PSYCH OpenIR  > 健康与遗传心理学研究室
Effects of Tai Chi or Exercise on Sleep in Older Adults With Insomnia A Randomized Clinical Trial
Siu, Parco M.1; Yu, Angus P.1; Tam, Bjorn T.2; Chin, Edwin C.1; Yu, Doris S.3; Chung, Ka-Fai4; Hui, Stanley S.5; Woo, Jean6; Fong, Daniel Y.3; Lee, Paul H.7; Wei, Gao X.8; Irwin, Michael R.9,10
First AuthorSiu, Parco M.
Contribution Rank8
Abstract

IMPORTANCE Previous studies that have shown tai chi to improve sleep were mainly based on subjective assessments, which might have produced results confounded by self-reporting bias. OBJECTIVE To compare the effectiveness of tai chi for improving sleep in older adults with insomnia with conventional exercise and a passive control group using actigraphy-based objective measurements. DESIGN, SETTING, AND PARTICIPANTS This randomized, 3-arm, parallel group, assessor-masked clinical trial was conducted at a single research unit in Hong Kong between August 2014 and August 2018. Eligible participants, aged 60 years or older and with chronic insomnia, were randomly allocated into tai chi training, exercise, and control groups. INTERVENTIONS 12-week tai chi training, 12-week conventional exercise, and no intervention control. MAIN OUTCOMES AND MEASURES Primary outcomes were measures taken from actigraphy sleep assessment. Secondary outcomes included remission of insomnia, insomnia treatment response, Pittsburgh Sleep Quality Index score, Insomnia Severity Index score, and self-reported sleep using a 7-day sleep diary. Assessments were performed at baseline, end of the intervention (postintervention), and 24 months after the intervention (follow-up). Data analysis was performed from September 2018 to August 2020. RESULTS A total of 320 participants (mean [SD] age, 67.3 [6.8] years; mean [SD] insomnia duration, 124.4 [134.5] months; 256 [80.0%] women) were randomly allocated into control (110 participants), exercise (105 participants), and tai chi (105 participants) groups and included in the data analysis. Compared with the control group, the exercise and tai chi groups showed improved sleep efficiency (exercise vs control: adjusted mean difference, +3.5%; 95% CI, 1.8-5.2; P < .001; tai chi vs control: adjusted mean difference, +3.4%; 95% CI, 1.6-5.1; P < .001) and reductions of wake time after sleep onset (exercise vs control: -17.0 minutes; 95% CI, -24.9 to -9.0; P < .001; tai chi vs control: -13.3 minutes; 95% CI, -21.3 to -5.2; P = .001) and number of awakenings (exercise vs control: -2.8 times; 95% CI, -4.0 to -1.6; P < .001; tai chi vs control: -2.2 times; 95% CI, -3.5 to -1.0; P < .001) as assessed by actigraphy at postintervention; although there were no significant differences between the exercise and tai chi groups. The actigraphy-assessed beneficial effects were maintained in both intervention groups at follow-up. CONCLUSIONS AND RELEVANCE Conventional exercise and tai chi improved sleep and the beneficial effects sustained for 24 months, although the absolute improvements in sleep parameters were modest. Improvements in objective sleep parameters were not different between the tai chi and exercise groups, suggesting that tai chi can be an alternative approach for managing insomnia.

2021-02-15
Language英语
DOI10.1001/jamanetworkopen.2020.37199
Source PublicationJAMA NETWORK OPEN
ISSN2574-3805
Volume4Issue:2Pages:14
Subtype实证研究
Indexed BySCI
Funding ProjectHealth and Medical Research Fund[11122361] ; Food and Health Bureau, Hong Kong SAR
PublisherAMER MEDICAL ASSOC
WOS KeywordCOMPARATIVE METAANALYSIS ; PRACTICE GUIDELINE ; AMERICAN ACADEMY ; QUALITY ; EXTENSION ; EFFICACY ; THERAPY ; LIFE
WOS Research AreaGeneral & Internal Medicine
WOS SubjectMedicine, General & Internal
WOS IDWOS:000619606600005
WoS QuartileQ1
Citation statistics
Cited Times:1[WOS]   [WOS Record]     [Related Records in WOS]
Document Type期刊论文
Identifierhttp://ir.psych.ac.cn/handle/311026/38605
Collection健康与遗传心理学研究室
Corresponding AuthorSiu, Parco M.
Affiliation1.Univ Hong Kong, Li Ka Shing Fac Med, Sch Publ Hlth, Div Kinesiol,Pokfulam, Hong Kong, Peoples R China
2.Concordia Univ, Dept Hlth Kinesiol & Appl Physiol, Montreal, PQ, Canada
3.Univ Hong Kong, Li Ka Shing Fac Med, Sch Nursing, Pokfulam, Hong Kong, Peoples R China
4.Univ Hong Kong, Li Ka Shing Fac Med, Dept Psychiat, Pokfulam, Hong Kong, Peoples R China
5.Chinese Univ Hong Kong, Fac Educ, Dept Sports Sci & Phys Educ, Hong Kong, Peoples R China
6.Chinese Univ Hong Kong, Fac Med, Dept Med & Therapeut, Hong Kong, Peoples R China
7.Hong Kong Polytech Univ, Fac Hlth & Social Sci, Sch Nursing, Hung Hom, Hong Kong, Peoples R China
8.Chinese Acad Sci, Inst Psychol, Beijing, Peoples R China
9.Univ Calif Los Angeles, Cousins Ctr Psychoneuroimmunol, Los Angeles, CA USA
10.Univ Calif Los Angeles, Dept Psychiat & Biobehav Sci, Los Angeles, CA 90024 USA
Recommended Citation
GB/T 7714
Siu, Parco M.,Yu, Angus P.,Tam, Bjorn T.,et al. Effects of Tai Chi or Exercise on Sleep in Older Adults With Insomnia A Randomized Clinical Trial[J]. JAMA NETWORK OPEN,2021,4(2):14.
APA Siu, Parco M..,Yu, Angus P..,Tam, Bjorn T..,Chin, Edwin C..,Yu, Doris S..,...&Irwin, Michael R..(2021).Effects of Tai Chi or Exercise on Sleep in Older Adults With Insomnia A Randomized Clinical Trial.JAMA NETWORK OPEN,4(2),14.
MLA Siu, Parco M.,et al."Effects of Tai Chi or Exercise on Sleep in Older Adults With Insomnia A Randomized Clinical Trial".JAMA NETWORK OPEN 4.2(2021):14.
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