Mindfulness Exercises Associated With Improved Sleep Quality, Duration in At-Risk Children

A mindfulness curriculum characterized by slow, deep breathing and yoga-based movement may provide significant benefits in sleep duration and quality for at-risk children, according to study findings published this week in the Journal of Clinical Sleep Medicine.

Associated with impaired physical, behavioral, and social well-being, poor sleep is common in adolescents and has been shown to affect school performance.

Although sleeping more or keeping regular bedtimes may be considered as improving sleep health, study principal investigator Victor Carrion, MD, endowed professor for child and adolescent psychiatry and director of the Stanford Early Life Stress and Resilience Program, highlighted that environmental stressors such as crime and violence may also impact sleep.

"To fall asleep, you have to relax, but they have a hard time letting their experiences go," said Carrion, in a statement. "They don't feel safe and may have nightmares and fears at night."

Seeking to explore the efficacy of school-based training in mindfulness and yoga-informed practices on children’s behavior and well-being, researchers assessed the mindfulness curriculum in students from elementary/middle schools of 2 low socioeconomic status (SES), primarily Hispanic communities in San Francisco, California (N = 115 children; 49 girls; aged 8-11 at baseline).

Of the cohort, 58 children of one community received the intervention twice weekly for 2 years, with a control group of 57 children from the other SES-matched community participating in their usual physical education class. Both communities had high rates of crime and violence, and families faced stressors such as food insecurity and crowded, unstable housing.

Leveraging the Pure Power Curriculum, instructors educated the children on stress and encouraged them to use the techniques to help them rest and relax, but they did not give any instruction on sleep-improvement techniques such as maintaining consistent bedtimes.

All participants were assessed for sleep via in-home ambulatory polysomnography and perceived social stress at baseline and 1 and 2 years of follow-up.

At baseline, children of the control group were found to sleep 54 minutes more on average (7.5 hours per night) than the intervention group (6.6 hours per night) and had 15 minutes of additional rapid-eye movement (REM) sleep per night.

After the 2-year follow-up, both groups exhibited different sleep patterns, with the control group’s total sleep declining by 64 minutes per night and REM remaining the same, which was noted to be in line with sleep reductions typically seen in later childhood and early adolescence. Conversely, those in the intervention group gained an average of 74 minutes of total sleep time and 24 minutes of REM sleep per night.

Sleep was indicated to improve within the first 3 months of curriculum exposure, in a dose-dependent fashion, with higher curriculum engagement, such as use of exercises outside of class, associated with larger gains in total and REM sleep duration.

Notably, those in the intervention group who experienced larger gains in total and REM sleep duration also experienced larger increases in perceived social stress.

Speaking on the study findings, the researchers highlighted that social stress did not mediate the quality or duration of measured sleep; that instead, the mindfulness training may have increased awareness of environmental stressors, while developing tools to reduce stress vulnerability.

“These results warrant additional investigation to assess whether benefits persist after discontinuation of the curriculum and whether the benefits generalize to other populations,” they concluded.

Reference

Chick CF, Singh A, Anker LA, et al. A school-based health and mindfulness curriculum improves children’s objectively measured sleep: a prospective observational cohort study. J Clin Sleep Med. Published online July 6, 2021. doi:10.5664/jcsm.9508