Improving sleep quality in older adults with moderate sleep complaints: A randomized controlled trial of Tai Chi Chih

Abstract

Study objectives: To determine the efficacy of a novel behavioral intervention, Tai Chi Chih, to promote sleep quality in older adults with moderate sleep complaints.

Design: Randomized controlled trial with 16 weeks of teaching followed by practice and assessment 9 weeks later. The main outcome measure was sleep quality, as assessed by the Pittsburgh Sleep Quality Index (PSQI).

Setting: General community at 2 sites in the US between 2001 and 2005.

Participants: Volunteer sample of 112 healthy older adults, aged 59 to 86 years.

Intervention: Random allocation to Tai Chi Chih or health education for 25 weeks.

Results: Among adults with moderate sleep complaints, as defined by PSQI global score of 5 or greater, subjects in the Tai Chi Chih condition were more likely to achieve a treatment response, as defined by PSQI less than 5, compared to those in health education (P < 0.05). Subjects in the Tai Chi Chih condition with poor sleep quality also showed significant improvements in PSQI global score (P < 0.001) as well as in the sleep parameters of rated sleep quality (P < 0.05), habitual sleep efficiency (P < 0.05), sleep duration (P < 0.01), and sleep disturbance (P < 0.01).

Conclusions: Tai Chi Chih can be considered a useful nonpharmacologic approach to improve sleep quality in older adults with moderate complaints and, thereby, has the potential to ameliorate sleep complaints possibly before syndromal insomnia develops.

Clinical trials registration: ClinicalTrials.gov Identifier: NCT00118885.

Figures

Figure 1

Participant flow and distribution of subjects in study.

Figure 2

Changes in Pittsburgh Sleep Quality Index (PSQI) global score from baseline (preintervention) to postintervention (16 weeks) and follow-up (25 weeks) in older adults. Health education, PSQI ≥ 5 (○); Tai Chi Chih, PSQI ≥ 5 (●); Health Education, PSQI

Figure 3

Changes in Pittsburgh Sleep Quality Index (PSQI) sleep-quality component score from baseline (preintervention) to postintervention (16 weeks) and follow-up (25 weeks) in older adults. Health education, PSQI ≥ 5 (○); Tai Chi Chih, PSQI ≥ 5 (●); Health Education, PSQI