Nurse Wellness – Meditation

Meditation: In Depth

How much do we know about meditation?

Many studies have been conducted to look at how meditation may be helpful for a variety of conditions, such as high blood pressure, certain psychological disorders, and pain. A number of studies also have helped researchers learn how meditation might work and how it affects the brain.

What do we know about the effectiveness of meditation?

Some research suggests that practicing meditation may reduce blood pressure, symptoms of irritable bowel syndrome, anxiety and depression, and insomnia. Evidence about its effectiveness for pain and as a smoking-cessation treatment is uncertain.

What do we know about the safety of meditation?

Meditation is generally considered to be safe for healthy people. However, people with physical limitations may not be able to participate in certain meditative practices involving movement.

What Is Meditation?

Meditation is a mind and body practice that has a long history of use for increasing calmness and physical relaxation, improving psychological balance, coping with illness, and enhancing overall health and well-being. Mind and body practices focus on the interactions among the brain, mind, body, and behavior. A new report based on data from the 2017 National Health Interview Survey (NHIS) found that U.S. adults’ use of meditation in the past 12 months tripled between 2012 and 2017 (from 4.1 percent to 14.2 percent). The use of meditation by U.S. children (aged 4 to 17 years) also increased significantly (from 0.6 percent in 2012 to 5.4 percent in 2017).

There are many types of meditation, but most have four elements in common: a quiet location with as few distractions as possible; a specific, comfortable posture (sitting, lying down, walking, or in other positions); a focus of attention (a specially chosen word or set of words, an object, or the sensations of the breath); and an open attitude (letting distractions come and go naturally without judging them).

What the Science Says About the Effectiveness of Meditation

Many studies have investigated meditation for different conditions, and there’s evidence that it may reduce blood pressure as well as symptoms of irritable bowel syndrome and flare-ups in people who have had ulcerative colitis. It may ease symptoms of anxiety and depression, and may help people with insomnia.

Pain

Research about meditation’s ability to reduce pain has produced mixed results. However, in some studies scientists suggest that meditation activates certain areas of the brain in response to pain.
A small 2016 study funded in part by the National Center for Complementary and Integrative Health (NCCIH) found that mindfulness meditation does help to control pain and doesn’t use the brain’s naturally occurring opiates to do so. This suggests that combining mindfulness with pain medications and other approaches that rely on the brain’s opioid activity may be particularly effective for reducing pain. Visit the NCCIH Web site for more information on this study.
In another 2016 NCCIH-funded study, adults aged 20 to 70 who had chronic low-back pain received either mindfulness-based stress reduction (MBSR) training, cognitive-behavioral therapy (CBT), or usual care. The MBSR and CBT participants had a similar level of improvement, and it was greater than those who got usual care, including long after the training ended. The researchers found that participants in the MBSR and CBT groups had greater improvement in functional limitation and back pain at 26 and 52 weeks compared with those who had usual care. There were no significant differences in outcomes between MBSR and CBT. Visit the NCCIH Web site for more information on this study.

For High Blood Pressure

Results of a 2009 NCCIH-funded trial involving 298 university students suggest that practicing Transcendental Meditation may lower the blood pressure of people at increased risk of developing high blood pressure.
The findings also suggested that practicing meditation can help with psychological distress, anxiety, depression, anger/hostility, and coping ability.
A literature review and scientific statement from the American Heart Association suggest that evidence supports the use of Transcendental Meditation (TM) to lower blood pressure. However, the review indicates that it’s uncertain whether TM is truly superior to other meditation techniques in terms of blood-pressure lowering because there are few head-to-head studies.

For Irritable Bowel Syndrome

The few studies that have looked at mindfulness meditation training for irritable bowel syndrome (IBS) found no clear effects, the American College of Gastroenterology stated in a 2014 report. But the authors noted that given the limited number of studies, they can’t be sure that IBS doesn’t help.
Results of a 2011 NCCIH-funded trial that enrolled 75 women suggest that practicing mindfulness meditation for 8 weeks reduces the severity of IBS symptoms.
A 2013 review concluded that mindfulness training improved IBS patients’ pain and quality of life but not their depression or anxiety. The amount of improvement was small.

