The exercise of gratitude as a tool for happiness has been in the mainstream for years. Studies support its effectiveness, suggesting that a positive, appreciative attitude contributes to greater success in life. While many acknowledge gratitude’s list of benefits, it can be difficult to sustain. Many of us are trained to notice what is lacking in our lives. For gratitude to meet its full healing potential, it needs to become more than just a one-time thing. We need to find a new way of looking at things and create new habits.
Practice makes perfect. If we practice giving thanks for all we have, instead of complaining about what we lack, then we give ourselves the prospect to see all of life as an opportunity and a blessing.
Gratitude focuses on where we put our effort and attention. Gratitude balances us and gives us hope.
Some Ways to Practice Gratitude
• Keep a gratitude journal in which you list things for which you are thankful. You can make daily, weekly, or monthly lists. Greater frequency may be better for creating a new habit, but just keeping that journal where you can see it will remind you to think in a grateful way.
• Make a gratitude collage by drawing or pasting pictures.
• Practice gratitude around the dinner table or make it part of your nighttime routine.
• Make a game of finding the hidden blessing in a challenging situation.
• When you feel like complaining, make a gratitude list instead.
• Notice how gratitude is impacting your life. Write about it, sing about it, express thanks for gratitude.
As you practice, an inner shift begins to occur, and you may be delighted to discover how content and hopeful you are feeling. That sense of fulfillment is gratitude at work.
We can now add disturbed sleep to the growing list of problems made better by mindfulness training. Apparently, the practice of non-judgmental focused attention on the present moment leaves a residue that stills the brain/mind enough to help the involuntarily sleep deprived get their rest. At least that’s the conclusion from some solid new research just published in JAMA Internal Medicine.
An especially interesting, and useful, aspect of this research is that it was a randomized clinical trial using real-world interventions with real people. Adults 55 and older with at least moderate problems sleeping were randomly assigned to one of two groups. One group received a six week sleep hygiene education program. The other group participated in a community-based mindfulness program taught by a certified instructor. They also received sleep hygiene instruction.
The mindfulness group met two hours per week for six weeks. As stated in the NIH clinical trials database, those in this group “will be guided through in-class meditation practices and will be assigned daily meditation homework. Active program components include sitting and walking somatosensory-focused meditation, audio-guided body scan meditation, and loving kindness meditation.” This was the real deal. It was a much more immersive experience than something like just listening to oneself breathe a few times week or relying on one of the increasingly popular mindfulness apps, worthwhile endeavors in their own right but not the same intensity as what this research studied.
The sleep hygiene education group also met twice a week for six weeks. They met as a group so as to provide equal support, attention, time, and expectation of benefit. They were taught “knowledge of sleep biology, identifying characteristics of healthy and unhealthy sleep, sleep problems, and self-monitoring of sleep behavior.” The sleep hygiene component included the kind of advice health-care practitioners—myself included—frequently provide patients with moderate sleep problems. Advice such as no alcohol, caffeine, or screens before bed; establish a regular schedule for sleep; associate bed for sleeping not TV; make bedroom dark, cool, and relaxing; avoid large meals before going to bed; exercise during the day; and (personally my least favorite) avoid napping during the day.
While both groups showed improvements in sleep by the end of the study, the mindfulness training group did significantly better in reporting reductions in sleep problems. Plus, as the authors report, the mindfulness group also showed significant improvements in “secondary health outcomes of insomnia symptoms, depression symptoms, fatigue interference, and fatigue severity.”
We know that sleep problems are significantly associated with poor health outcomes. We also know that pharmacological sleep aids all carry significant risk and have significant side effects. We need effective options other than potentially dangerous meds, especially as the population ages and more people develop sleep problems. And the fact that mindfulness training has now been shown to improve sleep among the involuntarily sleep deprived is an important step towards a more well rested, and therefore healthier and happier, population.
It also means I will be changing what I do in my practice when it comes to patients who report sleep problems. From now on sleep hygiene plus a mindfulness practice seems to be the way to go.