The Effects of Online Group Mindfulness Training on Stress and Sleep Quality during the COVID-19 Pandemic in Singapore: a Retrospective Equivalence Trial

Abstract

Background: The COVID-19 pandemic has had a negative impact on psychological health. Mindfulness training, which helps individuals attend to the present moment with a non-judgmental attitude, improves sleep and reduces stress in regular times, and may be relevant in mitigating harmful health consequences during acute crises. However, restrictions may necessitate this training being delivered online, rather than in in-person group settings. Methods: Data from an ongoing study were used for this retrospective equivalence trial. Participants were recruited (with no exclusion criteria) from enrollees in mindfulness courses at a local charity organization promoting mental wellness. Three groups were created, two that received their training during the period of the COVID-19 pandemic (in-person (N = 36) and videoconferencing (N = 38)), and a second control group of participants tested before the pandemic (N = 86). Primary outcomes were self-reported stress and sleep quality. Baseline levels, and changes in these variables due to mindfulness training were compared among the groups using analysis of covariance and two one-sided t-tests. Findings: Perceived stress and sleep quality did not differ significantly between groups at baseline. Mindfulness training significantly reduced stress in all three groups, and this effect was statistically equivalent for videoconferencing compared to in-person training. Sleep quality improved significantly in the pre-pandemic group, but in neither of the groups during the pandemic. Participants reported shorter times to initiate sleep following mindfulness training pre-pandemic, but not during the pandemic. Course attendance was high and equivalent across the online and comparison groups, and participants engaged in marginally more daily practice in the online condition. Interpretation: Online mindfulness training via videoconferencing may be a useful intervention for stress reduction but not sleep improvement during times when traditional in-person training is not feasible. Funding: This study was supported by start-up funding from Duke-NUS Medical School and the National University of Singapore to JL.