Person sitting in a meditation pose

Meditation and Health: What the Research Shows

10 min read

Many people try meditation to feel calmer, sleep better or cope with stress. A 2014 review in JAMA Internal Medicine by Madhav Goyal and colleagues looked at 47 randomised trials with 3,515 adults who had a health condition, which the authors defined broadly to include stress, anxiety, pain, heart disease or older age, and found that mindfulness meditation programmes were linked with small to moderate improvements in anxiety, depression and pain, compared with control groups given a similar amount of time and attention.

This guide covers what that review and later research found, including effects on blood pressure, stress markers and sleep, what the evidence does not show, possible downsides, and how to start. Meditation is one option among several, and the evidence for it is real but modest.

3,515
Adults in 47 trials of meditation programmes compared with active control groups
Goyal et al. 2014, JAMA Internal Medicine
45
Trials comparing meditation with an active control on physiological stress markers
Pascoe et al. 2017
49
Older adults with moderate sleep problems in a 6-week trial of mindfulness against sleep hygiene education
Black et al. 2015
8.3%
Pooled rate of adverse events in a review of 83 studies, from 3.7% in experimental to 33.2% in observational studies
Farias et al. 2020
Sources: Goyal et al. 2014, JAMA Internal Medicine. Pascoe et al. 2017, Journal of Psychiatric Research. Black et al. 2015, JAMA Internal Medicine. Farias et al. 2020, Acta Psychiatrica Scandinavica.

What the main 2014 review found

Goyal and colleagues included only trials where the comparison group received an activity matched for time and attention, such as health education, which helps separate the effect of meditation from the effect of taking part. Mindfulness programmes showed moderate strength of evidence for improved anxiety, depression and pain, and low strength of evidence for improved stress and mental health-related quality of life. The effect sizes were small to moderate.

The review found low evidence of no effect, or not enough evidence to judge, for positive mood, attention, substance use, eating habits, sleep and weight. Only 9 trials reported on possible harms, and none of those found any. It found no evidence that meditation programmes were better than other active treatments, such as medicines, exercise or other behavioural therapies. Mindfulness-based stress reduction (MBSR) courses in the review typically provided between 20 and 27.5 hours of training over 8 weeks.

Effects on the body

A 2017 review in the Journal of Psychiatric Research by Michaela Pascoe and colleagues included 45 randomised trials comparing meditation with an active control. When all forms of meditation were analysed together, meditation was linked with lower cortisol (a stress hormone), C-reactive protein (a marker of inflammation), blood pressure, heart rate, triglycerides and tumour necrosis factor-alpha (another inflammation marker). All the types of meditation studied were linked with lower systolic blood pressure.

A 2017 Scientific Statement from the American Heart Association, led by Glenn Levine, reviewed meditation and heart and circulation risk. The authors concluded that studies suggest a possible benefit, although the overall quality and, in some cases, quantity of study data are modest. For blood pressure, they cite a 2015 analysis of 12 trials of transcendental meditation with 996 participants, mostly Black adults with or without high blood pressure, which found a mean reduction of 4/2 mm Hg compared with control groups. The statement says meditation may be considered as an addition to standard heart risk reduction, not a replacement, and that its benefits remain to be better established.

A 2011 paper in Perspectives on Psychological Science proposed how mindfulness might work, through attention, body awareness, emotion regulation and a changed view of the self. The authors note that brain imaging studies have begun to explore these processes, and that mindfulness practice is associated with changes in several brain areas. These links do not yet show cause and effect.

Meditation and sleep

The 2014 review found insufficient evidence on sleep. A later trial gives a clearer picture for one group. In a 2015 JAMA Internal Medicine trial by David Black and colleagues, 49 adults with an average age of 66 and moderate sleep problems took either a 6-week mindfulness course or a sleep hygiene education course, each meeting for 2 hours a week. Home practice in the mindfulness group started at 5 minutes a day and built up to 20 minutes a day.

Sleep quality scores (on a scale where lower is better) fell from 10.2 to 7.4 in the mindfulness group and from 10.2 to 9.1 in the sleep hygiene group. The mindfulness group's average was still above the score of 5 the trial used to define a sleep problem. The mindfulness group also had greater improvements in insomnia symptoms, depression symptoms and fatigue. There was no difference between groups for anxiety or stress. The trial was small, 43 of the 49 people attended sessions, and results were measured only straight after the course. Among others, it excluded smokers, people with sleep apnoea, more severe depression, problems with memory or thinking or a BMI (body mass index) above 34.9, and people already meditating more than 15 minutes a day.

Sleep improved more with mindfulness Fall in Pittsburgh Sleep Quality Index score after 6 weeks (a bigger fall means better sleep) Mindfulness course 2.8 points Sleep hygiene course 1.1 points 0 1.5 3
Source: Black et al. 2015, JAMA Internal Medicine. Both groups started at an average score of 10.2. A small trial in older adults with moderate sleep problems, measured straight after the course.

Possible downsides

A 2020 systematic review in Acta Psychiatrica Scandinavica by Farias and colleagues looked at 83 studies with 6,703 people who practised meditation. Of those studies, 65% reported at least one adverse event. The pooled rate of adverse events was 8.3%, ranging from 3.7% in experimental studies to 33.2% in observational studies. The most common were anxiety, depression and changes in thinking. Suicidal behaviour was reported in 6 of the 83 studies. The authors found these events can occur in people with no previous history of mental health problems. If you have thoughts of harming yourself, call 111 and select the mental health option, or call Samaritans on 116 123. Call 999 or go to A&E if your life is at risk.

