Improve the Quality of Sleep with Tai Chi
By John M. de Castro, Ph.D.
“Tai Chi significantly improved sleep quality for healthy patients and those with chronic health conditions. Their physical performance and psychological well being improved compared with the control group. Along with better sleep, came a reduction in pain. “ – Balanced Life
Modern society has become more around-the-clock and more complex producing considerable pressure and stress on the individual. The advent of the internet and smart phones has exacerbated the problem. The resultant stress can impair sleep. Indeed, it is estimated that over half of Americans sleep too little due to stress. As a result, people today sleep 20% less than they did 100 years ago. Not having a good night’s sleep has adverse effects upon the individual’s health, well-being, and happiness. It has been estimated that 30 to 35% of adults have brief symptoms of insomnia, 15 to 20% have a short-term insomnia disorder, and 10% have chronic insomnia
Insomnia is more than just an irritant. Sleep deprivation is associated with decreased alertness and a consequent reduction in performance of even simple tasks, decreased quality of life, increased difficulties with memory and problem solving, increased likelihood of accidental injury including automobile accidents, and increased risk of dementia and Alzheimer’s disease. It also can lead to anxiety about sleep itself. This is stressful and can produce even more anxiety about being able to sleep. About 4% of Americans revert to sleeping pills. But these do not always produce high quality sleep and can have problematic side effects. So, there is a need to find better methods to treat insomnia. Mindfulness-based practices have been reported to improve sleep amount and quality and help with insomnia.
Tai Chi is an ancient mindfulness practice involving slow prescribed movements. It is gentle and completely safe, can be used with the elderly and sickly, is inexpensive to administer, can be performed in groups or alone, at home or in a facility or even public park, and can be quickly learned. In addition, it can also be practiced in social groups without professional supervision. This can make it fun, improving the likelihood of long-term engagement in the practice. Indeed, studies have shown that Tai Chi practice is effective in improving sleep. The evidence is accumulating. So, it makes sense to step back and summarize what has been learned.
In today’s Research News article “Tai Chi Chuan for Subjective Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7439202/ ) Si and colleagues review, summarize, and perform a meta-analysis of published randomized controlled trials of the effectiveness of Tai Chi in improving sleep quality. They identified 25 published randomized controlled with adults as participants.
They report that the published research studies found that Tai Chi practiced produced a significant improvement in sleep quality with moderate effect size. They report that the optimum effects were produced by practices that lasted 60 to 90 minutes. Tai Chi was effective in both healthy and clinical populations but it had its greatest effects on sleep in healthy populations. In addition, Tai Chi practice produced large significant improvements in the sleep quality of Asian participants but not American participants.
Importantly, the largest effects were seen in studies with low methodological quality while 8 studies with the highest methodological quality did not observe significant improvements in sleep quality. The primary differences between low and high methodological quality studies revolved around how much the participants knew about the study and its intentions. This suggests that participant expectancy factors may be very important here.
That participant expectancies may be driving the results is further reflected in the fact that the largest effects were present in Asian participants while they were not significant in American participants. Tai Chi has been practiced in Asia for centuries and is believed to be very beneficial. It has only recently been practiced in America and Americans are generally ignorant or skeptical of its benefits. Hence, Asian participants would be expected to have the largest participant expectancies of positive benefits and they were the only population showing significant effects.
In summary, the results suggest that 60 to 90 minutes of Tai Chi practice produce improvements in sleep quality in healthy and clinical populations. But there is a strong suspicion that participant expectancies of Tai Chi efficacy my be responsible for the effects. There is a need, then, for more tightly controlled studies to determine if Tai Chi and not participant bias is responsible for the established benefits.
So, improve the quality of sleep with Tai Chi.
“Tai chi was reported useful in alleviating insomnia, and when combined with qigong, it improved sleep dysfunction and depression.“ – Christina Seluzicki
CMCS – Center for Mindfulness and Contemplative Studies
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Si, Y., Wang, C., Yin, H., Zheng, J., Guo, Y., Xu, G., & Ma, Y. (2020). Tai Chi Chuan for Subjective Sleep Quality: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-based complementary and alternative medicine : eCAM, 2020, 4710527. https://doi.org/10.1155/2020/4710527
This review aims to investigate the efficacy of Tai Chi Chuan on subjective sleep quality among adults.
We systematically searched PubMed, Embase, Cochrane Library, Scopus, CNKI (China National Knowledge Infrastructure), and the Wanfang Database from their inception to August 2019 and identified 25 eligible studies that were published in both English and Chinese.
24 out of 25 studies were identified to be high-quality studies according to the PEDro scale. The pooled results confirmed that Tai Chi Chuan elicited moderate improvements in subjective sleep quality (SMD = −0.512, 95% CI [−0.767, −0.257], P < 0.001). Notably, Tai Chi Chuan yielded more significant effects on sleep quality among the healthy population (SMD = −0.684, 95% CI [−1.056, −0.311], P < 0.001) than the clinical population (SMD = −0.395, 95% CI [−0.742, −0.047], P=0.026) and more benefits among the Asian population (SMD = −0.977, 95% CI [−1.446, −0.508], P < 0.001) than the American population (SMD = −0.259, 95% CI [−0.624, 0.105], P=0.164). After controlling the methodological quality of studies, it has been noted that Asians could achieve the most significant sleep-promoting benefit when Tai Chi Chuan was practiced between 60 and 90 min per session.
Available data implied that subjective sleep quality was improved via Tai Chi training, but more thorough studies must be executed to ascertain our findings and optimize Tai Chi practices accordingly toward various populations.