JMIR Publications

ABSTRACT

Background:

The efficacy of digital meditation is well established. However, the extent to which benefits remain after 12-weeks in real-world settings remains unknown. In addition, findings related to dosage and practice habits have been mixed, conducted on small and homogenous samples, and used a limited range of analysis procedures and meditation techniques (focused on internal body awareness – interception, compared to external awareness – exteroception). Findings related to the predictors of adherence are also lacking and may help inform future meditators and meditation programs on how to best structure healthy sustainable practices.

Objective:

The goal of this study was to measure outcome change across a large and globally diverse population of meditators and meditations in their naturalistic practice environments, assess the dose-response relationships between practice habits and outcome change, and identify predictors of adherence.

Methods:

We used Ecological Momentary Assessment to assess participants wellbeing over a 14-month period. We engineered outcomes related to the variability of change over time (equanimity) and recovery following a drop in mood (resilience) and established the convergent and divergent validity of these outcomes using a validated scale. Using linear mixed effects and generalised additive mixed effects models we modelled outcome change and patterns of dose-response across outcomes. We then used logistic regression to study the practice habits of participants in their first 30 sessions to derive odds-ratios of long-term adherence.

Results:

Significant improvements were observed across all outcomes. Generalised additive mixed models revealed rapid improvements over the first 50-100 sessions with further improvements observed until the end of the study. Outcome change corresponded to 1 extra day of improved mood for every 5 days meditated and half-a day faster mood recovery compared to baseline. Overall, the consistency of practice was associated with the largest outcome change (4-7 pays per-week). No overall significant differences were observed across session lengths in linear models, however, generalised additive models revealed significant differences over time. Longer sessions (21-30 minutes) were associated with the largest magnitude change in mood; however, outsized benefit was not seen until after the 20th session. Longer sessions were associated with less sessions to recovery, mid-length sessions (11-20 minutes) were associated with the largest magnitude decreases in recovery, while mood stability was similar across session lengths. Completing a greater variety of practice types was associated with significantly greater improvements across all outcomes. Adhering to a practice long-term was best predicted by practice consistency (4-7 days per-week), a morning routine, and maintaining an equal balance between interoceptive and exteroceptive meditations.

Conclusions:

A long-term real-world digital meditation practice is effective and associated with improvements in mood, equanimity, and resilience. Practice consistency and variety rather than length best predicts improvement. Long-term sustainable practices are best predicted by consistency, a morning routine, and a practice balanced across objects of focus.