Therapies & Traditions · Mind-body practice

Meditation and Mindfulness

Meditation and mindfulness (practices that train attention and awareness) · also called Meditation, mindfulness, MBSR, MBCT, mindfulness-based programs, focused attention, open monitoring, Transcendental Meditation, loving-kindness meditation, meditación, atención plena

Meditation is a family of practices that train attention and awareness, and mindfulness is one of them. Trials have studied it for anxiety, preventing depression relapse, chronic pain, blood pressure, sleep and quality of life in cancer. Most effects are small, they shrink against active treatments, and the research may be inflated by selective reporting. Difficult experiences such as anxiety and low mood are reported by some people, and anyone with psychosis, bipolar disorder or trauma should ask a mental health professional first.

General information, not medical advice. Last substantive update October 31, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

About Meditation and Mindfulness

Meditation is a family of practices that train attention and awareness. In trials, mindfulness programs gave small to moderate gains for anxiety, stress and preventing depression relapse, and small gains for pain, but effects shrink against active treatments, several uses are low certainty, and some people have difficult experiences.

What meditation and mindfulness are

NCCIH describes meditation as a variety of practices that focus on mind and body integration. Some focus attention on something such as the breath, a sound, a visual image or a mantra. Mindfulness means keeping attention on the present moment without judgment.

NCCIH says meditation has a history that goes back thousands of years and that many techniques began in Eastern traditions. It describes MBSR as a program that teaches mindful meditation along with discussion and strategies for stress, and MBCT as combining mindfulness with cognitive behavioural therapy.

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Types and styles

Researchers describe two commonly studied styles: focused attention, which holds attention on a chosen object, and open monitoring, which watches the content of experience from moment to moment without reacting. Studied programs include MBSR, MBCT, mindfulness-based relapse prevention, Transcendental Meditation and loving-kindness or compassion meditation.

Most reviews pool many program types, so a result is rarely tied to one style. The 2013 American Heart Association statement graded Transcendental Meditation separately for blood pressure (Class IIB, Level B), and a 2014 review found kindness-based meditation lowered depression and raised compassion compared with no practice.

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What trials found, by outcome

For anxiety, pooled trials found lower scores than no treatment, with smaller gaps against stronger comparisons, and one trial found an 8-week MBSR course noninferior to escitalopram. For people with recurrent depression who were well or nearly well, MBCT was linked to a lower risk of relapse over 60 weeks than usual care or antidepressants. In community adults, distress was lower a few months after group programs than in passive controls.

For chronic pain a review found a small decrease with low-quality evidence, and in a back pain trial MBSR did about as well as CBT. A 2024 analysis of 12 small trials found lower blood pressure, while the American Heart Association judged the evidence modest and mixed. Sleep results were mixed, with a small positive trial and a review finding no benefit in chronic insomnia and cancer. In people with cancer, small gains in distress and symptoms were found, mostly in breast cancer.

In older adults small gains in attention and memory were found, mostly in healthy people. In one trial of aftercare for substance use, MBRP was linked to fewer days of use at 12 months, though NCCIH says it was not more effective than other treatments at preventing relapse. A large UK school trial found no benefit at one year.

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How strong is the research?

Effects are mostly small and shrink as the comparison gets stronger: one large review found d 0.55 against no treatment, 0.23 against specific active controls and no difference from evidence-based treatments. The 2014 review found no evidence that meditation programs were better than any active treatment.

A study of the trial literature found that 87 percent of 124 published mindfulness trials reported a positive result in the abstract, 1.6 times the number expected from the average effect size, and 62 percent of 21 registered trials were unpublished 30 months after completion. The authors conclude positive results may be overstated. Harm is also poorly reported: only 7 of 38 chronic pain trials and none of 39 psychosis trials reported on side effects.

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How programs were run in trials, and choosing a teacher

Trials usually used supervised group programs. Examples: 8 weekly MBRP group sessions with 12 months of follow-up; 8 weekly 2-hour MBSR groups in the back pain trial; a 6-week program of 2 hours a week in the sleep trial; and 10 lessons in the school trial. Reviews pooled many formats and did not settle on a best length or schedule. These describe what was studied, not what any person should do.

NCCIH advises asking about the instructor's training and experience, not using meditation to replace conventional care, and telling your providers about complementary approaches you use.

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At a glance

Traditional uses history, not proof

NCCIH says meditation has a history that goes back thousands of years and that many meditative techniques began in Eastern traditions

Studied for research

Anxiety, moderate certainty against no treatment, smaller against active comparisons
Preventing depression relapse with MBCT, moderate certainty
Stress and psychological distress in community adults, moderate certainty
Sleep quality and insomnia, mixed
Chronic pain, low certainty
Blood pressure, low certainty
Relapse after substance-use treatment, low certainty
Attention and thinking in older adults, low certainty
Distress and quality of life in cancer, low certainty
School programs for adolescents, no benefit found in a large trial

Main compounds

Focused attention meditation
Open monitoring meditation
Mindfulness-based stress reduction (MBSR)
Mindfulness-based cognitive therapy (MBCT)
Transcendental Meditation
Loving-kindness and compassion meditation

Common forms

Group programs such as MBSR and MBCT
Mindfulness-based relapse prevention
Loving-kindness meditation
Transcendental Meditation
School-based programs
Retreats and home practice

Research links: 2014 review: meditation programs for stress and well-being (47 trials) · 2016 analysis: MBCT and depression relapse (9 trials) · 2023 trial: MBSR versus escitalopram for anxiety · 2017 review: mindfulness meditation for chronic pain (38 trials) · 2020 review: adverse events in meditation (83 studies) · NCCIH: Meditation and Mindfulness, Effectiveness and Safety · Research Library · Genes & Biomarkers Library

What it is and its history

Accepted scientific name: Meditation and mindfulness (a family of mind-body practices)
Common names: Meditation (English); Mindfulness (English); Meditación (Spanish); Atención plena (mindfulness) (Spanish)
Family or group: Mind-body practice. NCCIH describes meditation as a variety of practices that focus on mind and body integration.
Look-alikes and adulterants: Name: Yoga; Note: Includes meditation but also postures and breathing; it has its own page.; Name: Breathwork and relaxation; Note: Related practices studied on their own.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Origins	NCCIH says meditation has a history that goes back thousands of years, and that many meditative techniques began in Eastern traditions.	s-nccih-meditation
Modern programs	NCCIH describes mindfulness-based stress reduction (MBSR) as a program that teaches mindful meditation along with discussion and strategies for stress, and mindfulness-based cognitive therapy (MBCT) as combining mindfulness with cognitive behavioural therapy. The sources read do not give dates or founders for these programs.	s-nccih-meditation

Traditional use shows how it was used. It does not show that it works or is safe today.

What it includes, and how it may work

The parts and styles of the practice, and how researchers think it may act on the body. Proposed mechanisms are not proven effects in people.

Main parts and styles

Part or style	Kind	Where it is used	Activity studied	Level of evidence
Focused attention meditation	style	Lutz and colleagues describe it as the voluntary focusing of attention on a chosen object. NCCIH gives examples such as the breath, a sound, a visual image or a mantra.	Trains holding and returning attention; the 2023 older-adult cognition analysis suggests it may do best for cognition. ^{19 23 20}	Human data
Open monitoring meditation	style	Described as the nonreactive monitoring of the content of experience from moment to moment.	Many mindfulness programs combine this with focused attention; the reviews read do not separate the two. ¹⁹	Human data
Mindfulness-based stress reduction (MBSR)	program	A group program combining mindful meditation with discussion and strategies for stress (NCCIH). In the low back pain trial it was 8 weekly 2-hour groups and included yoga.	Studied for anxiety, pain, sleep, blood pressure and cancer care. ^{23 5 14}	Human data
Mindfulness-based cognitive therapy (MBCT)	program	Combines mindfulness with cognitive behavioural therapy (NCCIH). Studied as manualized MBCT for preventing relapse in recurrent depression.	Lower relapse risk in pooled trials over about a year. ^{23 16}	Human data
Mindfulness-based relapse prevention (MBRP)	program	A group aftercare program that integrates mindfulness-based interventions with cognitive-behavioural relapse prevention.	Studied in people who finished substance-use treatment. ²	Human data
Transcendental Meditation	style	Graded by the American Heart Association's 2013 statement as Class IIB, Level of Evidence B for blood pressure. The sources read do not describe how it is practised.	Evaluated mainly for blood pressure. ³	Human data
Loving-kindness and compassion meditation	style	Kindness-based meditation is described as techniques developed to elicit kindness in a conscious way.	Studied for depression, compassion and positive emotions. ⁹	Human data

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
How meditation might work		The reviews read measured symptoms, not mechanisms. Explanations such as better attention control, less reactivity to thoughts or a calmer stress response are proposals. Brain imaging studies were not read for this page. ¹⁹	Not established

Isolated compounds versus whole extracts

Meditation programs are packages of practice, teaching, group discussion and homework, and often include yoga or cognitive therapy. The trials read did not separate which part gives any benefit.

11benefits and uses looked at

23studies and sources checked

Moderate certaintybest evidence rating found

6lab markers tracked in trials

3 moderate certainty1 mixed findings6 low certainty1 evidence against

What was looked at

The 11 benefits and uses checked for Meditation and Mindfulness, each with how strong the evidence is. Tap one to open it.

AnxietyModerate certainty
Depression relapse (mindfulness-based cognitive therapy)Moderate certainty
Stress and psychological distress in the general adult populationModerate certainty
Sleep quality and insomniaMixed findings
Relapse after treatment for substance useLow certainty
Attention and thinking skillsLow certainty
Loving-kindness and compassion meditationLow certainty
School-based mindfulness for adolescentsEvidence against
Chronic painLow certainty
Blood pressureLow certainty
Distress and quality of life in cancerLow certainty

Lab markers tracked in the studies

Psychological distress (pooled questionnaire scores)Depressive relapse within 60 weeksSleep quality (Pittsburgh Sleep Quality Index, lower is better)Chronic pain intensityMeaningful improvement in back pain bothersomeness (at least 30 percent)Systolic blood pressure

What is Meditation and Mindfulness good for?

The main studied uses and how strong the human evidence is for each. These describe what trials found in the groups they studied. They are not advice to meditate for any condition, and each result is for the program type tested.

