Shapiro, S. L., Bootzin, R. R., Figueredo, A. J., Lopez, A. M., & Schwartz, G. E. (2003). The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: an exploratory study. Journal of Psychosomatic Research, 54, 85–91.

The intervention consisted of six weekly, two-hour sessions and a one-hour silent treatment session. Participants were trained in meditative practices (Kabat-Zinn), sitting meditation, body scan, Hatha yoga, and “Loving Kindness” meditation.

Participants were given didactic material on physical and psychological effects of stress and tools to cope with stress. The control group chose a stress management technique to engage in each week and used a workbook and diary.

The outcome was sleep.

• The sample was comprised of 63 women with a history of stage II breast cancer (free-choice control group, n = 32; mindfulness-based stress reduction [MBSR] group, n = 31). 
• Mean age was 57 years (range 18–80).
• The women were working, retired, or on disability.

• Participants’ homes
• Western United States

Participants were undergoing the long-term follow-up phase of care.

The study was a randomized, controlled trial.

Sleep diary and a daily diary to record the activities they engaged in for stress management

Hypotheses:

• Sleep function is associated with psychological distress:  confirmed
• Sleep efficiency would be improved after controlling for baseline distress:  not confirmed
• Sleep efficiency and sleep quality would improve with MBSR:  partially confirmed

• The study lacked compliance with the practice of mindfulness techniques; the control group was given too much leeway in their choice of activities to reduce stress.
• Patients self-reported in sleep diaries.
• Personnel trained in Kabat-Zinn and Hatha yoga are needed.