As an important life activity, sleep supports all major physiological systems of middle-aged and elderly people and has an important influence on their cognitive function and maintenance. Previous studies have shown that mindfulness can improve people's sleep quality, but there are few related studies in middle-aged and elderly people, and the investigation on its mechanism and boundary conditions is even less. Especially, there is a lack of research on the effect of mindfulness on improving sleep quality in middle-aged and elderly people through experimental intervention. Based on the related theories of the relationship between mindfulness and sleep, this paper investigates the effect of mindfulness on sleep quality, the mediating role of perceived stress and the moderating role of cognitive reappraisal on the above-mentioned relationship through both questionnaire surveys and experimental interventions.
In Study 1, 579 middle-aged and elderly people (age ≥ 45 years old) were recruited online and measured with Pittsburgh Sleep Index, Simplified Five-factor Mindfulness Awareness Scale, Chinese Perceived Stress Scale, Emotional Regulation Scale. The results showed that the mindfulness level of middle-aged and elderly people was positively correlated with sleep quality. Perceived stress mediated the relationship between mindfulness level and sleep quality. Cognitive reappraisal moderated the indirect effect of perceived stress between mindfulness and sleep quality. Specially, the indirect effect of perceived stress was stronger among the middle-aged and elderly people with high (versus low) levels of cognitive reappraisal.
Study 2 investigates the effects of mindfulness cognitive therapy on sleep quality of middle-aged and elderly people by an experimental intervention. A total of 136 middle-aged and elderly people were recruited online and randomly divided into experimental group and control group with 68 people in each group. The control group received routine sleep education and the experimental group received mindfulness cognitive therapy intervention besides routine sleep education. The results showed that, after intervention, the mindfulness level of the experimental group improved significantly and the perceived stress decreased significantly. However, there was no significant difference in mindfulness level and perceived stress of the control group. With regard to sleep quality, although the sleep quality of both the experimental group and the control group was significantly improved, the improvement of the experimental group was significantly higher than that of the control group. Furthermore, the mediating test shows that the perceived stress mediated the relationship between mindfulness cognitive intervention and sleep quality.
The current research demonstrates that the higher the mindfulness level of the middle-aged and elderly people, the better their sleep quality is, and the relationship was mediated by perceived stress. As an effective emotion regulation strategy, cognitive reappraisal can enhance the indirect effect of perceived stress between mindfulness and sleep. In addition, mindfulness cognitive therapy can improve the mindfulness level of the middle-aged and elderly people, relieve their perceived stress, and further effectively improve the sleep quality. This study reveals the mechanism and boundary conditions of mindfulness on sleep quality in the middle-aged and elderly people, and verifies the effect of mindfulness cognitive therapy on sleep improvement in middleaged and elderly people with experimental intervention method, which has certain theoretical significance and clinical practice value.
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