Tai chi or cognitive behavioural therapy for treating insomnia in middle aged and older adults: randomised non-inferiority trial

作者：Parco M. Siu, Danny J. Yu, Angus P. Yu, Francesco Recchia, Shirley Xin Li, R.N.Y. Chan, Dyt Fong, Derwin KC Chan, Stanley Sai‐chuen Hui, Ka‐Fai Chung, Jean Woo, Chenchen Wang, Michael R. Irwin · 发表于：BMJ · 年份：2025 · DOI：10.1136/bmj-2025-084320 · 被引用次数：7 · 研究领域：Sleep and related disorders、Sleep and Wakefulness Research、Balance, Gait, and Falls Prevention

OBJECTIVE: To assess whether tai chi is non-inferior to cognitive behavioural therapy for insomnia (CBT-I), the first line treatment, for managing chronic insomnia in middle aged and older adults. DESIGN: Randomised, assessor masked, non-inferiority trial. SETTING: A single research site in Hong Kong with participants recruited from the local community between 18 May 2020 and 14 July 2022. PARTICIPANTS: , fifth edition. INTERVENTIONS: Tai chi and CBT-I interventions were delivered in group format over three months, consisting of one hour sessions twice a week for a total of 24 sessions. MAIN OUTCOME MEASURES: The primary outcome was the change in perceived insomnia severity measured by the Insomnia Severity Index after the intervention (month 3) and at 12 month follow-up (month 15). To assess whether tai chi is non-inferior to CBT-I, a threshold of four points was used as the margin of non-inferiority. RESULTS: 200 participants were randomised (1:1) to receive tai chi (n=100) or CBT-I (n=100). The per protocol principle was adopted. At month 3, the tai chi group showed a reduction of 6.67 (95% confidence interval 5.61 to 7.73) in Insomnia Severity Index scores, while the CBT-I group had a reduction of 11.19 (10.06 to 12.32), resulting in a between group difference of 4.52 (-∞ to 5.81). Tai chi was deemed inferior to CBT-I at month 3 because the upper confidence limit exceeded the non-inferiority margin. At month 15, the reductions for tai chi and CBT-I were 9.51 (8.47 to 10.5...