AnxietyModerate certaintyPooled trials found lower anxiety than no treatment, with smaller gaps against other treatments. One trial found an 8-week MBSR course noninferior to an anxiety medicine. Depression relapse (mindfulness-based cognitive therapy)Moderate certaintyA pooled analysis of 9 trials found lower relapse risk over 60 weeks with MBCT in people with recurrent depression in remission, including against antidepressants. Stress and psychological distress in the general adult populationModerate certaintyDistress was lower a few months after group mindfulness programs than in passive controls, a small to moderate effect in volunteers. Sleep quality and insomniaMixed findingsOne small trial favoured mindfulness over sleep education in older adults, but a review found no benefit in chronic insomnia and cancer. Relapse after treatment for substance useLow certaintyOne trial of 286 adults found lower relapse risk than usual aftercare at 6 months, and fewer days of use at 12 months than the other groups. NCCIH says MBRP was not more effective than other treatments at preventing relapse. Attention and thinking skillsLow certaintySmall gains in attention, memory and spatial thinking in older adults, mostly healthy ones. Earlier evidence for attention in adults was low or insufficient. Loving-kindness and compassion meditationLow certaintyLower depression and higher compassion than no practice, inconclusive against active practices, and small studies. School-based mindfulness for adolescentsEvidence againstA trial of 84 UK schools found no benefit over normal teaching at one year. Chronic painLow certaintyA small decrease in pain with low-quality evidence; in one back pain trial MBSR did about as well as CBT and better than usual care. Blood pressureLow certaintyA 2024 analysis of 12 small trials found lower blood pressure; the American Heart Association's 2013 statement called the evidence for meditation modest and mixed. Distress and quality of life in cancerLow certaintySmall gains in distress, fatigue, sleep and pain in people with cancer, mostly breast cancer, with effects fading at follow-up.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Anxiety

Moderate certainty

Pooled trials find lower anxiety scores after mindfulness programs than with no treatment, but the gap shrinks against other treatments. One large trial found an eight-week mindfulness course did about as well as an anxiety medicine.

3 studiesPrograms were mostly mindfulness-based programs such as MBSR. In the …

Studies, doses and limits

What the trials found

A 2014 review of 47 trials (3,515 adults) with active controls found moderate evidence of lower anxiety from mindfulness programs. A 2018 review of 142 samples (12,005 people) found mindfulness beat no treatment and active controls, with smaller gaps against stronger comparisons. A 2023 trial of 276 adults with anxiety disorders compared an 8-week MBSR course with the antidepressant escitalopram.

Results

Anxiety effect size 0.38 at about 8 weeks and 0.22 at 3 to 6 months in the 2014 review. In the 2018 review the gap versus no treatment was d 0.55, versus specific active controls d 0.23, and there was no difference from evidence-based treatments. In the 2023 trial MBSR was noninferior to escitalopram on a clinician-rated scale (difference -0.07), with fewer study-related side effects (15.4 vs 78.6 percent).

Effect sizes as reported

2014: anxiety 0.38 (95% CI 0.12 to 0.64) at 8 weeks, 0.22 (0.02 to 0.43) at 3 to 6 months. 2018: d 0.55, 0.37, 0.35, 0.23 against no, minimal, non-specific active and specific active controls; -0.004 against evidence-based treatment. 2023 trial: group difference -0.07 (-0.38 to 0.23).

Why this rating

Compiler's rating: moderate against no treatment, because the 2014 reviewers rate it moderate and several reviews agree. It drops to low against active comparisons, where effects shrink and the 2014 reviewers found no evidence of being better than any active treatment. The noninferiority trial has no placebo arm.

Form and dose studied

Programs were mostly mindfulness-based programs such as MBSR. In the 2023 trial the course was weekly and lasted 8 weeks. These describe what was studied, not what anyone should do.

Who was studied

Adults with a diagnosed anxiety disorder (2023 trial), or varied clinical and community groups (reviews).

Limits

Self-reported symptoms, people knew what they had, small trials, and active controls often not matched for attention and group support. Few long-term follow-ups.

Why researchers looked

Meditation trains a way of paying attention to worry without getting carried along by it, so researchers asked whether that lowers anxiety.

Proposed mechanism Hypothesis

Proposed: less reacting to worrying thoughts and a calmer body stress response. The reviews read measured symptoms, not these mechanisms.

A proposed mechanism does not show that the effect happens in people.

In the 2023 trial no one left the MBSR group because of adverse events. See the Safety tab for what is known about difficult experiences.

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Depression relapse (mindfulness-based cognitive therapy)

Moderate certainty

For people who have had depression several times and are now well or nearly well, a pooled analysis found a lower risk of relapse over about a year with mindfulness-based cognitive therapy, including against antidepressants.

1 studiesManualized MBCT. The abstract does not state session length or number…

Studies, doses and limits

What the trials found

A 2016 individual-patient-data analysis of 9 randomised trials (1,258 adults with recurrent depression in full or partial remission) followed people for 60 weeks.

Results

Lower risk of relapse than with usual care or no MBCT (hazard ratio 0.69, 95% CI 0.58 to 0.82) and than with active treatments including antidepressants (hazard ratio 0.79, 0.64 to 0.97). The effect was larger in people with more symptoms before treatment.

Effect sizes as reported

Hazard ratio 0.69 (0.58 to 0.82) vs no MBCT/usual care; 0.79 (0.64 to 0.97) vs active treatments.

Why this rating

Compiler's rating: consistent result from pooled individual data across 9 trials, but only about a year of follow-up, the active-treatment effect is modest and its interval comes close to 1, and the abstract gives no blinding or publication-bias check.

Form and dose studied

Manualized MBCT. The abstract does not state session length or number of sessions. NCCIH describes MBCT as combining mindfulness with cognitive behavioural therapy.

Who was studied

Adults with recurrent depression in remission; mean age 47, three in four women. Not people in a current severe depressive episode.

Limits

Follow-up limited to 60 weeks; people knew their treatment; results do not apply to treating an active episode.

Why researchers looked

Depression often returns, so researchers asked whether a skills course (MBCT, which combines mindfulness with cognitive behavioural therapy) can lower the chance of relapse.

Proposed mechanism Hypothesis

Proposed: noticing early low-mood thoughts and not getting pulled into them. Not tested in the analysis read.

A proposed mechanism does not show that the effect happens in people.

Safety data were not summarised in the abstract.

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Stress and psychological distress in the general adult population

Moderate certainty

In community adults who chose to join a group mindfulness course, distress was lower a few months later than in people who waited. The effect was small to moderate.

2 studiesIn-person, expert-defined, teacher-led group programmes, measured 1 t…

Studies, doses and limits

What the trials found

A 2023 individual-participant-data analysis of 13 randomised trials (2,371 adults in 8 countries, median age 34, 71 percent women) compared in-person, teacher-led mindfulness programmes with passive controls. The 2014 review also found low evidence of improved stress or distress and quality of life.

Results

Distress was lower 1 to 6 months after the programme (standardised mean difference -0.32, 95% CI -0.41 to -0.24). No clear difference by starting distress, gender, age, education or trait mindfulness.

Effect sizes as reported

SMD -0.32 (-0.41 to -0.24); 2014 review: low evidence for stress/distress.

Why this rating

Compiler's rating: the 2023 authors state high confidence in the main result and it holds across trials, but it is against passive controls only, in volunteers, and the 2014 review rates the stress evidence low.

Form and dose studied

In-person, expert-defined, teacher-led group programmes, measured 1 to 6 months after they ended. The abstract does not give their length.

Who was studied

Community adults who volunteered for a mindfulness course, moderately distressed on average.

Limits

Passive controls cannot separate mindfulness from any structured group activity; volunteers; 20 percent of outcome data missing.

Why researchers looked

Many people take meditation courses to manage everyday stress, so researchers asked how much they lower distress in people without a mental health diagnosis.

Proposed mechanism Hypothesis

Proposed: practice in noticing and not reacting to stressful thoughts. Not tested in the analysis read.

A proposed mechanism does not show that the effect happens in people.

Not summarised in the abstract.

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Sleep quality and insomnia

Mixed findings

A small trial in older adults found better sleep quality after a six-week mindfulness course than after sleep education. A larger review of MBSR found no benefit in chronic insomnia and cancer, and only a possible benefit against waiting lists.

3 studiesThe trial used a 6-week program of 2 hours a week with homework. The …

Studies, doses and limits

What the trials found

A 2015 trial of 49 older adults with moderate sleep disturbance compared a 6-week mindfulness program with sleep hygiene education. A 2022 review of 20 trials of MBSR in adults with sleep disturbance looked at sleep quality and daytime problems.

Results

2015 trial: Pittsburgh Sleep Quality Index fell from 10.2 to 7.4 with mindfulness and 10.2 to 9.1 with education (difference 1.8, 95% CI 0.6 to 2.9), with better insomnia symptoms, depression and fatigue but no difference for anxiety or stress. 2022 review: no improvement in objective or subjective sleep in chronic insomnia or cancer; a possible improvement in self-rated sleep versus waiting lists (SMD -0.32, 95% CI -0.56 to -0.08) with large differences between trials; no daytime benefit versus active controls. The 2014 review found low or insufficient evidence for sleep.

Effect sizes as reported

2015: difference 1.8 (0.6 to 2.9), effect size 0.89. 2022: SMD -0.32 (-0.56 to -0.08), I-squared 71 percent.

Why this rating

A small positive trial and a possible benefit against waiting lists sit beside a review finding no benefit in chronic insomnia and cancer, with bias concerns and small trials.

Form and dose studied

The trial used a 6-week program of 2 hours a week with homework. The review pooled MBSR courses; lengths are not in the abstract.

Who was studied

Older adults with moderate sleep disturbance (trial); adults with sleep disturbance including chronic insomnia and cancer (review).

Limits

Only 24 and 25 people in the trial arms; short-term; sleep mostly self-rated; bias concerns in the review.

Why researchers looked

Racing thoughts keep many people awake, so researchers asked whether mindfulness can improve sleep.

Proposed mechanism Hypothesis

Proposed: lower arousal and less rumination at bedtime. Not tested in the studies read.

A proposed mechanism does not show that the effect happens in people.

Not summarised in the abstracts.

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Relapse after treatment for substance use

Low certainty

In one large trial of aftercare, a mindfulness-based relapse prevention group lowered relapse risk compared with usual aftercare at 6 months, and at 12 months people in it reported fewer days of use and heavy drinking than in the other groups.

4 studiesMBRP was 8 weekly group sessions after initial treatment. This descri…

Studies, doses and limits

What the trials found

A 2014 trial randomised 286 adults who had finished initial treatment at one facility to MBRP, cognitive-behavioural relapse prevention (RP) or treatment as usual and followed them for 12 months. The 2018 review found its most consistent mindfulness evidence in depression, pain, smoking and addictive disorders. The 2014 review found low or insufficient evidence for substance use.

