The Effect of Online Mindfulness Based Stress Reduction Program on Sleep Quality in Mothers of Children with Autism Spectrum Disorder: A Randomized Clinical Trial

Fatemeh Miryounesi,, Sima Ghezelbash,, Mousa Alavi

Abstract


Background: Mothers of children with autism spectrum disorder (ASD) would experience elevated levels of stress and psychological distress. This study examined the effect of an online Mindfulness‑Based Stress Reduction (MBSR) Program on sleep quality in mothers of children with ASD. Materials and Methods: This was a randomized single‑blinded controlled trial that was conducted in 2022 on 72 mothers of children with ASD from Fatemeh Zahra and Parnian Autism Centers in Isfahan City, Iran. Participants were recruited through a convenient sampling and randomly assigned to intervention (n = 36) and control (n = 36) groups. The intervention group underwent eight 90‑min MBSR sessions twice a week. Data were collected using a demographic information form and the Pittsburgh Sleep Quality Index (PSQI) at baseline, immediately after, and one month after the intervention. Data were analyzed using independent samples: t‑test, Chi‑square, and one‑way repeated‑measure. Results: The intervention group showed significantly improved sleep quality scores immediately after (F = 107.004, P < 0.001) and one month after (F = 107.004, P < 0.001) the intervention compared to the control group (lower PSQI score indicates better sleep quality). Repeated‑measure ANOVA indicated a significant change in sleep quality scores over time within the intervention group (F = 107.004, P < 0.05), but no significant change was found in the control group (F = 1.292, P > 0.05). Conclusions: The findings of this study demonstrate that MBSR effectively improves sleep in mothers of children with ASD. Given its cost‑effectiveness, MBSR should be integrated into healthcare protocols.

 


Keywords


Autism spectrum disorder, disease managements, mindfulness, nursing, sleep quality, stress

Full Text:

PDF

References


Enea V, Rusu D. Raising a child with autism spectrum disorder: A systematic review of the literature investigating parenting stress. J Ment Health Res Intellect Disabil 2020;13:283 321.

Daniel LC, Walsh CM, Meltzer LJ, Barakat LP, Kloss JD. The relationship between child and caregiver sleep in acute lymphoblastic leukemia maintenance. Support Care Cancer 2018;26:1123 32.

Lindor E, Sivaratnam C, May T, Stefanac N, Howells K, Rinehart N. Problem behavior in autism spectrum disorder: Considering core symptom severity and accompanying sleep disturbance. Front Psychiatry 2019;10:487.

McAuliffe T, Thomas Y, Vaz S, Falkmer T, Cordier R. The experiences of mothers of children with autism spectrum disorder: Managing family routines and mothers’ health and wellbeing. Aust Occup Ther J 2019;66:68 76.

Shaw KA, Williams S, Patrick ME, Valencia Prado M, Durkin MS, Howerton EM, et al. Prevalence and early identification of autism spectrum disorder among children aged 4 and 8 years autism and developmental disabilities monitoring network, 16 sites, United States, 2022. MMWR Surveill Summ 2025;74:1 22.

Grosvenor LP, Croen LA, Lynch FL, Marafino BJ, Maye M, Penfold RB, et al. Autism diagnosis among US children and adults, 2011 2022. JAMA Netw Open 2024;7:e2442218.

van der Lubbe A, Swaab H, Vermeiren R, van Rossum EFC, van Balkom IDC, Ester WA. Chronic parenting stress in parents of children with autism: Associations with chronic stress in their child and parental mental and physical health. J Autism Dev Disord 2025. doi: 10.1007/s10803 025 06736 9.

Pignatiello GA, Martin R, Kraus N, Gutierrez A, Cusick R, Hickman RL. Sleep interventions for informal caregivers of persons with dementia: A systematic review. West J Nurs Res 2022;44:886 98.

Baweja R, Waschbusch DA, Mayes SD. Physical aggression toward others and self: Correlates in autism, attention deficit/ hyperactivity disorder, and population based child samples. JAACAP Open 2023;1:274 83.

Mihaila I, Hartley SL. Parental sleep quality and behavior problems of children with autism. Autism 2018;22:236 44.

Bulut N, Aydın Yağcıoğlu G, Uğur F, Yayıcı Köken Ö, Gürbüz İ, Yılmaz Ö, et al. Sleep quality and daytime sleepiness amongst family caregivers of children with Spinal Muscular Atrophy. Res Dev Disabil 2024;152:104811.

Kim SM, Park JM, Seo HJ, Kim J, Noh JW, Kim HL. Effects of mindfulness based stress reduction on adults with sleep disturbance: An updated systematic review and meta analysis. BMJ Open 2022;12:e058032.

