The effects of an integrated mindfulness-based tai chi chuan programme on sleep disturbance among community-dwelling elderly people: protocol for a randomized controlled trial

Sunny Ho-Wan Chan, Siu-Man Ng, Chong-Ho Yu, Ching-Man Chan, Shu-Mei Wang, Wai-Chi Chan, Sunny Ho-Wan Chan, Siu-Man Ng, Chong-Ho Yu, Ching-Man Chan, Shu-Mei Wang, Wai-Chi Chan

Abstract

Background: Many elderly individuals who experience sleep disturbances would consider complementary and alternative medicine as an alternative therapeutic option in light of the limitations of traditional treatments. Mindfulness-based interventions (MBIs) and Tai Chi Chuan (TCC) are two alternative forms of complementary and alternative medicine. They both share the common feature of a focus on breathing but represent distinct approaches with different mechanisms and philosophical orientations. The trial described in this protocol aims to evaluate the effects of an integrated form of mindfulness-based Tai Chi Chuan (MBTCC) programme and the underlying mechanisms of the beneficial effects over a 12-month follow-up.

Methods: The planned study is a four-armed randomized controlled trial with repeated measures. A total of 256 community-dwelling older adults with sleep problems will be recruited and randomized into four groups: (1) an MBTCC group, (2) an MBI group, (3) a TCC group, and (4) a sleep hygiene education (SHE) control group. The outcome measures in terms of insomnia severity, interoception, sleep-wake pattern, health status, rumination, and hyperarousal level will be collected at four time points: at baseline (T1), after the 8-week intervention (T2), 6 months after the intervention (T3), and 1 year after the intervention (T4). In addition, qualitative evaluation through focus group interviews will be conducted at the end of the 12-month assessment period (T4).

Discussion: This trial will illuminate the synergetic effect of combining both MBIs and TCC on optimizing improvements in sleep disturbance. The findings from this study can provide empirical support for this integrated treatment, which provides an alternative for healthcare professionals in elderly service to select appropriate practices to treat elderly people with sleep disturbance. It can further help to lessen the growing public health burden of sleep disturbances among the elderly living in the community.

Trial registration: ClinicalTrials.gov . NCT05396092 . Published on 24 May 2022.

Keywords: Community-dwelling elderly; Mind-body interventions; Mindfulness-based tai chi chuan; Randomized controlled trial; Sleep disturbance.

Conflict of interest statement

The authors declare that they have no competing interests.

© 2022. The Author(s).

Figures

Fig. 1
Fig. 1
Theoretical framework about the mechanisms of MBI and TCC in relation to sleep disturbances. MBI, mindfulness-based intervention; TCC, Tai Chi Chuan
Fig. 2
Fig. 2
Flow chart of the study. MBTCC, mindfulness-based Tai Chi Chuan; MBI, mindfulness-based intervention; TCC, Tai Chi Chuan; SHE, sleep hygiene education

