Meditation and Mindfulness for Stress, Sleep and Anxiety: What the Evidence Shows

If you are in crisis or thinking about harming yourself, call, text or chat the 988 Suicide & Crisis Lifeline in the US. It is free and confidential, day or night. [1] For a life-threatening emergency, call 911. Meditation is not a substitute for emergency care or for treatment from a clinician.

The evidence at a glance

1. Stress in healthy adults

   promising but limited

   An analysis of 29 studies (2,668 adults) found mindfulness-based stress reduction (MBSR) moderately effective, with high variation between studies. [3]

2. Mental health in non-clinical settings

   promising but limited

   136 trials: better than no intervention for anxiety, depression and distress, but confidence ranged from moderate to very low. [4]

3. Anxiety disorders

   mixed

   One trial of 276 adults found MBSR not worse than the medicine escitalopram. [5] NCCIH describes mixed short-term results and no long-term effects in the few studies that followed people longer. [2]

4. Depression

   established as one option for relapse prevention; mixed for current symptoms

   Mindfulness-based cognitive therapy (MBCT) lowered relapse risk in people who were well but had recurrent depression. [6]

5. Sleep

   promising but limited

   Better than non-specific comparison groups, no different from evidence-based sleep treatments. [7]

6. PTSD

   promising but limited

   Modest benefit in a veterans trial. [8]

7. ADHD

   insufficient evidence to promising but limited

   No firm conclusion. [2]

Stress and burnout

For everyday stress the picture is small to moderate benefit, not a cure. A 2014 review of trials with active comparison groups found no evidence that meditation programs beat other active treatments such as drugs, exercise or other behavioral therapies. [9] Burnout is a workplace concept, not a medical diagnosis, and reviews of mindfulness for burnout are mixed. [10][11] See meditation and mindfulness for stress and burnout.

Sleep

A review of 18 trials (1,654 participants) found mindfulness meditation improved sleep quality compared with non-specific active controls, but not compared with evidence-based sleep treatments. [7] For long-lasting insomnia, the NHS says a GP may offer cognitive behavioral therapy (CBT). [12] See meditation for sleep and insomnia and CBT for insomnia.

Anxiety

In the escitalopram trial, anxiety scores fell by a similar amount in both groups over 8 weeks. [5] The trial compared two active treatments, so it says nothing about how either compares with no treatment. See meditation and mindfulness for anxiety and anxiety disorders.

Depression

MBCT is a group course that blends mindfulness with parts of cognitive therapy. NICE in England lists it as an option to prevent relapse in people at higher risk who do not wish to continue antidepressants. [13] See meditation and mindfulness for depression.

Trauma and attention

Meditation-based programs for PTSD have shown modest benefit, but the studies are few and varied. [14] For ADHD, a Cochrane review could draw no conclusions from four small studies. [15] See PTSD and trauma and ADHD and attention.