For Ulcerative Colitis

In a 2014 pilot study, 55 adults with ulcerative colitis in remission were divided into two groups. For 8 weeks, one group learned and practiced mindfulness-based stress reduction (MBSR) while the other group practiced a placebo procedure. Six and twelve months later, there were no significant differences between the two groups in the course of the disease, markers of inflammation, or any psychological measure except perceived stress during flare-ups. The researchers concluded that MBSR might help people in remission from moderate to moderately severe disease—and maybe reduce rates of flare-up from stress.

For Anxiety, Depression, and Insomnia

A 2014 literature review of 47 trials in 3,515 participants suggests that mindfulness meditation programs show moderate evidence of improving anxiety and depression. But the researchers found no evidence that meditation changed health-related behaviors affected by stress, such as substance abuse and sleep.
A 2012 review of 36 trials found that 25 of them reported better outcomes for symptoms of anxiety in the meditation groups compared to control groups.
In a small, NCCIH-funded study, 54 adults with chronic insomnia learned mindfulness-based stress reduction (MBSR), a form of MBSR specially adapted to deal with insomnia (mindfulness-based therapy for insomnia, or MBTI), or a self-monitoring program. Both meditation-based programs aided sleep, with MBTI providing a significantly greater reduction in insomnia severity compared with MBSR.

For Smoking Cessation

The results of 13 studies of mindfulness-based interventions for stopping smoking had promising results regarding craving, smoking cessation, and relapse prevention, a 2015 research review found. However, the studies had many limitations.
Findings from a 2013 review suggest that meditation-based therapies may help people quit smoking; however, the small number of available studies is insufficient to determine rigorously if meditation is effective for this.
A 2011 trial comparing mindfulness training with a standard behavioral smoking cessation treatment found that individuals who received mindfulness training showed a greater rate of reduction in cigarette use immediately after treatment and at 17-week follow-up.
Results of a 2013 brain imaging study suggest that mindful attention reduced the craving to smoke, and also that it reduced activity in a craving-related region of the brain.
However, in a second 2013 brain imaging study, researchers observed that a 2-week course of meditation (5 hours total) significantly reduced smoking, compared with relaxation training, and that it increased activity in brain areas associated with craving.

Other Conditions

Results from a 2011 NCCIH-funded study of 279 adults who participated in an 8-week Mindfulness-Based Stress Reduction (MBSR) program found that changes in spirituality were associated with better mental health and quality of life.
Guidelines from the American College of Chest Physicians published in 2013 suggest that MBSR and meditation may help to reduce stress, anxiety, pain, and depression while enhancing mood and self-esteem in people with lung cancer.
Clinical practice guidelines issued in 2014 by the Society for Integrative Oncology (SIC) recommend meditation as supportive care to reduce stress, anxiety, depression, and fatigue in patients treated for breast cancer. The SIC also recommends its use to improve quality of life in these people.
Meditation-based programs may be helpful in reducing common menopausal symptoms, including the frequency and intensity of hot flashes, sleep and mood disturbances, stress, and muscle and joint pain. However, differences in study designs mean that no firm conclusions can be drawn.
Because only a few studies have been conducted on the effects of meditation for attention deficit hyperactivity disorder (ADHD), there isn’t sufficient evidence to support its use for this condition.
A 2014 research review suggested that mind and body practices, including meditation, reduce chemical identifiers of inflammation and show promise in helping to regulate the immune system.
Results from a 2013 NCCIH-supported study involving 49 adults suggest that 8 weeks of mindfulness training may reduce stress-induced inflammation better than a health program that includes physical activity, education about diet, and music therapy.

Meditation and the Brain

Some research suggests that meditation may physically change the brain and body and could potentially help to improve many health problems and promote healthy behaviors.

What the Science Says About Safety and Side Effects of Meditation

Meditation is generally considered to be safe for healthy people.
People with physical limitations may not be able to participate in certain meditative practices involving movement. People with physical health conditions should speak with their health care providers before starting a meditative practice, and make their meditation instructor aware of their condition.
There have been rare reports that meditation could cause or worsen symptoms in people with certain psychiatric problems like anxiety and depression. People with existing mental health conditions should speak with their health care providers before starting a meditative practice, and make their meditation instructor aware of their condition.

NCCIH-Funded Research

NCCIH-supported studies are investigating meditation for:

Teens experiencing chronic, widespread pain, such as from fibromyalgia
Stress reduction for people with multiple sclerosis
Post-traumatic stress disorder, headaches, reducing blood pressure.

