Disturbance of sleep is common in the elderly. It directly produces impairments in daily activities. But, it also increases the risk for chronic disease and mortality in older adults. In particular insomnia appears to increase inflammation. Heightened markers of inflammations are associated with cardiovascular disease and diabetes and autoimmune diseases such as arthritis. In fact, inflammation is either directly or indirectly involved in nearly all diseases.
Chronic inflammation is the real problem. On the short term inflammation can be helpful in fighting off initial infection. But, if it continues over a prolonged period of time it can produce or exacerbate many health conditions. Since sleep disturbance in the elderly tends to be chronic and it increases inflammation it can be very detrimental to the individual’s health and thereby can increase mortality.
Obviously, it is important to the elderly to routinely get a good night’s sleep. In a previous post we discussed how insomnia affects older adults and contributes to decline in aging http://contemplative-studies.org/wp/index.php/2015/07/17/aging-healthily-sleeping-better-with-mindful-movement-practice/
In this post we reported that mindful movement practices such as Tai Chi was effective for the treatment of insomnia in the elderly. This study, however, did not compare mindful movements to other potential treatments and did not measure inflammation.
In today’s Research News article “Cognitive Behavioral Therapy vs. Tai Chi for Late Life Insomnia and Inflammatory Risk: A Randomized Controlled Comparative Efficacy Trial”
Irwin and colleagues demonstrated that indeed Tai Chi was effective for insomnia in older adults but that Cognitive Behavioral Therapy (CBT) was far superior, producing remission from insomnia in over half the participants treated with CBT compared to 30% for Tai Chi.
Importantly, Irwin and colleagues demonstrated that a marker of inflammation, C-reactive protein (CRP), was markedly reduced. CBT cut in half the proportion of participants with high inflammatory responses. In addition, the participants who had remission of insomnia had CRP levels that were nearly 50% lower. This is remarkable and indicates that CBT is highly effective in reducing not only insomnia but also the inflammatory response that frequently accompanies it. tai chi was also effective, but not to the same extent.
Although tai chi was not as effective as CBT it has marked advantages. CBT requires a formal treatment program with a trained therapist. This can be costly and inconvenient. Tai chi on the other hand can be engaged in without a therapist, at the convenience of the individual, and at virtually no cost. So, although CBT is superior in effectiveness, tai chi might be a better, more practical, alternative for many elderly.
So, it is important to treat insomnia in the elderly for their health and wellbeing. If practical choose Cognitive Behavioral Therapy but if that isn’t practical engage in tai chi practice.
CMCS – Center for Mindfulness and Contemplative Studies