Results

At 6 months both MBRP and RP had lower relapse risk to substance use and heavy drinking than treatment as usual, and RP delayed time to first drug use more than MBRP. At 12 months MBRP participants reported significantly fewer days of use and less heavy drinking than RP and treatment as usual.

Effect sizes as reported

Numbers are not in the abstract.

Why this rating

Compiler's rating: one trial at a single treatment facility with self-report plus urine tests, not replicated in the studies read here; the 2014 review rates the evidence low or insufficient, and the 2018 review's finding is across mixed addiction samples. NCCIH reports MBRP was not more effective than other treatments at preventing relapse.

Form and dose studied

MBRP was 8 weekly group sessions after initial treatment. This describes what was studied.

Who was studied

Adults aged 18 to 70, 71.5 percent male, who had finished initial treatment for substance use disorders at a private non-profit facility.

Limits

One treatment centre, much self-reported, no placebo group.

Why researchers looked

Craving and low mood are common triggers for relapse, and mindfulness practice teaches noticing urges without acting on them.

Proposed mechanism Hypothesis

Proposed by the trial authors: better ability to notice and cope with discomfort, craving and low mood. Not directly tested.

A proposed mechanism does not show that the effect happens in people.

Not summarised in the abstract.

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Attention and thinking skills

Low certainty

In older adults, mindfulness programs gave small gains in attention, memory and spatial thinking, mostly in healthy people. Earlier pooled evidence for attention in general adults was low or insufficient.

3 studiesMixed mindfulness interventions. The authors found no effect of progr…

Studies, doses and limits

What the trials found

A 2023 meta-analysis of 30 randomised trials in older adults pooled mindfulness interventions. The 2014 review looked at attention in a wider adult group.

Results

2023: overall small gain (Hedges' g 0.36), with attention 0.22, long-term memory 0.32 and visuospatial processing 0.22. Healthy older adults gained (g 0.27); those with mild cognitive impairment did not (g -0.09). Mindfulness worked about as well as other mind-body approaches but not as well as other interventions for cognition. 2014: low or insufficient evidence of an effect on attention.

Effect sizes as reported

Overall g 0.36 (0.06 to 0.65); attention 0.22 (0.09 to 0.35); memory 0.32 (0.08 to 0.56); healthy 0.27 (0.11 to 0.43); MCI -0.09 (-0.35 to 0.17).

Why this rating

Compiler's rating: small effects, pooled mixed interventions, older adults only, and the broader 2014 review found low or insufficient evidence for attention. NCCIH calls the evidence for ADHD inconclusive.

Form and dose studied

Mixed mindfulness interventions. The authors found no effect of program length or number of sessions, and suggest focused-attention practices may do best. This describes studies, not advice.

Who was studied

Healthy older adults and older adults with mild cognitive impairment or dementia.

Limits

Mixed types and tests; the analysis found no evidence of publication bias, but effects were small.

Why researchers looked

Focused attention is the core skill practised in many forms of meditation, so researchers asked whether it carries over to attention tests.

Proposed mechanism Hypothesis

Proposed: repeated practice in holding and returning attention to an object, such as the breath, strengthens attention control. This is the conceptual model of focused attention meditation; it was not tested by the reviews read.

A proposed mechanism does not show that the effect happens in people.

Not summarised in the abstract.

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Loving-kindness and compassion meditation

Low certainty

Trials of kindness-based meditation found lower depression and higher compassion and self-compassion than no practice, but results against other active practices were inconclusive and the studies were small.

1 studiesLoving-kindness and compassion meditation, in programs of varied leng…

Studies, doses and limits

What the trials found

A 2014 review of 22 randomised trials (searched to March 2013) of kindness-based meditation in patients and the general population.

Results

Against passive controls: lower self-reported depression (g -0.61), higher mindfulness (0.63), compassion (0.61) and self-compassion (0.45). Positive emotions were higher than with progressive relaxation (0.42). Inconclusive against active controls. The authors note it may initially be challenging for some people.

Effect sizes as reported

Depression -0.61 (-1.08 to -0.14); mindfulness 0.63 (0.22 to 1.05); compassion 0.61 (0.24 to 0.99); self-compassion 0.45 (0.15 to 0.75); positive emotions 0.42 (0.10 to 0.75).

Why this rating

Compiler's rating: the authors rate report quality low to moderate and describe wide intervals from small studies; results were inconclusive against active controls.

Form and dose studied

Loving-kindness and compassion meditation, in programs of varied length; the abstract gives no schedule.

Who was studied

Adult patients and general-population volunteers.

Limits

Small studies, wide intervals, search ended in 2013.

Why researchers looked

Loving-kindness meditation directs warm wishes toward oneself and others, so researchers asked whether it improves mood and connection.

Proposed mechanism Hypothesis

Proposed: deliberately cultivating kind feelings and concern for others. Not tested in the review read.

A proposed mechanism does not show that the effect happens in people.

The review notes that exposure may initially be challenging for some people.

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School-based mindfulness for adolescents

Evidence against

A very large UK school trial found no benefit over normal school teaching for mood, behaviour or well-being a year later.

1 studies10 lessons of psychoeducation and mindfulness practices, outcomes at …

Studies, doses and limits

What the trials found

The 2022 MYRIAD cluster trial randomised 85 UK schools (84 analysed, 8,376 students aged 11 to 14) to 10 mindfulness lessons or normal teaching.

Results

No evidence of superiority at 1 year on risk for depression (difference 0.005), social-emotional-behavioural functioning (0.02) or well-being (0.02). The authors report a high probability of cost-effectiveness at a stated threshold. No intervention-related adverse events were observed.

Effect sizes as reported

SMD 0.005 (-0.05 to 0.06); 0.02 (-0.02 to 0.07); 0.02 (-0.03 to 0.07).

Why this rating

Compiler's rating: a large, pre-registered, well-powered trial found no difference. This is for a universal school program for all students, not for individual young people seeking help.

Form and dose studied

10 lessons of psychoeducation and mindfulness practices, outcomes at 1 year.

Who was studied

School students aged 11 to 14 in the UK.

Limits

Universal program in whole classes; follow-up of one year; the authors suggest asking what works, for whom and how.

Why researchers looked

Earlier smaller studies suggested school mindfulness lessons could protect young people's mental health, so a large trial tested it.

No intervention-related adverse events were observed.

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Chronic pain

Low certainty

Pooled trials find a small decrease in pain after mindfulness meditation, with low-quality evidence. One trial in chronic low back pain found an 8-week MBSR course did about as well as cognitive behavioural therapy and better than usual care.

4 studiesMBSR in the trial was 8 weekly 2-hour group sessions (mindfulness med…

Studies, doses and limits

What the trials found

A 2017 review of 38 randomised trials in adults with chronic pain (30 with pain results). A 2016 trial in 342 adults with chronic low back pain compared MBSR, CBT and usual care. The 2014 review reported moderate evidence for pain, effect size 0.33.

Results

Review: small decrease in pain versus all kinds of control (low-quality evidence), plus better depression and quality of life. Trial at 26 weeks: meaningful improvement in back function in 60.5 percent with MBSR, 57.7 percent with CBT and 44.1 percent with usual care; in pain bothersomeness 43.6, 44.9 and 26.6 percent. No significant MBSR versus CBT difference. The MBSR result held at 52 weeks. NCCIH calls the pain results mixed (short-term gain in low back pain, not in fibromyalgia).

Effect sizes as reported

Trial: function RR 1.37 (1.06 to 1.77) and pain RR 1.64 (1.15 to 2.34) for MBSR vs usual care. 2014 review: pain 0.33 (0.03 to 0.62).

Why this rating

The 2017 reviewers grade the pain evidence low quality; the trial is a single well-run study in one health system. NCCIH calls the field mixed.

Form and dose studied

MBSR in the trial was 8 weekly 2-hour group sessions (mindfulness meditation and yoga), and only 53.7 percent attended at least 6 sessions. Review programs varied. This describes studies, not advice.

Who was studied

Adults with chronic pain of many kinds (review); adults aged 20 to 70 with chronic low back pain (trial).

Limits

People knew their group; usual care is not matched for attention; only 7 of 38 review trials reported safety.

Why researchers looked

Pain is shaped by attention and worry as well as by the body, so researchers asked whether changing how people relate to pain helps.

Proposed mechanism Hypothesis

Proposed: noticing pain without fighting it, which may lower distress about it. Not tested in the studies read.

A proposed mechanism does not show that the effect happens in people.

Few trials reported safety. See the Safety tab.

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Blood pressure

Low certainty

A 2024 pooled analysis of 12 small trials found lower blood pressure after mindfulness programs. A 2013 American Heart Association statement found modest, mixed or no consistent evidence for meditation, including Transcendental Meditation.

3 studiesMindfulness-based programs lasting 8 weeks in 10 of the 12 trials and…

Studies, doses and limits

What the trials found

A 2024 review of 12 randomised trials (715 people with prehypertension or hypertension), mostly 8-week programs. The American Heart Association's 2013 scientific statement graded meditation approaches.

Results

2024: systolic mean difference -9.12 mmHg (95% CI -12.18 to -6.05), diastolic -5.66 (-8.88 to -2.43) after the programs, larger when blood pressure started higher. 2013 statement: Transcendental Meditation class IIB, level of evidence B; other meditation techniques class III, level C; behavioural therapies generally had modest, mixed or no consistent evidence; exercise had stronger support. NCCIH describes the evidence as limited.

Effect sizes as reported

Systolic MD -9.12 (-12.18 to -6.05) mmHg; diastolic -5.66 (-8.88 to -2.43) mmHg.

Why this rating

Compiler's rating: the 2024 effect sizes are large for a behavioural program and the review pools small trials, so they probably overstate real life. The 2013 AHA statement graded meditation evidence modest or mixed.

Form and dose studied

Mindfulness-based programs lasting 8 weeks in 10 of the 12 trials and 6 weeks in one. Transcendental Meditation was graded in the AHA statement. This describes studies, not advice.

Who was studied

Adults with prehypertension or hypertension.

Limits

Small trials, uncertain blinding, short follow-up; the 2013 statement predates newer trials.

Why researchers looked

Stress raises blood pressure for a time, so researchers asked whether meditation lowers it over the longer term.

Proposed mechanism Hypothesis

Proposed: lower stress response and relaxation. Not tested in the studies read.

A proposed mechanism does not show that the effect happens in people.

No blood pressure medicine interaction study was found. People on blood pressure medicine should tell their doctor about any new practice.

^{4 3 23}

Distress and quality of life in cancer

Low certainty

Pooled trials in people with cancer found small gains in distress, anxiety, depression, fatigue, sleep and pain after mindfulness programs. Many effects were small.