Ling W, Yang C, Ho MH, Lee JJ. Effectiveness of acupressure on sleep quality among inpatients: A systematic review and meta analysis. Nurs Health Sci 2025;27:e70075.

Clauser P, Ding Y, Chen EC, Cho SJ, Wang C, Hwang J. Parenting styles, parenting stress, and behavioral outcomes in children with autism. School Psychol Int 2021;42:33 56.

Chan SH, Lui D, Chan H, Sum K, Cheung A, Yip H, et al. Effects of mindfulness based intervention programs on sleep among people with common mental disorders: A systematic review and meta analysis. World J Psychiatry 2022;12:636 50.

Ghadampour E, Shirazi A, Tehrani MA. Effectiveness of training of mindfulness based stress reduction on psychological well being of ADHD children’s mothers. J Except Child 2016;16:35 48.

Jones SMW, Sherman KJ, Bermet Z, Palazzo LG, Lewis CC. An experimental study to inform adoption of mindfulness based stress reduction in chronic low back pain. Implement Sci Commun 2022;3:87.

Gu S, Li Y, Liang F, Feng R, Zeng Z, Wang F. The mediating effects of coping style on the effects of breath count mindfulness training on depressive symptoms among international students in China. Neural Plast 2020;2020:8859251.

Foley E, Baillie A, Huxter M, Price M, Sinclair E. Mindfulness based cognitive therapy for individuals whose lives have been affected by cancer: A randomized controlled trial. J Consult Clin Psychol 2010;78:72 9.

Javadzade N, Esmaeili SV, Omranifard V, Zargar F. Effect of mindfulness based stress reduction (MBSR) program on depression, emotion regulation, and sleep problems: A randomized controlled trial study on depressed elderly. BMC Public Health 2024;24:271.

Dehestani M. The effectiveness of mindfulness based stress reduction program on depression, anxiety and depression of female students. Thoughts Behav Clin Psychol 2015;10:47 56.

Buysse DJ, Reynolds CF, Monk TH, Berman SR, Kupfer DJ. The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research. Psychiatry Res 1989;28:193 213.

Fatemeh K, Homayoon HR. Effectiveness of mindfulness based stress reduction training on the quality of sleep and psychological distress in patients with type II diabetes. J Diabetes Nurs 2019;7:844 856.

Sheybani F, Dabaghi P, Najafi S, Rajaeinejad M. Effectiveness of mindfulness based stress reduction (MBSR) on patients with chronic pain: A randomized clinical trial. Iran J Psychiatry Clin Psychol 2022;28:182 95.

Kriakous SA, Elliott KA, Lamers C, Owen R. The effectiveness of mindfulness based stress reduction on the psychological functioning of healthcare professionals: A systematic review. Mindfulness (N Y) 2021;12:1 28.

Polle E, Gair J. Mindfulness based stress reduction for medical students: A narrative review. Can Med Educ J 2021;12:e74 80.

Zhang JX, Liu XH, Xie XH, Zhao D, Shan MS, Zhang XL, et al. Mindfulness based stress reduction for chronic insomnia in adults older than 75 years: A randomized, controlled, single blind clinical trial. Explore (NY) 2015;11:180 5.

Koshki F, Haroon Rashidi H. Effectiveness of Mindfulness-based Stress Reduction Training on the Quality of Sleep and Psychological Distress in Patients with Type II Diabetes. J Diabetes Nurs 2019;7:844-856.

Rojas Torres LP, Alonso Esteban Y, López Ramón MF, Alcantud Marín F. Mindfulness based stress reduction (MBSR) and self compassion (SC) training for parents of children with autism spectrum disorders: A pilot trial in community services in Spain. Children (Basel) 2021;8:316.

Zhang D, Lee EKP, Mak ECW, Ho CY, Wong SYS. Mindfulness based interventions: An overall review. Br Med Bull 2021;138:41 57.

Darehzereshki S, Dehghani F, Enjezab B. Mindfulness based stress reduction group training improves of sleep quality in postmenopausal women. BMC Psychiatry 2022;22:254.

Dykens EM, Fisher MH, Taylor JL, Lambert W, Miodrag N. Reducing distress in mothers of children with autism and other disabilities: A randomized trial. Pediatrics 2014;134: e454 63.

Huberty J, Puzia ME, Green J, Vlisides-Henry RD, Larkey L, Irwin MR, et al. A mindfulness meditation mobile app improves depression and anxiety in adults with sleep disturbance: Analysis from a randomized controlled trial. Gen Hosp Psychiatry 2021;73:30-7.

Suh HW, Jeong HY, Hong S, Kim JW, Yoon SW, Lee JY, et al. The mindfulness based stress reduction program for improving sleep quality in cancer survivors: A systematic review and meta analysis. Complement Ther Med 2021;57:102667.


Refbacks

  • There are currently no refbacks.