The NHS says many people find mindfulness helpful, but it is "not right for everyone", and some people find it does not help them or can make them feel worse. In our view, if meditation leaves you feeling more anxious, low or unsettled, stop or shorten your sessions and speak to your GP (general practitioner). If you have a mental health condition, or have had trauma, speak to your GP or mental health team before starting, and look for a qualified teacher.

What the evidence does not show

Most trials in the 2014 review were short-term, and the American Heart Association calls for studies with long-term follow-up. The effects found were small to moderate, and meditation was not shown to be better than medicines, exercise or other therapies. The heart and blood pressure evidence is of modest quality, and the brain imaging research shows links rather than proof of cause. The NHS says mindfulness-based therapies are recommended by NICE (the National Institute for Health and Care Excellence) as a way to treat less severe depression, and that more research is needed for other mental health conditions.

In our view, do not stop or change any prescribed medicine because you have started meditating. Talk to your GP first.

How to start

These steps come from NHS advice and the trials above, with our own notes marked.

1
Start small
In the 2015 sleep trial, home practice began at 5 minutes a day and built up to 20 minutes a day over 6 weeks. In our view, this is a sensible pattern to copy.
2
Pick a regular time
The NHS suggests picking a regular time, such as a morning journey to work or a walk at lunchtime, to be aware of the sensations created by the world around you.
3
Bring your attention back
The NHS describes mindfulness meditation as sitting silently and paying attention to your breathing, sounds or body, bringing your attention back whenever your mind wanders.
4
Name your thoughts
The NHS says mindfulness is not about making thoughts go away. Some people find it helps to silently name them, such as: This is anxiety.

The NHS also notes that yoga and tai chi can help with awareness of your breathing. If you need urgent help for your mental health, the NHS advises calling 111 and selecting the mental health option, or asking for an urgent GP appointment. You can call Samaritans on 116 123. Call 999 or go to A&E if someone's life is at risk or you do not feel you can keep yourself or someone else safe.

Frequently asked questions

Does meditation reduce anxiety?
In a 2014 review of 47 trials, mindfulness programmes showed moderate evidence of small to moderate improvements in anxiety compared with active control groups. They were not shown to be better than other treatments.
Can meditation lower blood pressure?
A 2017 review of trials comparing meditation with active controls linked it with lower blood pressure. A 2015 analysis of transcendental meditation trials, mostly in Black adults, found a mean fall of 4/2 mm Hg compared with control groups. The American Heart Association says the evidence is of modest quality and meditation may be considered as an addition to standard care, not a replacement.
Does meditation help sleep?
The 2014 review found insufficient evidence on sleep. A small 2015 trial in older adults with moderate sleep problems found greater improvement in sleep quality after a 6-week mindfulness course than after sleep hygiene education.
How long should I meditate each day?
No single amount is proven. In the 2015 sleep trial, home practice began at 5 minutes a day and built up to 20 minutes a day. MBSR courses in the 2014 review provided between 20 and 27.5 hours of training over 8 weeks.
Can meditation have side effects?
A 2020 review of 83 studies found a pooled adverse event rate of 8.3%, ranging from 3.7% in experimental studies to 33.2% in observational studies. The most common were anxiety and depression. The NHS says mindfulness is "not right for everyone". In our view, if it makes you feel worse, stop and speak to your GP.

The bottom line

A 2014 review of 47 trials linked mindfulness meditation programmes with small to moderate improvements in anxiety, depression and pain compared with active control groups, but not with better results than other treatments. Later reviews linked meditation with lower blood pressure and stress markers, though the American Heart Association rates the heart evidence as modest. A small trial found better sleep quality in older adults after a mindfulness course. Adverse events, most often anxiety or low mood, occur in some people. In our view, meditation is worth trying alongside other healthy habits, starting with short daily sessions and stopping if it makes you feel worse.

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Related reading

Sources

  • Goyal M, Singh S, Sibinga EM, et al. Meditation programs for psychological stress and well-being: a systematic review and meta-analysis. JAMA Internal Medicine 2014;174(3):357-368. pubmed.ncbi.nlm.nih.gov/24395196
  • Pascoe MC, Thompson DR, Jenkins ZM, Ski CF. Mindfulness mediates the physiological markers of stress: systematic review and meta-analysis. Journal of Psychiatric Research 2017;95:156-178. pubmed.ncbi.nlm.nih.gov/28863392
  • Levine GN, Lange RA, Bairey-Merz CN, et al. Meditation and cardiovascular risk reduction: a scientific statement from the American Heart Association. Journal of the American Heart Association 2017;6(10):e002218. pubmed.ncbi.nlm.nih.gov/28963100
  • Hölzel BK, Lazar SW, Gard T, et al. How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective. Perspectives on Psychological Science 2011;6(6):537-559. pubmed.ncbi.nlm.nih.gov/26168376
  • Black DS, O'Reilly GA, Olmstead R, Breen EC, Irwin MR. Mindfulness meditation and improvement in sleep quality and daytime impairment among older adults with sleep disturbances: a randomized clinical trial. JAMA Internal Medicine 2015;175(4):494-501. pubmed.ncbi.nlm.nih.gov/25686304
  • Farias M, Maraldi E, Wallenkampf KC, Lucchetti G. Adverse events in meditation practices and meditation-based therapies: a systematic review. Acta Psychiatrica Scandinavica 2020;142(5):374-393. pubmed.ncbi.nlm.nih.gov/32820538
  • NHS. Mindfulness. Last reviewed 17 August 2026. nhs.uk
  • NHS. Where to get urgent help for mental health. Last reviewed 26 April 2023. nhs.uk
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