2 studiesMindfulness-based interventions, many following MBSR or MBCT manuals;…

Studies, doses and limits

What the trials found

A 2019 review of 29 randomised trials (3,274 people with cancer and survivors, searched to October 2018).

Results

Small pooled gains in distress right after the program (Hedges' g 0.32, 95% CI 0.22 to 0.41) and at follow-up (g 0.19, 0.07 to 0.30), and in anxiety, depression, fear of recurrence, fatigue, sleep and pain (g 0.20 to 0.51). Effects were larger when trials followed the original manuals, in younger patients, with passive controls and with shorter follow-up. NCCIH notes most participants were women with breast cancer.

Effect sizes as reported

Distress g 0.32 (0.22 to 0.41) and 0.19 (0.07 to 0.30); secondary outcomes g 0.20 to 0.51.

Why this rating

Compiler's rating: small effects on self-reported symptoms, larger against passive controls and fading at follow-up, with mostly breast cancer samples (per NCCIH).

Form and dose studied

Mindfulness-based interventions, many following MBSR or MBCT manuals; the abstract gives no schedule.

Who was studied

Adults with cancer and cancer survivors.

Limits

Self-reported outcomes; passive controls; one cancer type dominates.

Why researchers looked

Cancer and its treatment bring worry, tiredness and poor sleep, so researchers asked whether mindfulness courses ease these.

Proposed mechanism Hypothesis

Proposed: less rumination and worry about recurrence. The 2019 review found better mindfulness skills went with larger drops in distress, but that does not show the skills cause the change.

A proposed mechanism does not show that the effect happens in people.

Not summarised in the abstract.

^{6 23}

Connections to the rest of health

How Meditation and Mindfulness connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Evidence status	Context	Studies
Stress Anxiety	Moderate certainty	Anxiety: Pooled trials find lower anxiety scores after mindfulness programs than with no treatment, but the gap shrinks against other treatments. One large trial found an eight-week mindfulness course did about as well as an anxiety medicine. Stress and psychological distress in the general adult population: In community adults who chose to join a group mindfulness course, distress was lower a few months later than in people who waited. The effect was small to moderate.	^{12 11 14 10}
Mood Support	Moderate certainty	Depression relapse (mindfulness-based cognitive therapy): For people who have had depression several times and are now well or nearly well, a pooled analysis found a lower risk of relapse over about a year with mindfulness-based cognitive therapy, including against antidepressants. Loving-kindness and compassion meditation: Trials of kindness-based meditation found lower depression and higher compassion and self-compassion than no practice, but results against other active practices were inconclusive and the studies were small.	^{16 9}
Stress Relief	Moderate certainty	Stress and psychological distress in the general adult population: In community adults who chose to join a group mindfulness course, distress was lower a few months later than in people who waited. The effect was small to moderate. Loving-kindness and compassion meditation: Trials of kindness-based meditation found lower depression and higher compassion and self-compassion than no practice, but results against other active practices were inconclusive and the studies were small.	^{10 12 9 6 23}
Sleep Quality	Mixed findings	Sleep quality and insomnia: A small trial in older adults found better sleep quality after a six-week mindfulness course than after sleep education. A larger review of MBSR found no benefit in chronic insomnia and cancer, and only a possible benefit against waiting lists.	^{1 15 12}
Better Sleep	Mixed findings	Sleep quality and insomnia: A small trial in older adults found better sleep quality after a six-week mindfulness course than after sleep education. A larger review of MBSR found no benefit in chronic insomnia and cancer, and only a possible benefit against waiting lists.	^{1 15 12}
Addiction Support	Low certainty	Relapse after treatment for substance use: In one large trial of aftercare, a mindfulness-based relapse prevention group lowered relapse risk compared with usual aftercare at 6 months, and at 12 months people in it reported fewer days of use and heavy drinking than in the other groups.	^{2 11 12 23}
Focus Concentration	Low certainty	Attention and thinking skills: In older adults, mindfulness programs gave small gains in attention, memory and spatial thinking, mostly in healthy people. Earlier pooled evidence for attention in general adults was low or insufficient.	^{20 12 23}
Healthy Aging	Low certainty	Attention and thinking skills: In older adults, mindfulness programs gave small gains in attention, memory and spatial thinking, mostly in healthy people. Earlier pooled evidence for attention in general adults was low or insufficient.	^{20 12 23}
Stress Relief	Evidence against	School-based mindfulness for adolescents: A very large UK school trial found no benefit over normal school teaching for mood, behaviour or well-being a year later.	¹⁷
Mood Support	Evidence against	School-based mindfulness for adolescents: A very large UK school trial found no benefit over normal school teaching for mood, behaviour or well-being a year later.	¹⁷
Pain Relief	Low certainty	Chronic pain: Pooled trials find a small decrease in pain after mindfulness meditation, with low-quality evidence. One trial in chronic low back pain found an 8-week MBSR course did about as well as cognitive behavioural therapy and better than usual care.	^{13 5 12 23}
Blood Pressure	Low certainty	Blood pressure: A 2024 pooled analysis of 12 small trials found lower blood pressure after mindfulness programs. A 2013 American Heart Association statement found modest, mixed or no consistent evidence for meditation, including Transcendental Meditation.	^{4 3 23}
Heart Health	Low certainty	Blood pressure: A 2024 pooled analysis of 12 small trials found lower blood pressure after mindfulness programs. A 2013 American Heart Association statement found modest, mixed or no consistent evidence for meditation, including Transcendental Meditation.	^{4 3 23}
Cancer Support	Low certainty	Distress and quality of life in cancer: Pooled trials in people with cancer found small gains in distress, anxiety, depression, fatigue, sleep and pain after mindfulness programs. Many effects were small.	^{6 23}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Nervous System	Biological association	Moderate certainty	Studied for: Anxiety Studied for: Depression relapse (mindfulness-based cognitive therapy)	^{12 11 14 16 10 1 15 2 23 20 9 17 13 5}
Stress Mood	Biological association	Moderate certainty	Studied for: Anxiety Studied for: Depression relapse (mindfulness-based cognitive therapy)	^{12 11 14 16 10 2 23 9 17}
Sleep Recovery	Biological association	Mixed findings	Studied for: Sleep quality and insomnia	^{1 15 12}
Brain Cognition	Biological association	Low certainty	Studied for: Attention and thinking skills	^{20 12 23}
Musculoskeletal System	Biological association	Low certainty	Studied for: Chronic pain	^{13 5 12 23}
Cardiovascular System	Biological association	Low certainty	Studied for: Blood pressure	^{4 3 23}
Heart Circulation	Biological association	Low certainty	Studied for: Blood pressure	^{4 3 23}
Cancer Oncology	Biological association	Low certainty	Studied for: Distress and quality of life in cancer	^{6 23}
Whole Body	Biological association	Low certainty	Studied for: Distress and quality of life in cancer	^{6 23}

E. Health conditions

Connected to	Kind of connection	Evidence status	Context	Studies
Psychosis		Systematic review and qualitative research	Delusion-like ideas linked to meditation in interviews; trial programs for psychosis showed no excess harm but poor harm reporting. Preparation or compound: Intensive meditation, retreats	^{21 22}
Anxiety	Adverse effect or risk	Systematic review	Anxiety was the most commonly reported adverse event. Preparation or compound: Meditation practices	⁸
Anxiety		Moderate certainty	Lower anxiety than no treatment; MBSR noninferior to escitalopram in one trial. Preparation or compound: Mindfulness-based programs (MBSR)	^{12 14}
Depression relapse		Moderate certainty	Lower relapse risk over 60 weeks in recurrent depression in remission. Preparation or compound: Mindfulness-based cognitive therapy (MBCT)	¹⁶
Chronic pain		Low certainty	Small decrease in pain, low-quality evidence. Preparation or compound: Mindfulness meditation	^{13 5}
High blood pressure		Low certainty	Lower blood pressure in small trials; AHA judged evidence modest and mixed. Preparation or compound: Mindfulness programs, Transcendental Meditation	^{4 3}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Psychological distress (pooled questionnaire scores)	Biological association	Moderate certainty	Measured in trials: small to moderate fall compared with passive controls. A lab change is not the same as a health benefit.	¹⁰
Depressive relapse within 60 weeks	Biological association	Moderate certainty	Measured in trials: lower relapse risk compared with usual care and with active treatments. A lab change is not the same as a health benefit.	¹⁶
Sleep quality (Pittsburgh Sleep Quality Index, lower is better)	Biological association	Mixed findings	Measured in trials: lower than with sleep education in one small trial; no benefit in chronic insomnia and cancer in a review. A lab change is not the same as a health benefit.	^{1 15}
Chronic pain intensity	Biological association	Low certainty	Measured in trials: small decrease compared with all types of controls. A lab change is not the same as a health benefit.	¹³
Meaningful improvement in back pain bothersomeness (at least 30 percent)	Biological association	Moderate certainty	Measured in trials: more people improved with MBSR or CBT than with usual care at 26 weeks. A lab change is not the same as a health benefit.	⁵
Systolic blood pressure	Biological association	Low certainty	Measured in trials: lower after mindfulness programs in a pooled analysis of small trials. A lab change is not the same as a health benefit.	^{4 3}

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Focused attention meditation	Biological association	Human	Trains holding and returning attention; the 2023 older-adult cognition analysis suggests it may do best for cognition.	^{19 23 20}
Open monitoring meditation	Biological association	Human	Many mindfulness programs combine this with focused attention; the reviews read do not separate the two.	¹⁹
Mindfulness-based stress reduction (MBSR)	Biological association	Human	Studied for anxiety, pain, sleep, blood pressure and cancer care.	^{23 5 14}
Mindfulness-based cognitive therapy (MBCT)	Biological association	Human	Lower relapse risk in pooled trials over about a year.	^{23 16}
Mindfulness-based relapse prevention (MBRP)	Biological association	Human	Studied in people who finished substance-use treatment.	²
Transcendental Meditation	Biological association	Human	Evaluated mainly for blood pressure.	³
Loving-kindness and compassion meditation	Biological association	Human	Studied for depression, compassion and positive emotions.	⁹

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 31, 2026).

Evidence at a glance: what the research found for 11 outcomes

3Moderate certainty

6Low certainty

1Mixed findings

1Evidence against

Each outcome below is one thing researchers measured. Certainty is how far the evidence can be trusted, not how well it works. The full studies are on the next tab.

