New UCLA research shows that tai chi, a form of slow-moving meditation, is just as effective as cognitive behavioral therapy, which has been considered the “gold standard” treatment, with both showing enduring benefits over one year.
While cognitive behavioral therapy treats insomnia, it’s too expensive for some people and there is a shortage of trained professionals in the field, said Dr. Michael Irwin, the study’s lead author and a UCLA professor of psychiatry.
“Because of those limitations, we need community-based interventions like tai chi,” said Irwin, who is also director of the Cousins Center for Psychoneuroimmunology at the Semel Institute for Neuroscience and Human Behavior. Free or low-cost tai chi classes are often offered at libraries, community centers, or outdoors in parks.
In previous research, Irwin and colleagues found that tai chi, which relaxes the body and slows breathing, reduced inflammation in breast cancer survivors with the potential to lower risk for disease including cancer recurrence.
Irwin MR, Olmstead R, Carrillo C, Sadeghi N, Nicassio P, Ganz PA, Bower JE.
J Clin Oncol. 2017 May 10:JCO2016710285. doi: 10.1200/JCO.2016.71.0285. [Epub ahead of print]
Purpose Cognitive behavioral therapy for insomnia (CBT-I) and Tai Chi Chih (TCC), a movement meditation, improve insomnia symptoms. Here, we evaluated whether TCC is noninferior to CBT-I for the treatment of insomnia in survivors of breast cancer. Patients and Methods This was a randomized, partially blinded, noninferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up). Primary outcome was insomnia treatment response-that is, marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index-at 15 months. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression. Results Of 145 participants who were screened, 90 were randomly assigned (CBT-I: n = 45; TCC: n = 45). The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of noninferiority showed that TCC was noninferior to CBT-I at 15 months ( P = .02) and at months 3 ( P = .02) and 6 ( P < .01). For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01), but not polysomnography, with similar improvements in both groups.
Conclusion CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically noninferior to CBT-I, the gold standard for behavioral treatment of insomnia.
PMID: 28489508 DOI: 10.1200/JCO.2016.71.0285