Mindfulness beat sleep-hygiene classes in a trial, but CBT-I still leads for insomnia

Key takeaways

• In a 2015 trial of 49 older adults, a six-week mindfulness course improved sleep-quality scores more than a sleep-hygiene class, and eased fatigue and depression symptoms, too¹².
• A 2019 review of 18 trials found that mindfulness beat education-type programs for sleep quality, but showed no clear edge over proven sleep treatments such as cognitive behavioral therapy for insomnia (CBT-I)³⁶.
• In a head-to-head trial in cancer patients, CBT-I cut insomnia severity faster than mindfulness, and far fewer people dropped out⁴.
• Half of 14 Headspace trials in one review disclosed a conflict of interest tied to Headspace or Calm, so check who ran an app study⁵.
• Meditation is usually low risk, but about 8% of people in studies report a negative effect, and one insomnia program’s authors say it isn’t a fit for people with current PTSD or bipolar disorder⁶⁷.

In 2012, researchers from UCLA and the University of Southern California ran a trial with 49 adults who had sleep problems, average age 66¹². Each was assigned by chance to one of two six-week courses that met two hours a week².

One group learned mindfulness meditation, which trains you to keep your attention on the present moment without judging it¹. The other took a sleep-hygiene class, with lessons on habits such as relaxing before bed, tracking sleep and not eating right before sleep¹.

On a standard sleep questionnaire, where higher scores mean worse sleep and anything above 5 signals trouble, both groups started at 10.2². The mindfulness group dropped to 7.4. The sleep-hygiene group dropped to 9.1².

The lead author, David Black, called the effect on sleep quality large¹. The mindfulness group also reported less fatigue and fewer depression symptoms¹². The study was funded by the National Institutes of Health (NIH) and foundations, not by any app company¹.

That’s encouraging for a practice that is cheap, drug-free and generally low risk⁶. But one small trial isn’t the full picture. CBT-I still has stronger evidence, and app studies often carry company ties⁵. Below, we look at how the research adds up, and a plan to try meditation the way the trials did.

Meditation for sleep isn’t about trying to fall asleep

The surprise in this research is that mindfulness isn’t meant as a sleep trick. In a treatment chapter on their mindfulness-based therapy for insomnia, researchers J.C. Ong and R. Manber describe mindfulness as paying attention without getting caught up, not as relaxation⁷.

That matters at 3 a.m. Their approach teaches people lying awake to drop the urge to fix the problem, letting thoughts come and go rather than pushing them away⁷. Long stretches of lying awake in bed may teach your body to stay awake there, they note⁷.

The practices also help you feel the difference between sleepiness and fatigue⁷. Sleepiness means you could drift off. Fatigue means feeling drained or wired without being able to sleep. In their program, people go to bed when sleepy, not just tired⁷.

This approach has deep roots. People have meditated for millennia, and many of the methods taught today came out of Eastern traditions, according to the National Center for Complementary and Integrative Health (NCCIH)⁶. It also fits natural-health values well: it needs no product, costs nothing and draws on your body’s own ability to settle. Our upcoming articles on meditation basics and contemplative traditions explore those roots further.

Two trials put mindfulness on the sleep map

The UCLA trial had clear strengths. People were randomly assigned, the comparison group got real attention and lessons, and the mindfulness group improved more on insomnia symptoms and fatigue, too².

It also had limits. Results came from questionnaires, and they were measured right after the course, with no long-term follow-up¹². The groups didn’t differ on anxiety, stress or a blood marker of inflammation².

A second trial tested people with chronic insomnia. Funded by NCCIH and published in 2014, it assigned 54 adults with chronic insomnia to one of three groups⁸⁹:

• Mindfulness-based stress reduction (MBSR): eight weekly 2.5-hour classes plus a six-hour retreat⁸.
• Mindfulness-based therapy for insomnia (MBTI): the same meditation, with insomnia-specific behavioral steps in place of general health lessons⁸.
• Self-monitoring: eight weeks of keeping a sleep diary⁸.

Both meditation groups were asked to practice 30 to 45 minutes at least six days a week⁸. That’s a serious commitment.

The results were striking. In the two meditation groups, total time awake at night fell by about 44 minutes, compared with about 1 minute for self-monitoring⁹. Insomnia severity scores also fell much further⁹. Six months later, half the MBTI group met the study’s definition of remission, and about 79% met its definition of response to treatment⁹.

