- Design
- Bayesian random-effects network meta-analysis, searched to December 2025
- Population
- 45 trials, 3,568 older adults with sleep disturbance
- Primary outcome
- subjective sleep quality
- Effect
- vs control: meditation MD −3.49 (95% CrI −4.92 to −2.09), yoga −2.40, qigong −2.21, tai chi −1.87; meditation vs sleep hygiene education −2.87 (−4.45 to −1.30)
A network meta-analysis screened 3,792 studies and included 45 trials with 3,568 older participants with sleep disturbance, comparing mind-body therapies against each other and against control using Bayesian random-effects models.
Against control, four interventions improved subjective sleep quality: meditation (mean difference −3.49, 95% credible interval −4.92 to −2.09), yoga (−2.40, −4.55 to −0.27), qigong (−2.21, −4.01 to −0.42) and tai chi (−1.87, −2.99 to −0.77). Against sleep hygiene education specifically — the usual first-line advice — meditation was superior (−2.87, −4.45 to −1.30). Meditation had the highest probability of ranking best.
The outcomes are subjective sleep quality scales, not actigraphy or polysomnography, and these trials cannot blind participants to whether they are meditating. So some of the effect is expectation. But the comparison with sleep hygiene education is the useful one, because it holds attention and expectation roughly constant and still favours meditation — and for an older patient in whom you are trying to avoid a hypnotic, that is the practical alternative worth offering. Yoga, tai chi and qigong are all more familiar and more available in Indian settings than formal meditation programmes, and all three worked.
- Offer a mind-body practice before a hypnotic in older adults with sleep disturbance
- Where the patient has no preference, meditation had the strongest evidence
- Choose by what is locally available and what the patient will keep doing — all four worked
- Set expectations around subjective sleep quality; objective sleep was not measured
- Do not use this to justify stopping investigation of sleep apnoea or nocturia
Why it matters
It gives a ranked alternative to prescribing a hypnotic to an older adult, which is the decision this consultation usually turns on.
Don't overread it
All outcomes are self-reported sleep quality in trials that cannot blind participants — no objective sleep measurement was involved.
The statistics, in plain English
These are mean differences on sleep quality scales where lower is better, so −3.49 for meditation is roughly three and a half points of improvement — meaningful on a scale like the Pittsburgh index, where five points separates good from poor sleepers. Credible intervals are the Bayesian equivalent of confidence intervals; yoga's runs from −4.55 to −0.27, so its effect could be substantial or nearly nothing.
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