Sick and Tired: Understanding and Managing Sleep Difficulties in ...

activities because they no longer feel controlled by their thoughts and feelings
(McCracken & Zhao-O'Brien, 2010).
Mindfulness has been found to improve both mental and physical health in clinical
populations (Grossman, Niemann, Schmidt, & Walach, 2004). The results from pilot
studies in people with FMS have also been promising (Astin et al., 2003; Grossman,
Tiefenthaler-Gilmer, Raysz, & Kesper, 2007; Kaplan, Goldenberg, & Galvin-Nadeau,
1993; Lush et al., 2009). For example, Grossman et al (2007) found that people with
FMS who completed an eight week MBSR programme, demonstrated sustained benefit
on mental and physical health at three years, when compared to education and
relaxation control group; although the findings were limited by the small sample size of
N=58. In another trial with women with FMS, MBSR was found to improve women‟s
sense of coherence (perception that life is meaningful and manageable), in comparison
to a control group (Weissbecker et al., 2002). Interventions combining the mindfulness
approach with additional interventions have not been so encouraging; for example,
Astin et al (2003) found no significant improvements in patients with FMS receiving
mindfulness plus a Qi-Gong intervention, in comparison to an education support group.
Sephton et al (2007) explored the effect of an MBSR programme on depression and
sleep quality in patients with FMS and found that although improvements in depression
were found and sustained at two months, there was no significant change in sleep
quality. However, Sephton et al (2007) questioned the feasibility of implementing the
intervention as part of a daily schedule; therefore suggesting the need for an alternative
mode of delivery of the mindfulness approach for people with FMS.
To explore whether MBSR may work by reducing the physiological reaction (basal
sympathetic activation) that occurs in response to stress, Lush et al (2009) measured
skin conductance levels, heart rate and peripheral temperature (all associated with basal
sympathetic activation), before and after an eight week MBSR programme. Their study
revealed that skin conductance levels did significantly decrease after the MBSR
programme in patients with FMS, indicative of reduced basal sympathetic activation.
However, there was no significant difference in heart rate or peripheral temperature.
The authors highlighted that just under half (44%) of participants dropped out of the
intervention due to other commitments such as work and child care or difficulties
accessing the intervention due to physical impairment (Lush et al., 2009). This high
attrition rate has also been found in other FMS intervention studies (Goldenberg et al.,
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