Maintenance Notice

Due to necessary scheduled maintenance, the JMIR Publications website will be unavailable from Wednesday, July 01, 2020 at 8:00 PM to 10:00 PM EST. We apologize in advance for any inconvenience this may cause you.

Who will be affected?


Currently submitted to: Journal of Medical Internet Research

Date Submitted: Jun 24, 2020
Open Peer Review Period: Jun 24, 2020 - Aug 19, 2020
(closed for review but you can still tweet)

NOTE: This is an unreviewed Preprint

Warning: This is a unreviewed preprint (What is a preprint?). Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn (a note "no longer under consideration" will appear above).

Peer-review me: Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period (in this case, a "Peer-Review Me" button to sign up as reviewer is displayed above). All preprints currently open for review are listed here. Outside of the formal open peer-review period we encourage you to tweet about the preprint.

Citation: Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author).

Final version: If our system detects a final peer-reviewed "version of record" (VoR) published in any journal, a link to that VoR will appear below. Readers are then encourage to cite the VoR instead of this preprint.

Settings: If you are the author, you can login and change the preprint display settings, but the preprint URL/DOI is supposed to be stable and citable, so it should not be removed once posted.

Submit: To post your own preprint, simply submit to any JMIR journal, and choose the appropriate settings to expose your submitted version as preprint.

Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.

The effects of online group mindfulness training on stress and sleep quality during the COVID-19 pandemic in Singapore: a retrospective equivalence trial

  • Julian Lim; 
  • Zaven Leow; 
  • Jason Ong; 
  • Ly-Shan Pang; 
  • Eric Lim; 



The COVID-19 pandemic has had a negative impact on psychological health. Mindfulness training, which helps individuals attend to the present moment with a non-judgmental attitude, improves sleep and reduces stress in regular times, and may be relevant in mitigating harmful health consequences during acute crises. However, restrictions may necessitate this training being delivered online, rather than in in-person group settings.


The objective of our study was to establish equivalence of mindfulness interventions delivered via videoconferencing during the COVID-19 pandemic with similar programs delivered in person.


Data from an ongoing study were used for this retrospective equivalence trial. Participants were recruited (with no exclusion criteria) from enrollees in mindfulness courses at a local charity organization promoting mental wellness. Three groups were created, two that received their training during the period of the COVID-19 pandemic (in-person (N = 36) and videoconferencing (N = 38)), and a second control group of participants tested before the pandemic (N = 86). Primary outcomes were self-reported stress and sleep quality. Baseline levels, and changes in these variables due to mindfulness training were compared among the groups using analysis of covariance and two one-sided t-tests.


Perceived stress and sleep quality did not differ significantly between groups at baseline. Mindfulness training significantly reduced stress in all three groups, and this effect was statistically equivalent for videoconferencing compared to in-person training. Sleep quality improved significantly in the pre-pandemic group, but in neither of the groups during the pandemic. Participants reported shorter times to initiate sleep following mindfulness training pre-pandemic, but not during the pandemic. Course attendance was high and equivalent across the online and comparison groups, and participants engaged in marginally more daily practice in the online condition.


Online mindfulness training via videoconferencing may be a useful intervention for stress reduction but not sleep improvement during times when traditional in-person training is not feasible. Clinical Trial: The aims for this study were retrospectively registered as part of an ongoing protocol at with registration number NCT04417153


Please cite as:

Lim J, Leow Z, Ong J, Pang L, Lim E

The effects of online group mindfulness training on stress and sleep quality during the COVID-19 pandemic in Singapore: a retrospective equivalence trial

JMIR Preprints. 24/06/2020:21757

DOI: 10.2196/preprints.21757


Download PDF

Request queued. Please wait while the file is being generated. It may take some time.

© The authors. All rights reserved. This is a privileged document currently under peer-review/community review (or an accepted/rejected manuscript). Authors have provided JMIR Publications with an exclusive license to publish this preprint on it's website for review and ahead-of-print citation purposes only. While the final peer-reviewed paper may be licensed under a cc-by license on publication, at this stage authors and publisher expressively prohibit redistribution of this draft paper other than for review purposes.