Investigating Clinical Benefits of a Novel Sleep-Focused Mind-Body Program on Gulf War Illness Symptoms: A Randomized Controlled Trial

Psychosom Med. Jul/Aug 2017;79(6):706-718. doi: 10.1097/PSY.0000000000000469.


Objective: Mind-Body Bridging (MBB) has been shown to be effective for improving disturbed sleep. In this prospective randomized controlled trial, we evaluated the efficacy of sleep-focused MBB compared with sleep education control (SED) for improving sleep in previously deployed Gulf War veterans.

Methods: US military service members with sleep and physical health complaints who were deployed in 1990-1991 were randomized to receive three weekly sessions of either MBB (n = 33) or SED (n = 27) between 2012 and 2015. The primary outcome of Medical Outcomes Study Sleep Scale was completed at baseline, weekly during treatment, postintervention, and 3-month follow-up. Secondary outcome measures for posttraumatic stress disorder, depression, fatigue, quality of life, symptom severity, and mindfulness were completed at baseline, postintervention and 3-month follow-up. Salivary samples were collected at five time points per day at each visit for cortisol and α-amylase assessment. Clinician-administered assessments of sleep and co-occurring conditions were conducted at baseline and postintervention.

Results: MBB was significantly more efficacious than SED in reducing disturbed sleep at follow-up (F(1,180.54) = 4.04, p = .046). In addition, self-reported posttraumatic stress disorder (F(1,56.42) = 4.50, p = .038) for the treatment effect, depression (F(1,93.70) = 4.44, p = .038), and fatigue symptoms (F(1,68.58) = 3.90, p = .050) at follow-up improved in MBB compared with those in SED. Consistently higher percentages of veterans in MBB reported improvements of sleep, pain, and composite sleep/general co-occurring symptoms at the postclinical evaluation, as compared with veterans in SED. Finally, the mean waking level of salivary α-amylase in the MBB declined to a greater extent than that in the SED, at follow-up (F(1,88.99) = 3.78, p = .055), whereas no effects were found on cortisol.

Conclusions: Sleep-focused MBB can improve sleep and possibly also co-occurring symptoms in Gulf War veterans.

Clinical trial registration:, NCT01543997.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Combat Disorders / therapy*
  • Depression / therapy*
  • Fatigue / therapy*
  • Follow-Up Studies
  • Gulf War
  • Humans
  • Hydrocortisone / metabolism
  • Male
  • Middle Aged
  • Mind-Body Therapies / methods*
  • Outcome Assessment, Health Care*
  • Patient Education as Topic / methods
  • Sleep Wake Disorders / therapy*
  • Stress Disorders, Post-Traumatic / therapy*
  • Veterans*
  • alpha-Amylases / metabolism


  • alpha-Amylases
  • Hydrocortisone

Associated data