The Effect of Mindful Breathing on Sleep Quality
Nur Amni Binti Mohd Zain (1311558)
PSYC 3070 Experimental Psychology
Semester 1, 2017/2018
Department of Psychology
Kulliyyah of Islamic Revealed Knowledge and Human Sciences
International Islamic University Malaysia
The aim of this study was to examine the effect of mindful breathing on sleep quality of university students. Sixty undergraduate students (N = 60) from a public university in Malaysia age ranging from 20 to 25 years old were recruited using convenient sampling and were random sampling systematically by odd and even number into two groups: control group, n = 30 (a training mindful breathing condition) and experimental group, n = 30 (non-training mindful breathing condition). Each of the participants trained by themselves for 6 days after they had taken one session of education for mindful breathing practice. Before and after the training, each of the participants were completed a MOS sleep scale to measure initiation (time to fall asleep), quantity (hours of sleep each night), maintenance, respiratory problems, perceived adequacy and somnolence. It was hypothesized that three differences will be tested. Using a paired sample t-test, there is no statistically significant difference from two group of scores after the intervention and using an independent sample t-test also showing a significant difference between two group after the post-test of MOS sleep scale scores. This finding suggests that mindful breathing increased the university students sleep quality.
Keyword: meditation, mindfulness, intervention, MOS sleep scale, sleep problem
The Effect of Mindful Breathing on Sleep Quality
Sleeping is a crucial issue in everyday life. One person might sacrifice their sleep time for their unfinished task in the night and affect their sleep quality and their next day mostly. according to English Oxford Dictionary, sleep is a condition of body and mind which the nervous system become inactive while closing the eyes, relaxing the muscle posture and consciousness were practically suspended and it occurs in every night for several hours. The amount of sleep needs may vary for individuals as sleep can promote a good health. Watson, Badr, Belenky, Bliwise, Buxton, Buysse, Dinges, Gangwisch, Grandner, Kushida, Malhotra, Martin, Patel, Quan and Tasali (2015) stated that in order to promote an optimal health, an adult should sleep 7 or more hours per night on a regular basis. Lichtenstein (2015) studied that the National Sleep Foundation has set a good time for sleep in every level of age. A young adults (age 18-25 years) and adults (age 26-64 years) should receive 7 to 9 hours of sleep but not less than 6 hours or more than 10 hours (for adults) or 11 hours (for young adults). Whereas an older adults (65 years and older) should receive 7 to 8 hours of sleep but not less than 5 hours or more than 9 hours. Sleeping less than 7 hours on daily basis may results to weight gain, obesity, hypertension and increased risk of death. According to Watson et. al, consuming less than 7 hours sleeping in the night may associated with impaired immune function, increased pain, impaired performance, increased errors and greater risk of accidents.
Harvey, Stinson, Whitaker, Moskovitz and Virk (2008) cited from Hyyppa and Kronholm (1989) that a good sleep quality is identify with a positive result in the next day like better health, less daytime sleepiness, greater well-being as well as better psychological functioning. Sleep plays an important role in our life as mentioned by Takahashi (2012) that a key factor that supply the productivity in daily life is by having an adequate amounts of sleep.
Mindful breathing is practiced widely in this present as it benefits the person. Usinger (2014) explained that mindfulness helps people who is being trapped in their own though, it helps people to accept the thought with intention to observe and let it go gradually. Usinger supported his research with Brown and Ryan (2003) that mindfulness is formally defined as awareness the present and experience it with concentration, awareness and compassion by practicing a simple breathing (Ong, Ulmer, & Manber, 2012 cited in Usinger, 2014). Apart of that, mindfulness can be defined as set an attention to particular way with purpose, in the present moment with an acceptance of the present (Kabat-Zinn, 1994, cited in Vollestad, Siversten & Nielsen, 2011).
Mindful breathing are advantages to a lot people especially those who has a problem in his/her sleeping. Vøllestad, Sivertsen, & Nielsen (2011) observed mindfulness through Mindfulness-Based Stress Reduction (MBSR) intervention toward patients with heterogeneous anxiety disorders and the result showed positive effect on it which it increased quality of sleep.