Anxiety 3 studies · 276 people in trials Moderate certainty Depression relapse (mindfulness-based cognitive therapy) 1 study Moderate certainty Stress and psychological distress in the general adult population 2 studies Moderate certainty Sleep quality and insomnia 3 studies · 49 people in trials Mixed findings Relapse after treatment for substance use 4 studies · 286 people in trials Low certainty Attention and thinking skills 3 studies Low certainty Loving-kindness and compassion meditation 1 study Low certainty School-based mindfulness for adolescents 1 study Evidence against Chronic pain 4 studies · 342 people in trials Low certainty Blood pressure 3 studies Low certainty Distress and quality of life in cancer 2 studies Low certainty

The evidence

The research centre for Meditation and Mindfulness. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed, re-read the abstract of every review and trial cited, and read the NCCIH page on meditation through a tool that summarises pages. Full texts were not read. Certainty ratings are the compiler's own reading, except where a review gives its own GRADE (stated in the text). Funding is not stated in most abstracts, and this is noted where relevant.

Study library: every study we checked 23

Design Research type Year from Search

Study	Design	People	Product, dose, length	Result
Black 2015 Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial JAMA Intern Med · PMID 25686304 · DOI	Controlled trial	49 49 adults, mean age 66, with moderate sleep disturbance (Pittsburgh Sleep Quality Index above 5)	Standardised mindful awareness practices 6 weeks, 2 hours a week, with homework · vs Sleep hygiene education of the same length	Sleep quality improved more with mindfulness than with sleep education straight after the programme, along with insomnia symptoms, depression and fatigue. No group difference for anxiety, stress or NF-kB. Index fell from 10.2 to 7.4 with mindfulness and from 10.2 to 9.1 with sleep education; between-group difference 1.8 (0.6 to 2.9) Methods, limits and funding Outcomes: Pittsburgh Sleep Quality Index after the programme; insomnia symptoms, depression, anxiety, stress, fatigue, NF-kB (an inflammation signal) Limitations: Small trial (24 and 25 people), short-term result only. Funding and conflicts: Record lists NIH extramural research support; no conflict statement read. Registration: NCT01534338 Read: abstract
Bowen 2014 Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial JAMA Psychiatry · PMID 24647726 · DOI	Controlled trial	286 286 adults aged 18 to 70 who had finished initial treatment for substance use disorders at one private non-profit facility; 71.5 percent male	Mindfulness-based relapse prevention (MBRP), a group aftercare program 8 weekly group sessions, followed for 12 months · vs Cognitive-behavioural relapse prevention (RP) or treatment as usual (12-step programming and psychoeducation)	At 6 months both MBRP and RP showed lower relapse risk than treatment as usual, and RP delayed time to first drug use more than MBRP. At 12 months MBRP participants reported fewer days of substance use and less heavy drinking than RP and treatment as usual. Not given as numbers in the abstract (Not given in the abstract) Methods, limits and funding Outcomes: Relapse to drug use and heavy drinking; days of use in the past 90 days (self-report and urine tests) Limitations: One treatment centre; much of the outcome was self-reported. Funding and conflicts: Record lists NIH extramural research support; no conflict statement read. Registration: NCT01159535 Read: abstract
Brook 2013 Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association Hypertension · PMID 23608661 · DOI	Guideline statement	Expert review of non-drug, non-diet approaches to lowering blood pressure	Transcendental Meditation and other meditation techniques, among other approaches Not given (a review of evidence) · vs Not given (a review of evidence)	Transcendental Meditation: Class IIB, Level of Evidence B. Other meditation techniques: Class III, Level of Evidence C. Overall the behavioural therapies had modest, mixed or no consistent evidence. Exercise had relatively stronger support. Not given as numbers in the abstract (Not given in the abstract) Methods, limits and funding Outcomes: Blood-pressure-lowering evidence graded by class of recommendation and level of evidence Limitations: A 2013 statement; newer trials exist. The abstract does not name the trials it relied on. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Chen 2024 Effect of mindfulness-based interventions on people with prehypertension or hypertension: a systematic review and meta-analysis of randomized controlled trials BMC Cardiovasc Disord · PMID 38350849 · DOI	Systematic review meta analysis	715 12 randomised trials, 715 people with prehypertension or hypertension (searched to May 2023)	Mindfulness-based interventions 8 weeks in 10 trials, 6 weeks in one · vs Control groups (kinds not detailed in the abstract)	Pooled blood pressure was lower after the programmes, with larger effects in people whose blood pressure started higher. The abstract also reports reductions in anxiety, depression and stress, but the effect sizes quoted for these (up to -5.9) are unusually large and suggest strong differences between trials. Systolic MD -9.12 mmHg; diastolic MD -5.66 mmHg (Systolic -12.18 to -6.05; diastolic -8.88 to -2.43) Methods, limits and funding Outcomes: Systolic and diastolic blood pressure, anxiety, depression, perceived stress Limitations: Small trials; risk of bias assessed but the result is not given in the abstract; the authors call for large, long-term trials. Funding and conflicts: No funding or conflict statement in the record read. Registration: PROSPERO CRD42021282504 Read: abstract
Cherkin 2016 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 · PMID 27002445 · DOI	Controlled trial	342 342 adults aged 20 to 70 with chronic low back pain in a Washington State health system; mean pain duration 7.3 years	Mindfulness-based stress reduction (mindfulness meditation and yoga) 8 weekly 2-hour groups; followed to 52 weeks · vs Cognitive behavioural therapy (CBT) in 8 weekly 2-hour groups, or usual care	At 26 weeks more people improved with MBSR or CBT than with usual care, with no significant difference between MBSR and CBT. The MBSR result persisted at 52 weeks. Only 53.7 percent attended at least 6 of 8 sessions. Meaningful function gain: MBSR 60.5 percent, CBT 57.7 percent, usual care 44.1 percent. Pain bothersomeness: MBSR 43.6, CBT 44.9, usual care 26.6 percent (Function RR MBSR vs usual care 1.37 (1.06 to 1.77); pain RR 1.64 (1.15 to 2.34)) Methods, limits and funding Outcomes: At least 30 percent improvement in back-related function and in pain bothersomeness at 26 weeks (interviewer-blinded) Limitations: Participants knew their group; usual care is not an attention-matched control. Funding and conflicts: Record lists NIH extramural research support; no conflict statement read. Registration: NCT01467843 Read: abstract
Cillessen 2019 Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials Psychooncology · PMID 31464026 · DOI	Systematic review meta analysis	3274 29 randomised trials (38 papers) in people with cancer and survivors (searched to October 2018)	Mindfulness-based interventions Not given in the abstract · vs Passive and active controls	Small pooled gains in distress right after the programme and at follow-up, and in several self-rated secondary outcomes. Effects were larger in trials that followed the original manuals, in younger patients, with passive controls and with shorter follow-up. Better mindfulness skills went with larger reductions in distress. Distress Hedges' g 0.32 after the programme and 0.19 at follow-up; secondary outcomes 0.20 to 0.51 (Distress 0.22 to 0.41 and 0.07 to 0.30) Methods, limits and funding Outcomes: Psychological distress; anxiety, depression, fear of cancer recurrence, fatigue, sleep disturbance, pain Limitations: Self-reported outcomes; many effects small; larger effects with passive controls. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Coronado-Montoya 2016 Reporting of Positive Results in Randomized Controlled Trials of Mindfulness-Based Mental Health Interventions PLoS One · PMID 27058355 · DOI	Meta research	124 124 published randomised trials of mindfulness-based therapy, 21 trial registrations and 36 systematic reviews	Mindfulness-based therapy (research reporting) Not given (qualitative study) · vs Not given (qualitative study)	87 percent of trials reported at least one positive outcome in the abstract and 88 percent concluded the therapy worked, 1.6 times more than the number expected from the average effect size (65.7 trials). Of 21 registrations, 13 (62 percent) were still unpublished 30 months after completion. None of 36 reviews concluded that reporting bias had inflated effects. The authors conclude that the share of positive trials may overstate what happens in practice. 108 of 124 trials positive; expected 65.7 (Not given in the abstract) Methods, limits and funding Outcomes: Share of trials reporting positive results compared with what would be expected, and unpublished registered trials Limitations: A study of reporting patterns, not of whether mindfulness works. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Farias 2020 Adverse events in meditation practices and meditation-based therapies: a systematic review Acta Psychiatr Scand · PMID 32820538 · DOI	Systematic review	6703 83 studies (experimental, observational and case studies) with 6,703 adults who practised meditation (searched to October 2019)	Meditation practices and meditation-based therapies (yoga postures excluded) Not given (a review of evidence) · vs Not given (a review of evidence)	55 of the 83 studies (65 percent) reported at least one type of adverse event. Overall prevalence 8.3 percent; 3.7 percent in experimental studies and 33.2 percent in observational studies. Most common: anxiety, depression and cognitive anomalies; least frequent: gastrointestinal problems and suicidal behaviours. Events can occur in people with no previous mental health history. Overall 8.3 percent; experimental 3.7 percent; observational 33.2 percent (Overall 0.05 to 0.12; experimental 0.02 to 0.05; observational 0.25 to 0.41) Methods, limits and funding Outcomes: Meditation adverse events, their types and prevalence Limitations: Studies defined and recorded harms very differently, and the estimate varies widely by study type. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Galante 2014 Effect of kindness-based meditation on health and well-being: a systematic review and meta-analysis J Consult Clin Psychol · PMID 24979314 · DOI	Systematic review meta analysis	22 randomised trials in adults, patients and general population (searched to March 2013)	Kindness-based meditation, including loving-kindness and compassion meditation Not given in the abstract · vs Passive controls, and active controls such as progressive relaxation	Against passive controls, depression was lower and mindfulness, compassion and self-compassion were higher. Positive emotions were higher than with progressive relaxation. Results were inconclusive against active controls, and the authors note it may be challenging for some people at first. Depression g=-0.61; mindfulness 0.63; compassion 0.61; self-compassion 0.45; positive emotions (versus relaxation) 0.42 (Depression -1.08 to -0.14; mindfulness 0.22 to 1.05; compassion 0.24 to 0.99; self-compassion 0.15 to 0.75; positive emotions 0.10 to 0.75) Methods, limits and funding Outcomes: Depression, mindfulness, compassion, self-compassion, positive emotions Limitations: Report quality low to moderate; small studies with wide confidence intervals. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Galante 2023 Individual participant data systematic review and meta-analysis of randomised controlled trials assessing adult mindfulness-based programmes for mental health promotion in non-clinical settings Nat Ment Health · PMID 37867573 · DOI	Systematic review meta analysis	2371 13 randomised trials with shared individual data, community adults in 8 countries; median age 34, 71 percent women, moderately distressed on average	In-person, teacher-led mindfulness-based programmes Distress measured 1 to 6 months after the programme; length not given in the abstract · vs Passive control groups (for example waiting list)	Distress was lower after the programmes than in passive controls. No clear sign that age, gender, education, starting distress or trait mindfulness changed the effect. The authors state high confidence in the main result. Standardised mean difference -0.32 (-0.41 to -0.24) Methods, limits and funding Outcomes: Psychological distress (anxiety, depression and related unpleasant experiences) Limitations: Compared only with passive controls, so it cannot separate mindfulness from any structured group activity; participants were volunteers; 20 percent missing outcome data. Funding and conflicts: No funding or conflict statement in the record read. Registration: PROSPERO CRD42020200117 Read: abstract