More to Consider

Don’t use meditation to replace conventional care or as a reason to postpone seeing a health care provider about a medical problem.
Ask about the training and experience of the meditation instructor you are considering.
Tell all your health care providers about any complementary or integrative health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

Key References

Barrett B, Hayney MS, Muller D, et al. Meditation or exercise for preventing acute respiratory infection: a randomized controlled trial. Annals of Family Medicine. 2012;10:337–346.
Black LI, Barnes PM, Clarke TC, Stussman BJ, Nahin RL. Use of yoga, meditation, and chiropractors among U.S. children aged 4–17 years. NCHS Data Brief, no 324. Hyattsville, MD: National Center for Health Statistics. 2018.
Brewer JA, Mallik S, Babuscio TA, et al. Mindfulness training for smoking cessation: results from a randomized controlled trial. Drug and Alcohol Dependence. 2011;119(1–2):72–80.
Brook RD, Appel RJ, Rubenfire M, et al. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association. Hypertension. 2013;61(6):1360–1383.
Carim-Todd L, Mitchell SH, Oken BS. Mind-body practices: an alternative, drug-free treatment for smoking cessation? A systematic review of the literature. Drug and Alcohol Dependence. 2013;132(3):399–410.
Chen KW, Berger CC, Manheimer E, et al. Meditative therapies for reducing anxiety: a systematic review and meta-analysis of randomized controlled trials. Depression and Anxiety. 2012;29(7):545–562.
Cherkin DC, Sherman KJ, Balderson BH, et al. Effect of mindfulness-based stress reduction vs cognitive behavioral therapy or usual care on back pain and functional limitations in adults with chronic low back pain: a randomized clinical trial. JAMA. 2016;315(12):1240–1249.
Clarke TC, Barnes PM, Black LI, Stussman BJ, Nahin RL. Use of yoga, meditation, and chiropractors among U.S. adults aged 18 and over. NCHS Data Brief, no 325. Hyattsville, MD: National Center for Health Statistics. 2018.
Cramer H, Haller H, Lauche R, et al. Mindfulness-based stress reduction for low back pain. A systematic review. BMC Complementary and Alternative Medicine. 2012;12(162):1–8.
Dakwar E and Levin FR. The emerging role of meditation in addressing psychiatric illness, with a focus on substance use disorders. Harvard Review of Psychiatry. 2009;17(4):254–267.
Desbordes G, Negi LT, Pace TW, et al. Effects of mindful-attention and compassion meditation training on amygdala response to emotional stimuli in an ordinary, non-meditative state. Frontiers in Human Neuroscience. 2012;6:1–15
Fang CY, Reibel DK, Longacre ML, et al. Enhanced psychosocial well-being following participation in a mindfulness-based stress reduction program is associated with increased natural killer cell activity. Journal of Complementary and Alternative Medicine. 2010;16(5):531–538.
Gaylord SA, Palsson OS, Garland EL, et al. Mindfulness training reduces the severity of irritable bowel syndrome in women: results of a randomized controlled trial. American Journal of Gastroenterology. 2011;106(9):1678–1688.
Goldstein CM, Josephson R, Xie S, et al. Current perspectives on the use of meditation to reduce blood pressure. International Journal of Hypertension. 2012;2012:578397.
Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine. 2014;174(3):357–368.
Greeson JM, Webber DM, Smoski MJ, et al. Changes in spirituality partly explain health-related quality of life outcomes after Mindfulness-Based Stress Reduction. Journal of Behavioral Medicine. 2011;34(6):508–518.
Jedel S, Hoffman A, Merriman P, et al. A randomized controlled trial of mindfulness-based stress reduction to prevent flare-up in patients with inactive ulcerative colitis. Digestion. 2014;89:142–155.
Lakhan SE, Schofield KL. Mindfulness-based therapies in the treatment of somatization disorders: a systematic review and meta-analysis. PLoS One. 2013;26;8(8):e71834.
Luders E. Exploring age-related brain degeneration in meditation practitioners. Annals of the New York Academy of Sciences. 2013;1307:82–88.
Luders E, Kurth F, Mayer EA, et al. The unique brain anatomy of meditation practitioners: alterations in cortical gyrification. Frontiers in Human Neuroscience. 2012;6:1–9.
Nidich SI, Rainforth MV, Haaga DAF, et al. A randomized controlled trial on effects of the transcendental meditation program on blood pressure, psychological distress, and coping in young adults. American Journal of Hypertension. 2009;22(12):1326–1331.
Morgan N, Irwin MR, Chung M, et al. The effects of mind-body therapies on the immune system: meta-analysis. PLOS One. 2014;9(7):1–14.
Ong JC, Manber R, Segal Z, et al. A randomized controlled trial of mindfulness meditation for chronic insomnia. Sleep. 2014;37(9):1553–1563.
Reiner K, Tibi L, Lipsitz JD. Do mindfulness-based interventions reduce pain intensity? A critical review of the literature. Pain Medicine. 2013;14:230–242.
Rosenkranz M, Davidson RJ, MacCoon D, et al. A comparison of mindfulness-based stress reduction and an active control in modulation of neurogenic inflammation. Brain, Behavior, and Immunity. 2013;27(1):174–184.
Rubia K. The neurobiology of meditation and its clinical effectiveness in psychiatric disorders. Biological Psychology. 2009;82(1):1–11.
Tang Y-Y, Tang R, Posner MI. Brief meditation training induces smoking reduction. Proceedings of the National Academy of Sciences. 2013;110(34):13971–13975.
Westbrook C, Creswell JD, Tabibnia G, et al. Mindful attention reduces neural and self-reported cue-induced craving in smokers. Social Cognitive and Affective Neuroscience. 2013;8(1):73–84.
Zeidan F, Adler-Neal AL, Wells RE, et al. Mindfulness-meditation-based pain relief is not mediated by endogenous opioids. Journal of Neuroscience. 2016;36(11):3391–3397.

