Improving sleep with mindfulness and acceptance: a metacognitive model of insomnia.

Published

Journal Article (Review)

While there is an 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 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.

Full Text

Duke Authors

Cited Authors

  • Ong, JC; Ulmer, CS; Manber, R

Published Date

  • November 2012

Published In

Volume / Issue

  • 50 / 11

Start / End Page

  • 651 - 660

PubMed ID

  • 22975073

Pubmed Central ID

  • 22975073

Electronic International Standard Serial Number (EISSN)

  • 1873-622X

Digital Object Identifier (DOI)

  • 10.1016/j.brat.2012.08.001

Language

  • eng

Conference Location

  • England