Goldberg 2018 Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis Clin Psychol Rev · PMID 29126747 · DOI	Systematic review meta analysis	12005 142 non-overlapping samples in clinical populations (psychiatric and some pain and addiction samples)	Mindfulness-based interventions of several kinds Not given in the abstract · vs Five levels: no treatment, minimal treatment, non-specific active control, specific active control, evidence-based treatment	At the end of treatment mindfulness beat no treatment, minimal treatment and active controls, with smaller gaps against stronger comparisons. It did not differ from evidence-based treatments. The most consistent evidence was for depression, pain, smoking and addictive disorders. Versus no treatment d=0.55; minimal treatment 0.37; non-specific active control 0.35; specific active control 0.23; evidence-based treatments -0.004 (Not given in the abstract) Methods, limits and funding Outcomes: Disorder-specific symptoms at the end of treatment and at follow-up Limitations: Effect shrinks as the comparison group gets stronger; heterogeneity across disorders. Funding and conflicts: Record lists NIH extramural support; no conflict statement read. Read: abstract
Goyal 2014 Meditation programs for psychological stress and well-being: a systematic review and meta-analysis JAMA Intern Med · PMID 24395196 · DOI	Systematic review meta analysis	3515 47 randomised trials with active controls in adults with a range of clinical conditions (searched to November 2012)	Meditation programs (mindfulness meditation programs had most of the evidence) Effects reported at about 8 weeks and at 3 to 6 months; program length not given in the abstract · vs Active controls (for example drugs, exercise, other behavioural therapies, education) or other controls	Moderate evidence of improved anxiety, depression and pain from mindfulness meditation programs; low evidence for stress or distress and mental-health quality of life; low or insufficient evidence of any effect on positive mood, attention, substance use, eating habits, sleep and weight. No evidence that meditation programs were better than any active treatment. Anxiety effect size 0.38 at 8 weeks and 0.22 at 3 to 6 months; depression 0.30 and 0.23; pain 0.33 (Anxiety 0.12 to 0.64 and 0.02 to 0.43; depression 0.00 to 0.59 and 0.05 to 0.42; pain 0.03 to 0.62) Methods, limits and funding Outcomes: Anxiety, depression, stress or distress, mood, quality of life, attention, substance use, eating habits, sleep, pain, weight Limitations: Authors call for stronger study designs; many trials were small; effects were small to moderate. Funding and conflicts: No funding or conflict statement in the record read. The record lists U.S. public health service research support. Read: abstract
Hilton 2017 Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis Ann Behav Med · PMID 27658913 · DOI	Systematic review meta analysis	38 randomised trials in adults with chronic pain (30 gave pain results; 7 reported on safety)	Mindfulness meditation interventions Not given in the abstract · vs All types of controls	Low-quality evidence of a small decrease in pain compared with all types of controls. Depression symptoms and quality of life also improved. The authors say more rigorous, large trials are needed. Small decrease in pain (numbers not in the abstract) (Not given in the abstract) Methods, limits and funding Outcomes: Pain, depression, quality of life, analgesic use Limitations: GRADE rated the pain evidence low quality; only 7 of 38 trials reported on safety. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Hoge 2023 Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial JAMA Psychiatry · PMID 36350591 · DOI	Controlled trial	276 276 adults with a diagnosed anxiety disorder at 3 US medical centres (208 completed); mean age 33, 75 percent women	Mindfulness-based stress reduction (MBSR), a weekly group course 8 weeks · vs Escitalopram (an antidepressant), 10 to 20 mg flexibly dosed	MBSR was noninferior to escitalopram on the main anxiety measure. Study-related adverse events occurred in 15.4 percent on MBSR and 78.6 percent on escitalopram. Score fell by 1.35 on MBSR and 1.43 on escitalopram; difference -0.07 (-0.38 to 0.23 (noninferiority margin -0.495)) Methods, limits and funding Outcomes: Clinical Global Impression of Severity (anxiety), blinded interviewer; follow-up to 24 weeks Limitations: No placebo or waiting-list arm, so the trial cannot show how much either treatment beat no treatment; one in four did not complete. Funding and conflicts: Record lists NIH extramural research support; no conflict statement read. Registration: NCT03522844 Read: abstract
Kim 2022 Effects of mindfulness-based stress reduction on adults with sleep disturbance: an updated systematic review and meta-analysis BMJ Open · PMID 36332952 · DOI	Systematic review meta analysis	20 randomised trials (21 reports) in adults with sleep disturbance, including chronic insomnia and cancer-related sleep problems	Mindfulness-based stress reduction (MBSR) Not given in the abstract · vs Waiting list or active controls	MBSR did not improve objective or subjective sleep quality in chronic insomnia or in cancer. Against waiting lists it might improve self-rated sleep quality, with large differences between trials. Against active controls it did not improve daytime problems. Self-rated sleep quality versus waiting list: SMD -0.32 (I-squared 71 percent) (-0.56 to -0.08) Methods, limits and funding Outcomes: Objective and subjective sleep quality; daytime impairment (depression, anxiety, stress, fatigue, quality of life) Limitations: Concern about performance and detection bias; more than half of the trials were small. Funding and conflicts: No funding or conflict statement in the record read. Registration: PROSPERO CRD42015027963 Read: abstract
Kuyken 2016 Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials JAMA Psychiatry · PMID 27119968 · DOI	Systematic review meta analysis	1258 9 randomised trials with individual patient data (10 in the review) in adults with recurrent depression in full or partial remission; mean age 47, 75 percent female	Manualized mindfulness-based cognitive therapy (MBCT) Relapse followed for 60 weeks; program length not given in the abstract · vs Usual care and other active treatments, including antidepressants	MBCT was linked to a lower risk of relapse than no MBCT, and than active treatments including antidepressants. Greater symptom severity before treatment was linked to a larger effect versus other treatments. Hazard ratio 0.69 versus usual care or no MBCT; 0.79 versus active treatments (0.58 to 0.82; 0.64 to 0.97) Methods, limits and funding Outcomes: Depressive relapse within 60 weeks Limitations: The review is an update of an earlier meta-analysis; the abstract does not report blinding or funding. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Kuyken 2022 Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial Evid Based Ment Health · PMID 35820992 · DOI	Cluster rct	8376 85 UK schools randomised (84 analysed, 8,376 students aged 11 to 14)	School-based mindfulness training: 10 lessons of psychoeducation and mindfulness practices 10 lessons; outcomes at 1 year · vs Normal school teaching including standard social-emotional teaching	No evidence that the mindfulness training was better than normal teaching at 1 year on any of the three main outcomes. It had a high probability of being cost-effective at a stated threshold. No intervention-related adverse events were observed. Differences 0.005 (depression risk), 0.02 (functioning), 0.02 (well-being) (-0.05 to 0.06; -0.02 to 0.07; -0.03 to 0.07) Methods, limits and funding Outcomes: Risk for depression, social-emotional-behavioural functioning and well-being at 1 year Limitations: Universal programme for all students, not for students seeking help; students were not blinded. Funding and conflicts: Funded by the Wellcome Trust (stated in the abstract). Registration: ISRCTN86619085 Read: abstract
Lindahl 2017 The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists PLoS One · PMID 28542181 · DOI	Qualitative mixed methods	Interviews with Western Buddhist meditation practitioners and experts in Theravada, Zen and Tibetan traditions, followed by a survey	Buddhist-derived meditation practices Not given (qualitative study) · vs Not given (qualitative study)	Interviews produced a list of 59 meditation-related experiences in 7 domains (cognitive, perceptual, affective, somatic, conative, sense of self, social) and 26 influencing factors in 4 domains. Distress and impairment ranged from minimal and passing to severe and lasting. The same experience was valued very differently by different people. No prevalence figure in the abstract (Not given in the abstract) Methods, limits and funding Outcomes: Meditation-related experiences described as challenging, distressing or functionally impairing, and the factors that shape them Limitations: A qualitative study of Western Buddhist practitioners, not a trial; it cannot give how common the experiences are in the general population or in short courses. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Lutz 2008 Attention regulation and monitoring in meditation Trends Cogn Sci · PMID 18329323 · DOI	Narrative review	Review of meditation research	Focused attention and open monitoring meditation Not given in the abstract	The authors describe meditation as a family of attention and emotion regulation training regimes. Two commonly studied styles are focused attention meditation, the voluntary focusing of attention on a chosen object, and open monitoring meditation, the nonreactive monitoring of the content of experience from moment to moment. They propose that these practices could have long-term effects on the brain and behaviour. Not given in the abstract (Not given in the abstract) Methods, limits and funding Outcomes: Conceptual description of two commonly studied styles Limitations: A conceptual review from 2008; the abstract gives no trial results. Funding and conflicts: Record lists NIH extramural research support; no conflict statement read. Read: abstract
Mirabito 2023 The Effects of Mindfulness Interventions on Older Adults' Cognition: A Meta-Analysis J Gerontol B Psychol Sci Soc Sci · PMID 36148552 · DOI	Systematic review meta analysis	30 randomised trials in healthy older adults and older adults with mild cognitive impairment or dementia	Mindfulness interventions (several types) Not given in the abstract; length and number of sessions did not change the effect · vs Control groups, and other mind-body and non-mind-body interventions	Small gains in cognition overall, in attention, long-term memory and visuospatial processing. Healthy older adults gained; those with mild cognitive impairment did not. Mindfulness worked about as well as other mind-body approaches but not as well as other interventions for cognition. Overall Hedges' g 0.36; attention 0.22; long-term memory 0.32; visuospatial 0.22; healthy older adults 0.27; mild cognitive impairment -0.09 (Overall 0.06 to 0.65; attention 0.09 to 0.35; memory 0.08 to 0.56; visuospatial 0.10 to 0.34; healthy 0.11 to 0.43; MCI -0.35 to 0.17) Methods, limits and funding Outcomes: Cognitive tasks: attention, long-term memory, visuospatial processing Limitations: Older adults only; mixed intervention types; the authors suggest focused-attention practices may do best. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
O'Brien-Venus 2024 Systematic review of the safety of mindfulness-based interventions for psychosis Clin Psychol Rev · PMID 38851179 · DOI	Systematic review meta analysis	2684 39 randomised trials (2,684 people) of mindfulness-based interventions for people with psychosis	Mindfulness-based interventions Not given in the abstract · vs Control arms (various)	No trial reported side effects of the intervention (0 percent), while 92 percent reported dropout. Hospitalisation and crisis-service use were higher in control arms than in intervention arms; no significant difference in adverse events, death, symptom deterioration, non-completion, dropout or side effects. The authors say reporting of harm was inconsistent and does not allow a balanced weighing of benefits and harms. Risk difference for hospitalisation -0.136; crisis service use -0.160 (-0.23 to -0.05; -0.299 to -0.024) Methods, limits and funding Outcomes: 8 harm indices: death, adverse events, hospitalisation, dropout, non-completion, side effects, symptom deterioration, crisis service use Limitations: Harm was poorly and inconsistently reported across trials. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
Solomonova 2025 "I was trying to save the world": delusion-like ideation and associated impacts reported by Western practitioners of Buddhist meditation Front Psychol · PMID 41209790 · DOI	Qualitative mixed methods	Interviews with more than 100 Western Buddhist meditation practitioners and experts (teachers and clinicians)	Buddhist meditation practice, mostly retreat settings Not given (qualitative study) · vs Not given (qualitative study)	The authors describe eight types of delusion-like ideas linked to meditation, with four case studies. Some experts called these a red flag that deserves close monitoring or immediate help. The authors also note that such experiences are sometimes treated as ordinary in meditation cultures. No prevalence figure in the abstract (Not given in the abstract) Methods, limits and funding Outcomes: Delusion-like ideas linked to meditation, their types, impacts and outcomes Limitations: Qualitative and not designed to give how common the experiences are; a sample of Buddhist practitioners. Funding and conflicts: No funding or conflict statement in the record read. Read: abstract
s-nccih-meditation NCCIH: Meditation and Mindfulness: Effectiveness and Safety (page marked Last Updated June 2022) · Source	Health agency n/a			Methods, limits and funding Read: full-text