This is the catch. MBTI blends meditation with core parts of behavioral sleep treatment, such as sleep restriction (limiting time in bed) and stimulus control (getting out of bed when you can’t sleep)⁷⁸. So some of its success likely belongs to those tools. The trial was also small and not very diverse, its authors noted⁸.

Pooled studies: better than classes, no better than CBT-I

A single trial can mislead, so reviews that pool many trials matter more.

In 2019, a team led by H.L. Rusch combined 18 randomized trials with 1,654 people³. Against programs matched for time and attention, such as health education, mindfulness improved sleep quality, with a small-to-moderate effect that grew at follow-up³⁶. The reviewers rated that evidence moderate in strength³.

Against proven sleep treatments such as CBT-I and exercise, mindfulness showed no difference³⁶. That sounds like a tie, but the evidence for that comparison was rated low in strength³. “No difference found” in a few small studies isn’t the same as “equally good.”

Guideline panels have been cautious. In 2021, the American Academy of Sleep Medicine (AASM) made no recommendation for or against mindfulness therapies for chronic insomnia, because fewer than three studies met its standards¹⁰. One wrinkle: the same guideline lists meditation among the relaxation techniques it conditionally supports. What fell short was mindfulness therapy judged as its own category¹⁰.

A 2019 guideline from the Department of Veterans Affairs and Department of Defense also found the evidence insufficient, NCCIH reports¹¹.

Not every review agrees with Rusch. A 2022 review of 20 studies with 2,890 people concluded that MBSR might not improve sleep quality in people with insomnia, though NCCIH notes that the studies were small and showed bias¹¹.

A recent summary comes from Norway’s National Research Center in Complementary and Alternative Medicine. Its August 2026 summary of two 2023 reviews in people with cancer found that mindfulness improved self-reported sleep compared with usual care or wait lists, but not compared with other active treatments¹². Results on objective sleep measures were inconsistent¹².

Head to head, CBT-I worked faster

Few trials have pitted meditation directly against CBT-I. One, led from the University of Calgary and published in 2014 in the Journal of Clinical Oncology, enrolled 111 people with cancer and insomnia. The figures below come from The ASCO Post‘s report on the paper⁴.

Patients got eight weekly 90-minute sessions of either CBT-I or MBSR, and the MBSR group added a six-hour silent retreat⁴.

CBT-I pulled ahead early. On a standard insomnia severity scale, scores in the CBT-I group dropped from about 18 to about 8 when the program ended, while the MBSR group went from about 18 to about 12⁴. MBSR missed the trial’s bar for being nearly as good as CBT-I at that point, then cleared it at the three-month check⁴.

At three months, people fell asleep 22 minutes faster with CBT-I and 14 minutes faster with MBSR⁴. Staying power differed, too: half the MBSR group (32 of 64) quit, compared with 7 of 47 in CBT-I⁴.

The researchers concluded that MBSR produced clinically meaningful gains, but that CBT-I “remains the best choice” among nondrug insomnia treatments⁴.

Think of meditation as a slower, gentler path that may suit people who want it, and CBT-I as the first choice for chronic insomnia. Our upcoming insomnia article explains how to find CBT-I.

Sleep apps sell meditation. Check who ran the study

App research deserves the same scrutiny readers give drug-company studies.

In 2022, researchers reviewed every randomized trial of Headspace and Calm they could find: 14 Headspace trials and 1 Calm trial⁵. Seven of the 14 Headspace trials disclosed a conflict of interest involving Headspace or Calm, and three had no conflict statement at all⁵. In two, company staff helped conceive or run the study, and in 10 Headspace provided free premium access⁵. Thirteen of the 14 tested people without a diagnosed condition⁵.

A 2026 Headspace trial shows what an independent test looks like. Researchers assigned 135 staff members at a California university to use the app 10 minutes a day for eight weeks or wait for access¹³. Headspace supplied free access codes but had no role in collecting, analyzing or reporting the data, and the money came from a University of California grant and an NIH award¹³.

The app group rated their sleep quality better, by about half a point to nearly a point on a 10-point scale¹³. Fitbit data showed longer sleep, about 24 minutes, only at week five, and no change in sleep efficiency¹³. The study didn’t select people with insomnia, and only about half the app users stayed through week eight¹³.

