Tai Chi Chih vs Cognitive Behavioral Therapy for Insomnia in Breast Cancer Survivors


Key Points

  • Tai Chi Chih was noninferior to cognitive behavior therapy in improving insomnia in breast cancer survivors.
  • Treatment response was observed in more than 40% of patients at 15 months, and both groups had significant improvements in sleep quality and insomnia symptoms.

In a study reported in the Journal of Clinical Oncology by Irwin et al, Tai Chi Chih, a form of movement meditation, was noninferior to insomnia-specific cognitive behavioral therapy in improving insomnia in breast cancer survivors.

Study Details

In the study, 90 patients with insomnia from the Los Angeles community were randomized to 3 months of Tai Chi Chih (n = 45) or cognitive behavioral therapy (n = 45) after a 2-month phase-in period with repeated baseline assessment. The cognitive behavioral therapy and Tai Chi Chih programs were delivered to groups of 7 to 10 patients in weekly 120-minute sessions. Patients were evaluated at study months 3, 6, and 15. The primary outcome measure was insomnia treatment response, defined as a decrease of ≥ 5 points on the Pittsburgh Sleep Quality Index, at 15 months.

Similar Improvements

Treatment response was observed in 46.7% of the Tai Chi Chih group vs 43.7% of the cognitive behavioral therapy group at 15 months. Noninferiority testing indicated that Tai Chi Chih was noninferior to cognitive behavioral therapy at 15 months (P = .02) and at 3 (P = .02) and 6 months (P < .01).

Among secondary outcome measures, clinician-assessed insomnia remission rates using the Diagnostic and Statistical Manual of Mental Disorders Text Revision (DSM-IV-TR) criteria at 15 months were 37.9% vs 46.2%, and both groups showed similar significant improvements in sleep quality, sleep diary measures, and related symptoms (all P < .01). No significant treatment effects for polysomnography were observed, with no differences found between groups on any polysomnographic measure.

The investigators concluded: “[Cognitive behavioral therapy for insomnia and Tai Chi Chih] produce clinically meaningful improvements in insomnia. [Tai Chi Chih], a mindful movement meditation, was found to be statistically noninferior to [cognitive behavioral therapy for insomnia], the gold standard for behavioral treatment of insomnia.”

The study was supported by grants from the National Institutes of Health and the Cousins Center for Psychoneuroimmunology.

Michael R. Irwin, MD, of the Cousins Center for Psychoneuroimmunology, University of California Los Angeles, is the corresponding author of the Journal of Clinical Oncology article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.