Other References

Bonadonna R. Meditation’s impact on chronic illness. Holistic Nursing Practice. 2003;17(6):309–319.
Cardoso R, de Souza E, Camano L, et al. Meditation in health: an operational definition. Brain Research Protocols. 2004;14(1):58–60.
de Souza ICW, de Barros VV, Gomide HP, et al. Mindfulness-based interventions for the treatment of smoking: a systematic literature review. Journal of Alternative and Complementary Medicine. 2015;21(3):129–140.
Deng GE, Rausch SM, Jones LW, et al. Complementary therapies and integrative medicine in lung cancer: diagnosis and management of lung cancer, 3^rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5)(Suppl):e420S–e436S.
Edwards L. Meditation as medicine. Advance for Nurse Practitioners. 2003;11(5):49–52.
Ford AC, Moayyedi P, Lacy BE, et al. American college of gastroenterology monograph on the management of irritable bowel syndrome and chronic idiopathic constipation. American Journal Gastroenterology. 2014;109(suppl 1):S2–S26.
Greenlee H, Balneaves LG, Carlson LE, et al. Clinical practice guidelines on the use of integrative therapies as supportive care in patients treated for breast cancer. Journal of the National Cancer Institute Monographs. 2014;50:346–358.
Innes KE, Selfe TK, Vishnu A. Mind-body therapies for menopausal symptoms: a systematic review. Maturitas. 2010;66(2):135–149.
Krisanaprakornkit T, Ngamjarus C, Witoonchart C, et al. Meditation therapies for attention-deficit/hyperactivity disorder (ADHD). Cochrane Database of Systematic Reviews. 2010;(6):CD006507. Accessed at www.cochranelibrary.com on November 18, 2014.
Lipton L. Using yoga to treat disease: an evidence-based review. Journal of the American Academy of Physician Assistants. 2008;21(2):34–36, 38, 41.

Acknowledgments

NCCIH thanks the following individuals for their technical expertise and review of the 2014 edition of this publication: Richard J. Davidson, Ph.D., Vilas Professor, Psychology and Psychiatry, University of Wisconsin-Madison; Jeffrey M. Greeson, Ph.D., M.S., Assistant Professor, Psychiatry and Behavioral Sciences, Duke University Medical Center; Helané Wahbe, N.D., Assistant Professor, Neurology, Oregon Health & Science University; and John Glowa, Ph.D., and John (Jack) Killen, Jr., M.D., NCCIH. Thank you to David Shurtleff, Ph.D., NCCIH, for his review of the current edition of this publication.

This publication is not copyrighted and is in the public domain. Duplication is encouraged.

NCCIH has provided this material for your information. It is not intended to substitute for the medical expertise and advice of your health care provider(s). We encourage you to discuss any decisions about treatment or care with your health care provider. The mention of any product, service, or therapy is not an endorsement by NCCIH.

Last Updated: April 2016

Source:

https://www.nccih.nih.gov/health/meditation-in-depth