The objective of this study is to assess the effect of mindful breathing on the sleep quality. The mindful breathing is the practice of the participants to focus on breathing for 5 minutes before sleeping for six days consecutively. Whereas their sleep quality will be measured by using a sleep scale from a Medical Outcomes Study (MOS) developed by Hays and Stewart from Medical Outcomes Trust (Smith and Wegener, 2003).
Thus, it is hypothesized that:
H1: the participants who practice mindful breathing will improve their quality of their sleep compared to before they experience the mindful breathing.
H2: the participants who did not experience mindful breathing will have the similar quality of sleep.
H3: the participants who practice mindful breathing will have a better quality of sleep compared to the participants who did not experience mindful breathing.
The research design involved in this study is within-group design and between-group design. The participants will be divided into two groups; experimental group which the participants will be exposed to the mindful breathing intervention and control group where the participants were not exposed to any intervention. The score of pre-test and post-test of the participants are within-group design while the different score of post-test between two group is between-group design. Both research design is aimed to measure the effect of mindful breathing on sleep quality.
Sixty undergraduate students from a public university in Selangor, Malaysia were recruited through a convenient sampling. The participants age ranging from 20 to 25 years old (M = 22.62, SD = 1.439). Sixty participants (N = 60) were consisted of eighteen males (n = 18, 30%) and forty-two females (n = 42, 70%) from year 1 to year 4 of their studies. The study setting was conducted in two setting: lab setting for pre-experiment and post experiment session and the participant’s respective room for the intervention period.
An informed consent form, a set of Medical Outcome Study (MOS) sleep scale and a pen were given to the participants. MOS Sleep Scale were using during both pre-test and post-test to measure the participants sleep quality before and after the intervention.
MOS Sleep Scale was taken from RD Hays and AL
Stewart, Medical Outcomes Trust, 198 Tremont
Street #503, Boston, MA 02166. It consisted of 12 items that measures 6 dimensions initiation (time to fall asleep), quantity (hours of sleep each night), maintenance, respiratory problems, perceived adequacy and somnolence (using a Likert scale ranging from “All of the time” to “None of the time”). MOS Sleep Scale was reported its reliability analysis that the Cronbach alpha is ranging from 0.75 to 0.86 which shows high internal consistency (Smith and Wegener, 2003). Besides, the mindful breathing techniques were taken from
The participants were recruited through call and text messages. A briefing session were conducted during the first meeting and an informed consent form were distributed before the participants were divided into two groups; experimental group (the participants exposed to the intervention of mindful breathing) and control group (the participants were not exposed to the intervention of mindful breathing). The participants were given number from 1 to 40. The participants who received the odd numbers were assigned into experiment group while the even number participants were assigned to the control group.
Both groups were received a MOS Sleep Scale to know their quality of sleep before the intervention. The control group will not receive any intervention while the experiment group will be brief about how to practice the mindful breathing. The participants will practice the mindful breathing for 5 minutes every night before sleep for a consecutive of 6 days. Each participant was being reminded through a text message at 9 pm every night for a consecutive 6 days. After the 6 days, a second meeting for post-test session and a debrief session for all 60 participants were conducted. Both meeting was take place in lab setting.
The data from two tests, before and after the intervention were recorded and analysed using SPSS by running the descriptive on demographic profile and paired sample t-test and independent sample t-test to measure the differences of the participants sleep quality before and after the intervention.
