Mindfulness-based therapies for mood, insomnia and cognition in older adults

Difficulties getting to sleep, staying asleep and waking up too early, characterising insomnia, are widely prevalent in aging populations, with over 30-48% older adults reporting sleep issues. Sleep problems are often left untreated as it is viewed as part of the normal ageing process. Further, there are many barriers such as long waitlists, high financial costs and limited availability of trained service providers to accessing first-line treatments to insomnia like cognitive-behavioural therapy for insomnia (CBTi). Moreover, CBTi is found ineffective for 30-40% of the population. Thus, there is a critical need for alternative and accessible interventions to reduce the high health and financial burden that insomnia in older adults causes. Mindfulness-based therapy for insomnia (MBTi) which potentially targets both the cognitive arousal (e.g. dysfunctional beliefs about sleep) and metacognitive processes (e.g. bias in attention to sleep-related thoughts) that maintain insomnia may be a feasible alternative. MBTi has also been linked to improvements in mood and cognitive functioning. Overall, MBTi may have high clinical utility for older adults by reducing the cognitive-emotional arousal caused by aging and its related comorbidities. Further digitally-delivered MBTi in older adults have yet to be tested. A feasible, online intervention could potentially become a widely-disseminable, financially accessible and effective treatment for older adults. This would reduce the pressure on limited face-to-face service providers and allow a stepped-care approach to treatment.