What we do not know yet

No trial read compared meditation with a sham or placebo version, so how much benefit comes from the practice itself, as opposed to attention, a group or a teacher, is unknown.
Most follow-up is under a year, and long-term effects are not established.
Mindfulness trials report positive results more often than expected, and many registered trials are unpublished, so published effects may be overstated.
Harm is poorly reported in trials, and the studies read cannot say who is most at risk.
Brain imaging and Transcendental Meditation trials for mood were not read.
History beyond the NCCIH summary was not read from a source.

How new research is added

New studies are found by a saved PubMed search and placed in a review queue before the page changes.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Other 6

●

Psychological distress (pooled questionnaire scores)

Small to moderate fall compared with passive controls in trials

Combined self-rated anxiety, depression and related unpleasant feelings.

Moderate certainty

Results and what it means

Why it was measured

To see whether a program lowers how distressed people feel.

Statistical vs. clinical meaning

A small to moderate average change, in volunteers, against passive controls.

Study	Result	People	Product
¹⁰	Distress was lower by a standardised mean difference of 0.32 (95% CI 0.24 to 0.41) 1 to 6 months after the programme.	2,371 adults in 13 trials	In-person teacher-led mindfulness programmes vs passive controls

¹⁰

●

Depressive relapse within 60 weeks

Lower relapse risk compared with usual care and with active treatments in trials

Whether depression returned during follow-up in people who had recovered.

Moderate certainty

Results and what it means

Why it was measured

To see whether MBCT keeps people well longer.

Statistical vs. clinical meaning

A modest lasting change in risk over about a year.

Study	Result	People	Product
¹⁶	Hazard ratio 0.69 (0.58 to 0.82) vs no MBCT; 0.79 (0.64 to 0.97) vs active treatments including antidepressants.	1,258 adults with recurrent depression in 9 trials	Manualized MBCT

¹⁶

●

Sleep quality (Pittsburgh Sleep Quality Index, lower is better)

Lower than with sleep education in one small trial; no benefit in chronic insomnia and cancer in a review in trials

A questionnaire about sleep over the past month.

Mixed findings

Results and what it means

Why it was measured

To see whether mindfulness improves how well people sleep.

Statistical vs. clinical meaning

Short-term gain in one small trial; not confirmed in chronic insomnia.

Study	Result	People	Product
¹	Index 7.4 after mindfulness vs 9.1 after sleep education, from 10.2 in both; difference 1.8 (0.6 to 2.9).	49 older adults with moderate sleep disturbance	6-week mindfulness program vs sleep hygiene education
¹⁵	No improvement in objective or subjective sleep quality in chronic insomnia and cancers; possible gain vs waiting list (SMD -0.32).	20 trials in adults with sleep disturbance	MBSR

^{1 15}

●

Chronic pain intensity

Small decrease compared with all types of controls in trials

Self-rated pain scores.

Low certainty

Results and what it means

Why it was measured

To see whether meditation lowers how much pain people feel.

Statistical vs. clinical meaning

A small average change; the reviewers call for large rigorous trials.

Study	Result	People	Product
¹³	A small decrease in pain in 30 trials, low-quality evidence.	30 randomised trials in adults with chronic pain	Mindfulness meditation

¹³

●

Meaningful improvement in back pain bothersomeness (at least 30 percent)

More people improved with MBSR or CBT than with usual care at 26 weeks in trials

The share of people whose self-rated back pain bothersomeness (0 to 10) improved by at least 30 percent.

Moderate certainty

Results and what it means

Why it was measured

To see whether the improvement is large enough for people to notice.

Statistical vs. clinical meaning

A real difference from usual care that lasted to 52 weeks, with no difference from CBT.

Study	Result	People	Product
⁵	43.6 percent with MBSR, 44.9 percent with CBT and 26.6 percent with usual care improved; MBSR vs usual care RR 1.64 (1.15 to 2.34).	342 adults with chronic low back pain	8 weekly 2-hour MBSR groups vs CBT vs usual care

⁵

●

Systolic blood pressure

Lower after mindfulness programs in a pooled analysis of small trials in trials

The upper blood pressure number (mmHg).

Low certainty

Results and what it means

Why it was measured

To see whether blood pressure falls after a program.

Statistical vs. clinical meaning

A large average change that probably overstates real life; the 2013 AHA statement found the evidence modest and mixed.

Study	Result	People	Product
⁴	9.12 mmHg lower (95% CI 6.05 to 12.18) post-intervention; diastolic 5.66 mmHg lower.	715 people with prehypertension or hypertension in 12 trials	Mindfulness-based programs, 6 to 8 weeks

^{4 3}

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 2

Difficult experiences are not rare, and are under-reported. A 2020 review of 83 studies (6,703 meditators) found at least one kind of adverse event in 65 percent of the studies. The overall prevalence was 8.3 percent, 3.7 percent in experimental studies and 33.2 percent in observational studies. Anxiety, depression and cognitive anomalies were most common. They can happen in people with no earlier mental health history. NCCIH says practices usually have few risks but few studies have looked for harm. Systematic review and health agency guidance ^{8 23}
Meditation is not a substitute for treatment. NCCIH advises not using meditation or mindfulness to replace conventional care, and to tell your health care providers about any complementary approach you use. Authoritative guidance ²³

Side effects 4

Effect	How often	Severity and recovery	Evidence
Anxiety, depression and cognitive anomalies during or after practice Gastrointestinal problems and suicidal behaviours were the least frequent categories reported.	Overall adverse events 8.3 percent (95% CI 5 to 12 percent); 3.7 percent in experimental studies; 33.2 percent in observational studies. Anxiety was reported in 33 percent of the 55 studies with any adverse event, depression in 27 percent and cognitive anomalies in 25 percent.	Varied from minimal and passing to severe and lasting in interview research Not stated in the abstracts	Systematic review ^{8 18}
A wide range of other meditation-related experiences The seven domains were cognitive, perceptual, affective, somatic, conative, sense of self and social. Influencing factors included practitioner, practice, relationships and health behaviours.	A list of 59 experiences in seven domains came from interviews with Western Buddhist practitioners and experts; no frequency is given in the abstract.	From minimal and transient to severe and enduring; the same experience was valued very differently by different people Varied	Qualitative mixed methods study ¹⁸
Delusion-like ideas From interviews with more than 100 Western Buddhist practitioners and experts, mostly in retreat-type settings. Eight types were described, with four case studies.	Not stated in the abstract.	Experts described some as a red flag deserving close monitoring or immediate help Not stated	Qualitative mixed methods study ²²
Initial difficulty with loving-kindness practice The review notes that exposure to kindness-based meditation may initially be challenging for some people.	Not quantified.	Not stated Not stated	Systematic review ⁹

Medicines and supplements 2

With	Why it matters	Importance	Evidence	What to do
Blood pressure medicines prescription	No mechanism found.	No interaction study was found. Trials of blood pressure effects did not report on medicine interaction in the abstracts read.	Absence of evidence Not enough evidence ⁴	Absence of a study is not proof of safety. People who take blood pressure medicines can tell their doctor they are starting a new practice.
Mental health treatment and medicines other-treatments	No mechanism found.	A 2023 trial compared MBSR with escitalopram in separate groups, and a 2016 analysis compared MBCT with antidepressants; neither tested combining them in the abstracts read. NCCIH says not to use meditation to replace conventional care.	Authoritative guidance Not enough evidence ^{14 16 23}	Tell your doctor or pharmacist about all treatments you use, and do not stop a prescribed medicine because of a meditation course.

