–1682.
- Carney CE, Segal ZV, Edinger JD, Krystal AD. A comparison of rates of residual insomnia symptoms following pharmacotherapy or cognitive-behavioral therapy for major depressive disorder. Journal of Clinical Psychiatry. 2007;68(2):254–260.
- Nierenberg AA, Husain MM, Trivedi MH, et al. Residual symptoms after remission of major depressive disorder with citalopram and risk of relapse: a STARßD report. Psychological Medicine. 2010;40(1):41–50.
- Jansen PW, Saridjan NS, Hofman A, Jaddoe VWV, Verhulst FC, Tiemeier H. Does disturbed sleeping precede symptoms of anxiety or depression in toddlers? the Generation R study. Psychosomatic Medicine. 2011;73(3):242–249.
- Carney CE, Harris AL, Friedman J, Segal ZV. Residual sleep beliefs and sleep disturbance following cognitive behavioral therapy for major depression. Depression and Anxiety. 2011;28(6):464–470.
- McClintock SM, Husain MM, Wisniewski SR, et al. Residual symptoms in depressed outpatients who respond by 50% but do not remit to antidepressant medication. Journal of Clinical Psychopharmacology. 2011;31(2):180–186.
- Cho HJ, Lavretsky H, Olmstead R, Levin MJ, Oxman MN, Irwin MR. Sleep disturbance and depression recurrence in community-dwelling older adults: a prospective study. American Journal of Psychiatry. 2008;165(12):1543–1550.
- Roehrs T, Vogel G, Roth T. Rebound insomnia: its determinants and significance. American Journal of Medicine. 1990;88(3):39S–42S.
- Kupfer DJ, Reynolds CF. Management of insomnia. The New England Journal of Medicine. 1997;336(5):341–346.
- Freedman DX, Derryberry JS, Federman DD. Drugs and insomnia. The use of medications to promote sleep. Journal of the American Medical Association. 1984;251(18):2410–2414.
- Dashevsky BA, Kramer M. Behavioral treatment of chronic insomnia in psychiatrically ill patients. Journal of Clinical Psychiatry. 1998;59(12):693–699.
- Manber R, Rush AJ, Thase ME, et al. The effects of psychotherapy, nefazodone, and their combination on subjective assessment of disturbed sleep in chronic depression. Sleep. 2003;26(2):130–136.
- Smith MT, Huang MI, Manber R. Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders. Clinical Psychology Review. 2005;25(5):559–592.
- Taylor DJ, Lichstein KL, Weinstock J, Sanford S, Temple JR. A pilot study of cognitive-behavioral therapy of Insomnia in people with mild depression. Behavior Therapy. 2007;38(1):49–57.
- Manber R, Edinger JD, Gress JL, San Pedro-Salcedo MG, Kuo TF, Kalista T. Cognitive behavioral therapy for insomnia enhances depression outcome in patients with comorbid major depressive disorder and insomnia. Sleep. 2008;31(4):489–495.
- Britton WB, Haynes PL, Fridel KW, Bootzin RR. Polysomnographic and subjective profiles of sleep continuity before and after mindfulness-based cognitive therapy in partially remitted depression. Psychosomatic Medicine. 2010;72(6):539–548.
- Chan AS. Dejian Mind-Body Intervention: Clinical Application of Shaolin Chanwuyi. 4th edition. Hong Kong: Chanwuyi Publishing House Limited; 2009.
- Chan AS, Cheung MC, Tsui WJ, Sze SL, Shi D. Dejian mind-body intervention on depressive mood of community-dwelling adults: a randomized controlled trial. Evidence-Based Complementary and Alternative Medicine. 2011;2011 Article ID 473961.
- Chan AS, Sze SL, Shi D. Traditional Chinese mind-body exercises improve self control ability of an adolescent with Asperger’s disorder. Chinese Journal of Psychology. 2008;9:225–239.
- Chan AS, Sze SL, Cheung MC, Lam JMK, Shi D. Dejian mind-body intervention improves the functioning of a patient with chronic epilepsy: a case report. Cases Journal. 2009;2(11, article 9080)
- Chan AS, Sze SL, Cheung MC, Han YMY, Leung WWM, Shi D. Dejian mind-body intervention improves the cognitive functions of a child with autism. Evidence-Based Complementary and Alternative Medicine. 2011;2011 Article ID 549254.
- Chan AS, Cheung MC, Sze SL, Leung WWM, Shi D. Shaolin Dan Tian breathing Fosters relaxed and attentive mind: a randomized controlled neuro-electrophysiological study. Evidence-Based Complementary and Alternative Medicine. 2011;2011 Article ID 180704.
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition. Washington, DC, USA: American Psychiatric Association; 2000.
- So E, Kam I, Leung CM, Chung D, Liu Z, Fong S. The Chinese-bilingual SCID-I/P Project: stage 1—reliability for mood disorders and schizophrenia. Hong Kong Journal of Psychiatry. 2003;13(1):7–18.
- Hamilton M. Development of a rating scale for primary depressive illness. The British journal of social and clinical psychology. 1967;6(4):278–296.
- Chan AS. The Shaolin Chanwuyi: A Chinese Chan Buddhism. Hong Kong: Chanwuyi Publishing House Limited; 2010.
- Beck AT, Rush AJ, Shaw BF, Emery G. Cognitive Therapy of Depression. New York, NY, USA: Guilford Press; 1987.
- Greenberger D, Padesky C. Mind Over Mood: Change How You Feel by Changing the Way You Think. New York, NY, USA: Guildford Press; 1995.
- Bieling PJ, McCabe RE, Antony MM. Cognitive-Behavioural Therapy in Groups. New York, NY, USA: Guildford Press; 2006.
Source: PubMed