Researchers emphasize that these findings support the use of Tai Chi as a way to manage chronic insomnia in the long term in middle-aged and older adults.
Chronic insomnia is one of the most common sleep disorders among middle-aged and older adults and has been linked to an increased risk of cardiovascular disease, psychological disorders, and cognitive impairment.
Current treatments:
Cognitive behavioral therapy (CBT) is considered the optimal treatment for chronic insomnia, but access to it is often limited due to high costs and a shortage of specialized therapists.
Previous studies have also shown the benefits of Tai Chi in middle-aged and older adults with insomnia, but direct comparisons with effective treatments such as cognitive behavioral therapy have been few.
To fill this gap, researchers sought to assess whether Tai Chi is equivalent to (“non-inferior to”) cognitive behavioral therapy for insomnia (CBT-I) in managing chronic insomnia in middle-aged and older adults.
Study design and participant details:
The results are based on data from 200 Chinese adults aged 50 years or older, diagnosed with chronic insomnia and enrolled in a research center in Hong Kong between May 2020 and July 2022.
Participants were able to walk without assistance, did not suffer from chronic diseases that could affect sleep, did not participate in regular aerobic or mind-body exercises, had not previously received cognitive behavioral therapy for pain, and did not work shifts.
Participants were randomly assigned to receive either Tai Chi exercises or cognitive behavioral therapy for insomnia, each group consisting of one-hour group sessions, held twice a week, for a total of 24 sessions.
What’s in the results?
At the beginning of the trial, both groups showed moderate levels of insomnia severity.
In the third month, the Tai Chi group showed a decrease of 6.67 points in the “Insomnia Severity Index” scores, while the cognitive behavioral therapy for insomnia group experienced a decrease of 11.19 points, leading to a difference between the groups of 4.52 points.
However, in the fifteenth month, the decrease in the Tai Chi and cognitive behavioral therapy for pain groups reached 9.51 and 10.18 points, respectively, with a difference between the groups of 0.68 points. At this point, Tai Chi was considered less important than cognitive behavioral therapy for pain because the upper limit was within the non-inferiority margin.
Tai Chi exercises and cognitive behavioral therapy for insomnia also showed similar benefits in personal sleep quality measures, quality of life, mental health, and level of physical activity. No side effects occurred during the intervention period.
The authors acknowledge that the positive effects of Tai Chi may be partially related to participants’ continued exercise after the interventions ended, and state that further studies are needed to determine whether the benefits of Tai Chi can be applied in other countries or regions with different demographics.
However, they concluded that “our study supports Tai Chi as an alternative therapeutic approach for the long-term management of chronic insomnia in middle-aged and older adults.”
