Tai chi about as effective as CBT for long-term management of chronic insomnia
Cognitive behavioral therapy (CBT) was superior to tai chi in treating chronic insomnia at three months, but the interventions were equally as effective at 15 months, according to a trial of older patients in Hong Kong.
Tai chi was noninferior to cognitive behavioral therapy (CBT) for insomnia after 15 months in middle-age and older adults, a randomized trial in Hong Kong found.
Researchers randomized 100 patients with chronic insomnia who were at least 50 years of age to receive tai chi (77% female; mean age, 64.83 years) and 100 to receive CBT (84% female; mean age, 63.76 years). The study took place at a single site in Hong Kong in May 2020 to July 2022. Participants attended one-hour group sessions of the assigned intervention twice a week, for a total of 24 sessions. The primary outcome was change in perceived insomnia severity measured by the Insomnia Severity Index, with a threshold of four points was used as the margin of noninferiority. Findings were published by the BMJ on Nov. 26.
At three months, the tai chi group showed a reduction of 6.67 (95% CI, 5.61 to 7.73) in Insomnia Severity Index scores and the CBT group had a reduction of 11.19 (95% CI, 10.06 to 12.32), resulting in a between-group difference of 4.52. At month 15, the reductions for tai chi and CBT were 9.51 (95% CI, 8.47 to 10.54) and 10.18 (95% CI, 8.97 to 11.40), respectively, with a between-group difference of 0.68. Similarly, the rate of remission of insomnia was higher with CBT at month 3 (83.3% vs. 56.1%; P<0.001) but similar at month 15 (63.4% vs. 76.5%; P=0.067). No adverse events were reported, and results from the intention-to-treat analysis were consistent with per protocol findings, the study authors said. Adherence rates were similar for the tai chi and CBT groups (78.2% and 80.7%, respectively).
Limitations of the findings include uncertain generalizability to younger adults, the authors cautioned. They noted that additional research is needed to replicate results and determine if the benefits of tai chi can be applied to other demographics.
Overall, the study “supports the use of tai chi as an alternative approach for the long term management of chronic insomnia in middle aged and older adults,” the authors concluded.