References

    1. Silber MH. Clinical practice. Chronic insomnia. N Engl J Med. 2005;353:803–810. doi: 10.1056/NEJMcp043762.
    1. Morin CM, Benca R. Chronic insomnia. Lancet. 2012;379:1129–1141. doi: 10.1016/S0140-6736(11)60750-2.
    1. Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev. 2011;21:41–53. doi: 10.1007/s11065-010-9154-6.
    1. Cutler AJ. The role of insomnia in depression and anxiety: its impact on functioning, treatment, and outcomes. J Clin Psychiatry. 2016;77:e1010. doi: 10.4088/JCP.14076tx3c.
    1. Luo J, Zhu G, Zhao Q, Guo Q, Meng H, Hong Z, et al. Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai aging study. PLoS One. 2013;8:e81261. doi: 10.1371/journal.pone.0081261.
    1. Shallcross AJ, Visvanathan PD, Sperber SH, Duberstein ZT. Waking up to the problem of sleep: can mindfulness help? A review of theory and evidence for the effects of mindfulness for sleep. Curr Opin Psychol. 2019;28:37–41. doi: 10.1016/j.copsyc.2018.10.005.
    1. Lichstein KL, Nau SD, Wilson NM, Aguillard RN, Lester KW, Bush AJ, et al. Psychological treatment of hypnotic-dependent insomnia in a primarily older adult sample. Behav Res Ther. 2013;51:787–796. doi: 10.1016/j.brat.2013.09.006.
    1. Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Ann Intern Med. 2015;163:191–204. doi: 10.7326/M14-2841.
    1. Epstein DR, Sidani S, Bootzin RR, Belyea MJ. Dismantling multicomponent behavioral treatment for insomnia in older adults: a randomized controlled trial. Sleep. 2012;35:797–805. doi: 10.5665/sleep.1878.
    1. Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK, Fletcher ME, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med. 2011;171:887–895. doi: 10.1001/archinternmed.2010.535.
    1. Pearson N, Johnson L, Nahin R. Insomnia, trouble sleeping, and complementary and alternative medicine: analysis of the 2002 national health interview survey data. Arch Intern Med. 2006;166:1775–1782. doi: 10.1001/archinte.166.16.1775.
    1. Liu Y, Zhang J, Lam SP, Yu MWM, Li SX, Zhou J, et al. Help-seeking behaviors for insomnia in Hong Kong Chinese: a community-based study. Sleep Med. 2016;21:106–113. doi: 10.1016/j.sleep.2016.01.006.
    1. Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta Books; 1991.
    1. Osypiuk K, Thompson E, Wayne PM. Can tai chi and Qigong postures shape our mood? Toward an embodied cognition framework for mind-body research. Front Hum Neurosci. 2018;12:174. doi: 10.3389/fnhum.2018.00174.
    1. Kanen JW, Nazir R, Sedky K, Pradhan BK. The effects of mindfulness-based interventions on sleep disturbance: a meta-analysis. Adolesc Psychiatry. 2015;5:105–115. doi: 10.2174/2210676605666150311222928.
    1. Wong SYS, Zhang DX, Li CCK, Yip BHK, Chan DCC, Ling YM, et al. Comparing the effects of mindfulness-based cognitive therapy and sleep psycho-education with exercise on chronic insomnia: a randomised controlled trial. Psychother Psychosom. 2017;86:241–253. doi: 10.1159/000470847.
    1. Walther A, Lacker TJ, Ehlert U. Everybody was kung-fu fighting -- the beneficial effects of tai chi qigong and self-defense kung-fu training on psychological and endocrine health in middle aged and older men. Complement Ther Med. 2018;36:68–72. doi: 10.1016/j.ctim.2017.11.021.
    1. Wu W-W, Kwong E, Lan X-Y, Jiang X-Y. The effect of a meditative movement intervention on quality of sleep in the elderly: a systematic review and meta-analysis. J Altern Complement Med. 2015;21(9):509–519. doi: 10.1089/acm.2014.0251.
    1. Tsai PS, Wang SY, Wang M-Y, Su CT, Yang TT, Huang CJ, et al. Psychometric evaluation of the Chinese version of the Pittsburgh sleep quality index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14:1943–1952. doi: 10.1007/s11136-005-4346-x.
    1. Morin CM, Espie CA. Insomnia: a clinical guide to assessment and treatment. New York: Kluwer Academic/Plenum; 2003.
    1. Morin CM, Belleville G, Belanger L, Ivers H. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–608. doi: 10.1093/sleep/34.5.601.
    1. Mehling WE, Price C, Daubenmier JJ, Acree M, Bartmess E, Stewart A. The multidimensional assessment of interoceptive awareness (MAIA) PLoS One. 2012;7(11):e48230. doi: 10.1371/journal.pone.0048230.
    1. Lam CL, Tse EY, Gandek B. Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual Life Res. 2005;14:539–547. doi: 10.1007/s11136-004-0704-3.
    1. Trapnell PD, Campbell JD. Private self-consciousness and the five-factor model of personality: distinguishing rumination from reflection. J Pers Soc Psychol. 1999;76:284–304. doi: 10.1037/0022-3514.76.2.284.
    1. Pavlova M, Berg O, Gleason R, Walker F, Roberts S, Regestein Q. Self-reported hyperarousal traits among insomnia patients. J Psychosom Res. 2001;51:435–441. doi: 10.1016/S0022-3999(01)00189-1.

Source: PubMed

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