Decreased accumbens-amygdala connectivity is associated with sleep improvement in late-life depression following mindfulness-based cognitive therapy.

Background

Mindfulness-based cognitive therapy (MBCT) may improve sleep in major depressive disorder. This secondary analysis of a randomized controlled trial examined the effects of adjunctive MBCT on sleep quality and explored neural correlates of sleep improvement in late-life depression (LLD).

Methods

Sixty participants with LLD were randomized to 8-week MBCT plus Treatment as Usual (TAU) or TAU alone (ChiCTR1800017725). Subjective and objective sleep quality were assessed using the Pittsburgh Sleep Quality Index (PSQI) and cardiopulmonary coupling (CPC), respectively. In the MBCT+TAU group, post-treatment differences in functional connectivity between the meditation and resting states were examined, and associations with changes in sleep outcomes were analyzed.

Results

Global PSQI scores showed greater short-term improvement in the MBCT+TAU group than in the TAU group (p for interaction = 0.02). At Week 8, the between-group difference in change in global PSQI scores was -3.80 (95% CI, -6.50 to -1.10), but was nonsignificant at 3-month follow-up. Stable sleep also increased more in the MBCT+TAU group (difference in change, 0.94 h; 95% CI, 0.17 to 1.71). Reduced right nucleus accumbens-left amygdala functional connectivity during meditation relative to the resting state was associated with greater increases in stable sleep duration (r = 0.45, p = 0.013).

Conclusion

Adjunctive MBCT was associated with greater short-term improvement in subjective and objective sleep quality in LLD. Reduced right nucleus accumbens-left amygdala functional connectivity during meditation relative to the resting state was associated with increased stable sleep duration. MBCT may represent a promising adjunctive non-pharmacological intervention for sleep disturbances in LLD.