Tai chi exercise alleviates depressive symptoms and insomnia in older adults

Abstract

INTRODUCTION:Depressive mood is often associated with sleep disorders. This study examined the effects of tai chi on improving sleep and mood in insomniac elderly with depressive symptoms. METHODS: In this three-arm, single-blinded, randomised controlled trial, we recruited Chinese adults aged ≥ 60 years with chronic insomnia (diagnosed with Diagnostic and Statistical Manual of Mental Disorders, Fifth edition) and depressive symptoms (depression score of hospital anxiety and depression score or D-HADS ≥ 8) in Hong Kong community. Written informed consent was obtained before the study began. All experimental procedures received human ethics approval (HSEARS20120923002). Participants were randomly assigned to either control group (received no intervention), conventional exercise group (received 12-week generic exercise intervention three sessions weekly) or tai chi group (received 12-week tai chi intervention three sessions weekly). The primary endpoints were the remission of chronic insomnia and the change in D-HADS after 12-week post-randomization. Data were analysed by Chi-square test and generalized linear model using time and intervention as main effects with baseline as covariate. Pairwise comparison was conducted by closed test procedure. This study was registered on ClinicalTrials.gov (NCT02260843). RESULTS: Between February 2014 and August 2016, 73 Chinese elders were randomly assigned to control (n=23), conventional exercise (n=24) or tai chi groups (n=26). After 12 weeks post-randomization, the remission rate of chronic insomnia of control, conventional exercise and tai chi groups were 0% (0 participants), 17% (4 participants) and 23% (6 participants), respectively. The remission rates of tai chi (P=0.014) and conventional exercise (P=0.041) groups were significantly higher than the control group. Main effect of intervention (P=0.035) was observed in D-HADS. Tai chi group (-32% in D-HADS) showed a significant larger alleviation in depressive symptoms compared with control group (-12% in D-HADS) (P=0.035). The D-HADS of conventional exercise group was reduced by 23%, however the improvement of conventional exercise group was not significantly greater than the control group. CONCLUSION: These data demonstrated that a 12-week tai chi intervention alleviates insomnia and depressive mood in elderly with insomnia and depressive symptoms. Future study with a larger sample size is needed to determine the effectiveness of 12-week exercise intervention.