Our article on wellness apps looks at Calm’s sleep research and what to ask about any app study. Apps can help you start a habit. A kitchen timer and your own breath work, too.

Who should go slowly

NCCIH calls meditation usually low risk, while noting that few studies have looked carefully for harms⁶. A 2020 review of 83 studies found that about 8% of participants had a negative effect, similar to rates seen with talk therapy. Anxiety and depression were the most common⁶.

Ong and Manber advise that their group insomnia program isn’t a fit for people with current major depression, bipolar disorder, a psychotic disorder, PTSD or a substance use disorder⁷. These conditions may get in the way of practice or be worsened by it, they explain⁷. That’s caution about one structured program, not a ban, but it’s worth taking seriously.

If you have a trauma history or a serious mental health condition, start with short practices and guidance from a trained teacher or therapist. Our article on meditation groups covers adverse effects and how to vet a teacher.

If meditation stirs up thoughts of harming yourself, stop and call or text the 988 Suicide & Crisis Lifeline.

A four-week meditation-for-sleep starter plan

This plan is our own design, drawing on the trials above. It hasn’t been tested as a package. Practice in a chair, not in bed, for the first three weeks, and keep a simple log each morning: bedtime, wake time and a 0-to-10 rating of how rested you feel.

Week	When	How long	What to do	If you can’t sleep
1	Daytime or early evening	10 minutes	Follow your breath. When your mind wanders, notice where it went and come back.	Don’t fight it. Let thoughts come and go7.
2	Same time daily	15 minutes	Add a body scan: rest attention on each body part from toes to head, then let it go7.	Try a few minutes of the body scan lying still.
3	Plus a 2-minute check before bed	20 minutes	Before bed, ask: am I sleepy or just tired? Go to bed when sleepy7.	Notice whether you feel sleepy or wired.
4	Same as week 3	20 to 30 minutes	Build toward the 30 to 45 minutes used in the 2014 trial, if it suits you8.	Awake and not sleepy? Getting up is reasonable7. Sit somewhere dim and follow your breath until you feel sleepy.

Week-four self-check. Answer each question yes or no:

1. Did I practice at least five days a week in most weeks?
2. Has my average morning rating risen by a point or more since week one?
3. Do I feel less wound up at bedtime?
4. Do I spend less time fighting being awake at night?
5. Did practice ever leave me more anxious, upset or detached from myself?

Reading your answers. Mostly yes to 1 through 4? Keep going, and consider a structured course such as MBSR. No to question 1? Change the time of day before you judge the method. Yes to question 5? Pause and talk with a mental health professional⁶. Sleep trouble three or more nights a week for three months, whatever your answers? See a clinician about CBT-I¹⁰¹⁴.

What the evidence says, rated

Claim	What studies found	Evidence level
Mindfulness improves self-rated sleep quality more than education programs	Moderate-strength evidence in an 18-trial review; one 2022 review disagreed311	Promising but early
Mindfulness works as well as CBT-I	Low-strength evidence; CBT-I worked faster in a head-to-head trial34	Not enough evidence
MBTI helps chronic insomnia	One 54-person trial; includes behavioral sleep tools89	Promising but early
Meditation apps improve sleep	Small gains in self-rated sleep, mostly in nonclinical groups; frequent company ties513	Promising but early
Meditation changes objective sleep measures	Inconsistent results1213	Not enough evidence
Meditation is harmless for everyone	About 8% report a negative effect6	Evidence says no, or unsafe

When to get help

Meditation isn’t a substitute for medical care. Talk with a clinician if trouble falling or staying asleep happens at least three nights a week for three months or more, or if lost sleep is affecting your days¹⁴. Also get checked if:

• you regularly need more than 30 minutes to fall asleep¹⁵;
• you wake several times and struggle to get back to sleep, or wake too early¹⁵;
• you often feel sleepy during the day or fall asleep at the wrong times¹⁵;
• a bed partner notices loud snoring, gasping or pauses in your breathing¹⁴¹⁵;
• creeping or tingling feelings in your legs ease when you move, especially in the evening¹⁵.

If poor sleep comes with hopelessness or thoughts of self-harm, call or text 988 any time. Our upcoming articles on insomnia and when to get a sleep evaluation go deeper.