A paired-sample t-test was used to evaluate the impact of mindful breathing on student’s sleep quality scores on the Medical Outcomes Study (MOS) Sleep Scale. There was no statistically significant in MOS Sleep Scale scores from time 1 (M = 49.6, SD = 6.85) to time 2 (M = 52.3, SD = 6.49), t (29) = -1.99, p = .056 or p > .001 (two-tailed). The mean increase MOS score was –2.7 with a 95% confidence interval ranging from -5.47 to 0.07. The eta squared statistic (0.06) indicated a moderate effect size,
Table 1 (pre-test and post-test for experimental group)
The result of Paired sample t-test for Sleep Quality
p< .0 A paired-sample t-test was conducted to evaluate the score of student who did not expose to mindful breathing exercise on the Medical Outcomes Study (MOS) Sleep Scale. There was no statistically significant in MOS Sleep Scale scores from time 1 (M = 46.8, SD = 6.76) to time 2 (M = 47.13, SD = 6.43), t (29) = -0.23, p = 0.824 or p > .001 (two-tailed). The mean increase MOS sleep score was -.333 with a 95% confidence interval ranging from -0.37 to 2.7. The eta squared statistic (0.001) indicated a very small effect size.
Table 2 (pre-test and post-test for control group)
The result of Paired sample t-test for Sleep Quality
p< .05 An independent-sample t-test was run to compare the post-test of MOS Sleep Scale scores for experimental group and control group. There was a significant difference in score for control group (M = 52.3, SD = 6.49) and experimental group (M = 47.13, SD = 6.43; t (58) = -3.097, p = 0.003 or p < 0.005, two tailed). The magnitude of the differences in the means (mean difference = -5.167, 95% CI: -8.5 to -1.83) was very large effect size (eta squared = 0.14). Table 3 (post-test for experimental and control group) The result of Independent sample t-test for Sleep Quality Group N M SD t df Sig. (2-tailed) Sleep Quality experiment 30 52.3 6.49 -3.097 58 0.003 control 30 47.13 6.43 p< .05 Discussion The purpose of this study was to find out the effect of the mindful breathing as an intervention to sleep quality of the participants. Results shows that there were no statistically significant for both test score after the intervention. Therefore, the first and second hypothesis which the participants who practice mindful breathing will improve their quality of their sleep compared to before they experience the mindful breathing and the participants who did not experience mindful breathing will have the similar quality of sleep were rejected. The result from this study also shown that there is a statistically significance for the participants who practice mindful breathing will have a better quality of sleep compared to the participants who did not experience mindful breathing. Thus, the hypothesis was supported. Support by theory kat atas wehhh - restate the findings - connect to the data and results References 1. Smith, M. T. & Wegener, S. T. (2003). Measures of sleep: The Insomnia Severity Index, Medical Outcomes Study (MOS) Sleep Scale, Pittsburgh Sleep Diary (PSD), and Pittsburgh Sleep Quality Index (PSQI). Arthritis & Rheumatism (Arthritis Care & Research), 49(5), 184–196. DOI 10.1002/art.11409 2. Usinger, T. (2014). Effect of Internet Administered Mindfulness Training on Anxiety and Sleep Quality. Undergraduate Honors Theses. 727. https://scholar.colorado.edu/honr_theses/727 3. Watson, N. F., Badr, M. S., Belenky, G., Bliwise, D. L., Buxton, O. M., Buysse, D., Dinges, D. F., Gangwisch, J., Grandner, M. A., Kushida, C., Malhotra, R. K., Martin, J. L., Patel, S. R., Quan, S. F., Tasali, E. (2015). Recommended amount of sleep for a healthy adult: a joint consensus statement of the American Academy of Sleep Medicine and Sleep Research Society. Journal of Clinical Sleep Medicine, 11(6):591–592. 4. Lichtenstein, G. R. (2015). The Importance of Sleep. Gastroenterology & Hepatology, 11(12), 790. 5. Takahashi, M. (2012). Prioritizing sleep for healthy work schedules. Journal of Physiological Anthropology, 31(6), https://doi.org/10.1186/1880-6805-31-6 6. Harvey, A. G., Stinson, K., Whitaker, K. L., Moskovitz, D., & Virk, H. (2008). The Subjective Meaning of Sleep Quality: A Comparison of Individuals with and without Insomnia. Sleep, 31(3), 383–393. 7. Vøllestad, J., Sivertsen, B., & Nielsen, G. H., (2011). Mindfulness-based stress reduction for patients with anxiety disorders: evaluation in a randomized controlled trial. Behaviour Research and Therapy, 49(4):281-8. doi: 10.1016/j.brat.2011.01.007. 8.