Who should check first 3

Situation	Advice	Evidence
Psychosis, mania or delusional thinking (current or in the past)	A 2024 review of 39 trials (2,684 people) of mindfulness-based programs for psychosis found hospitalisation and crisis-service use were higher in control arms, and no significant difference in adverse events, death or symptom deterioration, but no trial reported side effects of the intervention and harm reporting was poor. Interview research describes delusion-like ideas linked to meditation, mostly in retreat-type settings, which experts called a possible red flag. Taken together this means studied, supervised programs seem safe in the trials read, while intensive solo or retreat practice has been linked to delusion-like experiences. Anyone with this history can ask their mental health professional before starting, and ask any teacher whether they have experience.	Systematic review and qualitative research ^{21 22}
A history of trauma, or of anxiety or depression	A 2020 review found anxiety and depression were the most common adverse events, including in people with no previous history. NCCIH reports a 2018 trial in veterans where meditation was as effective as prolonged exposure therapy for PTSD symptoms. The abstracts read do not state who is most at risk of re-experiencing trauma, so no specific risk statement is made here. If practice brings on strong distress, stopping and speaking with a mental health professional is reasonable.	Systematic review and authoritative guidance ^{8 23}
Bipolar disorder	Delusional ideation can occur in bipolar disorder and in meditation-related experiences according to the 2025 interview study. No trial on bipolar disorder was read. People with bipolar disorder can ask their psychiatrist before starting an intensive program.	Qualitative research ²²

Overdose, product quality and regulators

Body	Action	Date
National Center for Complementary and Integrative Health (NCCIH, part of the US National Institutes of Health) (United States)	Says meditation and mindfulness practices usually are considered to have few risks but few studies have looked for harm, cites a 2020 review in which about 8 percent of participants had a negative effect (anxiety and depression most common), advises not replacing conventional care with them, asking about the instructor's training and experience, and telling your health care providers about any complementary approach you use. source	2022-06

When to get medical help

Thoughts of harming yourself, or feeling unable to keep yourself safe: contact local emergency services or a crisis line in your country now, or go to the nearest emergency department.
Strong, lasting panic, a feeling of being unreal or detached from yourself, or flashbacks during or after practice: stop the practice and speak with a mental health professional.
New false beliefs, hearing or seeing things others do not, little need for sleep with unusual energy, or a sense of special mission: stop intensive practice and seek mental health care promptly.
A teacher or group that discourages you from seeking medical or mental health care, or that crosses personal boundaries: leave and talk with someone you trust.

Stop using the product and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

What is meditation?

NCCIH describes it as a variety of practices that focus on mind and body integration. Some focus attention on the breath, a sound, an image or a mantra. Mindfulness means keeping attention on the present moment without judgment.

²³

What is the difference between mindfulness and other meditation?

Mindfulness is one family of meditation. Two commonly studied styles are focused attention, which holds attention on a chosen object, and open monitoring, which watches experience from moment to moment without reacting.

^{19 23}

What are MBSR and MBCT?

NCCIH describes MBSR as a program that teaches mindful meditation along with discussion and strategies for stress, and MBCT as combining mindfulness with cognitive behavioural therapy. MBCT has been studied for preventing depression relapse.

^{23 16}

Does meditation help anxiety?

Pooled trials found lower anxiety than no treatment, and one trial of 276 adults found an 8-week MBSR course noninferior to the medicine escitalopram. Against stronger comparisons the gaps are smaller, and it has not been shown to be better than other active treatments.

^{12 11 14}

Can mindfulness stop depression coming back?

A 2016 pooled analysis of 9 trials found lower relapse risk over 60 weeks with MBCT in people with recurrent depression who were well or nearly well, including versus antidepressants. It was not tested as a treatment for an active severe episode.

¹⁶

Does meditation help with chronic pain?

A review of 38 trials found a small decrease in pain with low-quality evidence. In a trial of chronic low back pain, MBSR did about as well as CBT and better than usual care at 26 weeks.

^{13 5}

Does meditation lower blood pressure?

A 2024 analysis of 12 small trials found lower blood pressure after mindfulness programs, but the effects look large for such programs. The American Heart Association's 2013 statement judged meditation evidence modest, mixed or inconsistent. It has not been shown to replace blood pressure medicines; ask a doctor.

^{4 3}

Does meditation help sleep?

A small trial in older adults found better sleep quality than with sleep education. A larger review of MBSR found no benefit in chronic insomnia and cancer, and only a possible benefit against waiting lists.

^{1 15}

Is the research as strong as it sounds?

Effects are mostly small. A reporting study found 87 percent of mindfulness trials reported a positive result, 1.6 times more than expected from the average effect, and many registered trials were never published. Gaps against active treatments are smaller than against no treatment, and a large school trial found no benefit.

^{7 11 17}

Can meditation cause harm?

Yes, for some people. A 2020 review of 83 studies found adverse events overall in 8.3 percent, mainly anxiety, depression and cognitive anomalies, including in people with no earlier mental health history. NCCIH says few studies have looked for harm.

^{8 23}

Who should take extra care?

People with psychosis, mania or bipolar disorder, a history of trauma, or current severe depression or anxiety can ask a mental health professional first, and choose a teacher with experience. Interview research links intensive practice to delusion-like ideas in some people. The evidence is limited, so no one source gives a full list.

^{21 22 18}

Can meditation replace treatment?

No. NCCIH says not to use meditation or mindfulness to replace conventional care, and to tell your health care providers about any complementary approach you use.

²³

How do I choose a teacher?

NCCIH advises asking about the instructor's training and experience. It also advises telling your health care providers about the practices you use.

²³

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Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-31
Last substantive update: 2026-10-31
How we research: We searched PubMed, re-read the abstract of every review and trial cited, and read the NCCIH page on meditation through a tool that summarises pages. Full texts were not read. Certainty ratings are the compiler's own reading, except where a review gives its own GRADE (stated in the text). Funding is not stated in most abstracts, and this is noted where relevant.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown.

Sources 23

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

Black DS, O'Reilly GA, Olmstead R et al.. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Intern Med. 2015. PMID 25686304. DOI 10.1001/jamainternmed.2014.8081. (abstract)
Bowen S, Witkiewitz K, Clifasefi SL et al.. Relative efficacy of mindfulness-based relapse prevention, standard relapse prevention, and treatment as usual for substance use disorders: a randomized clinical trial. JAMA Psychiatry. 2014. PMID 24647726. DOI 10.1001/jamapsychiatry.2013.4546. (abstract)
Brook RD, Appel LJ, Rubenfire M et al.. Beyond medications and diet: alternative approaches to lowering blood pressure: a scientific statement from the American Heart Association. Hypertension. 2013. PMID 23608661. DOI 10.1161/HYP.0b013e318293645f. (abstract)
Chen Q, Liu H, Du S. Effect of mindfulness-based interventions on people with prehypertension or hypertension: a systematic review and meta-analysis of randomized controlled trials. BMC Cardiovasc Disord. 2024. PMID 38350849. DOI 10.1186/s12872-024-03746-w. (abstract)
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. PMID 27002445. DOI 10.1001/jama.2016.2323. (abstract)
Cillessen L, Johannsen M, Speckens AEM et al.. Mindfulness-based interventions for psychological and physical health outcomes in cancer patients and survivors: A systematic review and meta-analysis of randomized controlled trials. Psychooncology. 2019. PMID 31464026. DOI 10.1002/pon.5214. (abstract)
Coronado-Montoya S, Levis AW, Kwakkenbos L et al.. Reporting of Positive Results in Randomized Controlled Trials of Mindfulness-Based Mental Health Interventions. PLoS One. 2016. PMID 27058355. DOI 10.1371/journal.pone.0153220. (abstract)
Farias M, Maraldi E, Wallenkampf KC et al.. Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatr Scand. 2020. PMID 32820538. DOI 10.1111/acps.13225. (abstract)
Galante J, Galante I, Bekkers MJ et al.. Effect of kindness-based meditation on health and well-being: a systematic review and meta-analysis. J Consult Clin Psychol. 2014. PMID 24979314. DOI 10.1037/a0037249. (abstract)
Galante J, Friedrich C et al.. Individual participant data systematic review and meta-analysis of randomised controlled trials assessing adult mindfulness-based programmes for mental health promotion in non-clinical settings. Nat Ment Health. 2023. PMID 37867573. DOI 10.1038/s44220-023-00081-5. (abstract)
Goldberg SB, Tucker RP, Greene PA et al.. Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2018. PMID 29126747. DOI 10.1016/j.cpr.2017.10.011. (abstract)
Goyal M, Singh S, Sibinga EM et al.. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Intern Med. 2014. PMID 24395196. DOI 10.1001/jamainternmed.2013.13018. (abstract)
Hilton L, Hempel S, Ewing BA et al.. Mindfulness Meditation for Chronic Pain: Systematic Review and Meta-analysis. Ann Behav Med. 2017. PMID 27658913. DOI 10.1007/s12160-016-9844-2. (abstract)
Hoge EA, Bui E, Mete M et al.. Mindfulness-Based Stress Reduction vs Escitalopram for the Treatment of Adults With Anxiety Disorders: A Randomized Clinical Trial. JAMA Psychiatry. 2023. PMID 36350591. DOI 10.1001/jamapsychiatry.2022.3679. (abstract)
Kim SM, Park JM, Seo HJ et al.. Effects of mindfulness-based stress reduction on adults with sleep disturbance: an updated systematic review and meta-analysis. BMJ Open. 2022. PMID 36332952. DOI 10.1136/bmjopen-2021-058032. (abstract)
Kuyken W, Warren FC, Taylor RS et al.. Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse: An Individual Patient Data Meta-analysis From Randomized Trials. JAMA Psychiatry. 2016. PMID 27119968. DOI 10.1001/jamapsychiatry.2016.0076. (abstract)
Kuyken W, Ball S, Crane C et al.. Effectiveness and cost-effectiveness of universal school-based mindfulness training compared with normal school provision in reducing risk of mental health problems and promoting well-being in adolescence: the MYRIAD cluster randomised controlled trial. Evid Based Ment Health. 2022. PMID 35820992. DOI 10.1136/ebmental-2021-300396. (abstract)
Lindahl JR, Fisher NE, Cooper DJ et al.. The varieties of contemplative experience: A mixed-methods study of meditation-related challenges in Western Buddhists. PLoS One. 2017. PMID 28542181. DOI 10.1371/journal.pone.0176239. (abstract)
Lutz A, Slagter HA, Dunne JD et al.. Attention regulation and monitoring in meditation. Trends Cogn Sci. 2008. PMID 18329323. DOI 10.1016/j.tics.2008.01.005. (abstract)
Mirabito G, Verhaeghen P. The Effects of Mindfulness Interventions on Older Adults' Cognition: A Meta-Analysis. J Gerontol B Psychol Sci Soc Sci. 2023. PMID 36148552. DOI 10.1093/geronb/gbac143. (abstract)
O'Brien-Venus B, Ellett L, Burgess-Barr S et al.. Systematic review of the safety of mindfulness-based interventions for psychosis. Clin Psychol Rev. 2024. PMID 38851179. DOI 10.1016/j.cpr.2024.102445. (abstract)
Solomonova E, Lindahl JR, Gold I et al.. "I was trying to save the world": delusion-like ideation and associated impacts reported by Western practitioners of Buddhist meditation. Front Psychol. 2025. PMID 41209790. DOI 10.3389/fpsyg.2025.1644684. (abstract)
. NCCIH: Meditation and Mindfulness: Effectiveness and Safety (page marked Last Updated June 2022). . . (full-text)

Education, not medical advice. This page is for general information. It does not diagnose or treat any condition and is not a substitute for care from a qualified health professional. Natural does not automatically mean safe. Ask a clinician or pharmacist before changing your care, especially if you take medication, are pregnant or breastfeeding, or have a health condition.