Questions readers ask

The bottom line

Mindfulness meditation is a low-cost, drug-free practice that has beaten sleep-hygiene classes and diaries in randomized trials, mostly on how people rate their sleep. It teaches a useful skill for sleepless nights: stop wrestling with being awake. But it hasn’t matched CBT-I, which works faster and has stronger guideline support.

Try it with steady daily practice for at least a month, keep a simple log, and judge it by your results. If insomnia persists, or if meditation stirs up distress, bring in a professional.

Related reading

• The viral “military sleep method” hasn’t been tested in trials, unlike older relaxation methods
• What meditation groups can do, and what they can stir up
• Wellness apps help a little if you keep using them, and most people don’t
• Mindful walking eased stress in small trials, and the walking itself deserves some credit
• Who paid for the study matters, even when the science is real

Sources

1. Keck Medicine of USC. “Mindfulness meditation may improve sleep quality and daytime impairment in older adults” (news release on Black DS, et al., JAMA Internal Medicine, 2015). February 19, 2015. keck.usc.edu
2. Black DS, O’Reilly GA, Olmstead R, Breen EC, Irwin MR. “Mindfulness Meditation and Improvement in Sleep Quality and Daytime Impairment Among Older Adults With Sleep Disturbances: A Randomized Clinical Trial.” JAMA Internal Medicine, 2015 (abstract, Qigong Institute research database). qigonginstitute.org
3. Rusch HL, Rosario M, Levison LM, et al. “The effect of mindfulness meditation on sleep quality: a systematic review and meta-analysis of randomized controlled trials.” Annals of the New York Academy of Sciences, 2019;1445(1):5-16 (abstract, Qigong Institute research database). qigonginstitute.org
4. Stenger M. “Both Mindfulness-Based Stress Reduction and, More So, Cognitive Behavioral Therapy Improve Insomnia in Cancer Patients” (report on Garland SN, et al., Journal of Clinical Oncology, 2014). The ASCO Post, January 17, 2014. ascopost.com
5. O’Daffer A, Colt SF, Wasil AR, Lau N. “Efficacy and Conflicts of Interest in Randomized Controlled Trials Evaluating Headspace and Calm Apps: Systematic Review.” JMIR Mental Health, 2022;9(9):e40924. pubmed.ncbi.nlm.nih.gov
6. National Center for Complementary and Integrative Health. “Meditation and Mindfulness: Effectiveness and Safety.” NIH, updated June 2022. nccih.nih.gov
7. Ong JC, Manber R. “Mindfulness-Based Therapy for Insomnia.” In: Behavioral Treatments for Sleep Disorders, Chapter 14. Elsevier, 2011 (University of Pennsylvania copy). med.upenn.edu
8. National Center for Complementary and Integrative Health. “Mindfulness Meditation May Benefit People With Chronic Insomnia.” Research spotlight, September 1, 2014. nccih.nih.gov
9. Ong JC, Manber R, Segal Z, Xia Y, Shapiro S, Wyatt JK. “A randomized controlled trial of mindfulness meditation for chronic insomnia.” Sleep, 2014;37(9):1553-1563 (abstract, Qigong Institute research database). qigonginstitute.org
10. Edinger JD, Arnedt JT, Bertisch SM, et al. “Behavioral and psychological treatments for chronic insomnia disorder in adults: an American Academy of Sleep Medicine clinical practice guideline.” Journal of Clinical Sleep Medicine, 2021;17(2):255-262 (PMC full text). pmc.ncbi.nlm.nih.gov
11. National Center for Complementary and Integrative Health. “Psychological and Physical Approaches for Sleep Disorders: What the Science Says.” NIH clinical digest, March 2024. nccih.nih.gov
12. CAM Cancer (NAFKAM, UiT The Arctic University of Norway). “Does mindfulness work for sleep?” August 19, 2026. cam-cancer.org
13. Torok ZA, Gavrilova L, Patel A, Zawadzki MJ. “The Effectiveness of the Headspace App for Improving Sleep: Randomized Controlled Trial.” Journal of Medical Internet Research, 2026;28:e56287. pubmed.ncbi.nlm.nih.gov
14. National Heart, Lung, and Blood Institute. “Insomnia: Diagnosis.” NIH, updated March 24, 2022. nhlbi.nih.gov
15. MedlinePlus. “Sleep Disorders.” National Library of Medicine, updated December 4, 2025. medlineplus.gov