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Insomnia, Sleep Quality & Tai Chi

Journal of the American Geriatrics Society

Volume 52 Issue 6 Page 892 - June 2004


Tai Chi and Self-Rated Quality of Sleep and Daytime Sleepiness in Older Adults: A Randomized Controlled Trial

Fuzhong Li, PhD*, K. John Fisher, PhD*, Peter Harmer, PhD Dainis Irbe, MD , Robert G. Tearse, MD , and Cheryl Weimer, BS*

Objectives: To determine the effectiveness of tai chi on self-rated sleep quality and daytime sleepiness in older adults reporting moderate sleep complaints.

Design: Randomized, controlled trial with allocation to tai chi or exercise control.

Setting: General community.

Participants: One hundred eighteen women and men aged 60 to 92.

Intervention: Participants were randomized into tai chi or low-impact exercise and participated in a 60-minute session, three times per week, for 24 consecutive weeks.

Measurements: Primary outcome measures were the seven subscales of the Pittsburgh Sleep Quality Index (PSQI), PSQI global score, and Epworth Sleepiness Scale (ESS). Secondary outcome measures were physical performance (single leg stand, timed chair rise, 50-foot speed walk) and 12-item short form (SF-12) physical and mental summary scores.

Results: Tai chi participants reported significant improvements in five of the PSQI subscale scores (sleep quality, sleep-onset latency, sleep duration, sleep efficiency, sleep disturbances) (P<.01), PSQI global score (P=.001), and ESS scores (P=.002) in comparison with the low-impact exercise participants. Tai chi participants reported sleep-onset latency of about 18 minutes less per night (95% confidence interval (CI)= 28.64 to 7.12) and sleep duration of about 48 minutes more per night (95% CI=14.71 82.41) than low-impact exercise participants. Tai chi participants also showed better scores in secondary outcome measures were physical performance (single leg stand, timed chair rise, 50-foot speed walk) and 12-item short form (SF-12) physical and mental summary scores.

Conclusion: Older adults with moderate sleep complaints can improve self-rated sleep quality through a 6-month, low- to moderate-intensity tai chi program. Tai chi appears to be effective as a nonpharmacological approach to sleep enhancement for sleep-disturbed elderly individuals.

Tai Chi to improve sleep in older patients

American Family Physician, March 15, 2005 by Caroline Wellbery

. . . Of the 118 eligible participants, 62 were randomized to tai chi and 56 to low-impact exercise. Tai chi participants had significant improvement in subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbances, and sleep dysfunction, and improvements in the ESS scale. The low-impact exercise group did not have any improvements in these areas.

The Mysterious 'Medication' of Meditation

By Jeanie Lerche Davis, WebMD Medical News

Meditation-type exercises are "virtually curative of tension-related pain like tension headache. It's vitally important in PMS, infertility, hot flashes, insomnia," Benson says.

Regina's doctor, Stan Chapman, PhD, tells WebMD because all relaxation methods involve internal focus and putting distracting thoughts aside, "they can be effective in reducing pain." Chapman is a pain therapy specialist, psychologist, and professor at Emory University School of Medicine in Atlanta. "There's a lot of evidence in the research literature that pain tends to be worse when people are anxious, or when their muscles are tight."

Relaxation methods also help with sleep, a major issue for people with pain. "Many medications people use for sleep have untoward side effects, like carryover drowsiness during the day which affects their ability to function, remember, or drive, which is very critical to people," Chapman tells WebMD.

But in a busy world, if pain relief is not at stake, are people making time to meditate?

Schneider says that because meditation is a very natural activity, people easily adopt it as a routine. He reports that in his blood pressure study, 80% to 90% of people continued doing their daily meditation several months after the study.

"The jury is in on this; it's not even a question that it works," says cardiologist Paul Robinson, MD, of Emory University School of Medicine. But he has met some resistance.

Meditation has helped some of his patients, he says, but "they have to be agreeable to the technique and willing to go through what it takes to do meditation properly. That's one of the drawbacks, because in this country, many people don't understand it and don't want to take time to do it." While meditation will reduce some risk factors, like blood pressure and excessive heart rate, you still have to watch cholesterol, diet, exercise, says Robinson. Gordon tells WebMD that aside from the health benefits, meditation changes the way you look at the world, the way you live your life, and "that's quite important." Benson says yoga, tai chi, Lamaze breathing, and repetitive prayer such as the rosary can do the same. "They all share this common physiology," he says. "Repetition is key to creating the response. ? So it could be a mantra; it could be a prayer; it could be a repetitive muscular activity. The other feature is, when other thoughts come to mind when you do a repetition, simply let them go and come back to the repetition.

The bottom line is that any condition that's caused or exacerbated by stress can be alleviated, says Benson. "So with 60% to 90% of visits to physicians being in the mind-body, stress realm, you can see why this has such legion effects. Anxiety, mild and moderate depression, anger and hostility, hypertension, cardiac irregularities -- all forms of pain are made worse by stress. And that's why the relaxation response is useful."

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