Effects Of Mindfulness On Sleep Quality, Anxiety, Depression and Stress In Migraine

ObjectiveTo examine the change over time in sleep quality and psychosocial outcomes from the MRI Outcomes for Mindfulness Meditation Clinical Trial, assess how these mediated treatment response (50% reduction in headache frequency post-intervention) and examine the relationship between baseline values and treatment response. MethodsThis is a secondary analysis of a randomized placebo-controlled trial with single masking. Patients were recruited from the community, headache clinics and primary care offices in Baltimore Maryland. Eligible patients were aged 18-65 and met the International Classification of Headache Disorders criteria for episodic migraine (4-14 headache days in 28 days).The trial (primary outcomes previously reported) included 98 episodic migraine patients randomized to either enhanced (MBSR+) or stress management for headache (SMH). Follow-up visits occurred at 10, 20 and 52 weeks post baseline. Intervention groups met separately for two hours weekly for 8 weeks and then biweekly for an additional 8 weeks. MBSR+ had an additional half-day retreat held between weeks 6 and 8. ResultsThere was a significant improvement in sleep quality from baseline to post-intervention (p=0.0025), in both groups. There were no significant change from baseline or between groups in anxiety, depression and stress. There was also no significant association between baseline scores and treatment response. Mediation analysis showed a significant indirect effect for sleep, anxiety, stress, and depression on treatment response, ranging from 6-8%. ConclusionsThe findings indicate that in episodic migraine, treatment response to MBSR+ compared to SMH was mediated by small, but significant improvements in sleep, anxiety, stress, and depression.