ADVERTISEMENT
CURRENT ISSUE
MAY 2016
KINDLE EDITION



SEARCH JOURNAL ARCHIVES


SEARCH PUBMED


MANUSCRIPT SUBMISSIONS


SUBSCRIBE TO SLEEP

CONTINUING MEDICAL EDUCATION


ADVERTISE WITH US


ABOUT SLEEP

ABSTRACT SUPPLEMENTS


ACCEPTED PAPERS
Bookmark and Share         RSS Feed

VOLUME 37, ISSUE 09

CBT VS. TAI CHI FOR LATE LIFE INSOMNIA AND INFLAMMATORY RISK
Cognitive Behavioral Therapy vs. Tai Chi for Late Life Insomnia and Inflammatory Risk: A Randomized Controlled Comparative Efficacy Trial

http://dx.doi.org/10.5665/sleep.4008

Michael R. Irwin, MD1; Richard Olmstead, PhD1; Carmen Carrillo, MPH1; Nina Sadeghi, BS1; Elizabeth C. Breen, PhD1; Tuff Witarama, BS1; Megumi Yokomizo, BS1; Helen Lavretsky, MD1; Judith E. Carroll, PhD1; Sarosh J. Motivala, PhD1; Richard Bootzin, PhD2; Perry Nicassio, PhD1

1University of California, Los Angeles – Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, CA; 2University of Arizona, Department of Psychology, Tucson, AZ



  Expand  Table of Contents    
Text size:  

Study Objectives:

To investigate the comparative efficacy of cognitive behavioral therapy (CBT), Tai Chi Chih (TCC), and sleep seminar education control (SS) on the primary outcome of insomnia diagnosis, and secondary outcomes of sleep quality, fatigue, depressive symptoms, and inflammation in older adults with insomnia.

Design:

Randomized controlled, comparative efficacy trial.

Setting:

Los Angeles community.

Patients:

123 older adults with chronic and primary insomnia.

Interventions:

Random assignment to CBT, TCC, or SS for 2-hour group sessions weekly over 4 months with follow-up at 7 and 16 months.

Measurements:

Insomnia diagnosis, patient-reported outcomes, polysomnography (PSG), and high-sensitivity C-reactive protein (CRP) levels.

Results:

CBT performed better than TCC and SS in remission of clinical insomnia as ascertained by a clinician (P < 0.01), and also showed greater and more sustained improvement in sleep quality, sleep parameters, fatigue, and depressive symptoms than TCC and SS (all P values < 0.01). As compared to SS, CBT was associated with a reduced risk of high CRP levels (> 3.0 mg/L) at 16 months (odds ratio [OR], 0.26 [95% CI, 0.07–0.97] P < 0.05). Remission of insomnia was associated with lower levels of CRP (P < 0.05) at 16 months. TCC was associated with improvements in sleep quality, fatigue, and depressive symptoms as compared to SS (all P's < 0.05), but not insomnia remission. PSG measures did not change.

Conclusions:

Treatment of late-life insomnia is better achieved and sustained by cognitive behavioral therapies. Insomnia treatment and remission reduces a marker of inflammatory risk, which has implications for cardiovascular morbidity and diabetes observed with sleep disturbance in epidemiologic surveys.

Clinical Trial Registration:

ClinicalTrials.gov, NCT00280020

Citation:

Irwin MR, Olmstead R, Carrillo C, Sadeghi N, Breen EC, Witarama T, Yokomizo M, Lavretsky H, Carroll JE, Motivala SJ, Bootzin R, Nicassio P. Cognitive behavioral therapy vs. Tai Chi for late life insomnia and inflammatory risk: a randomized controlled comparative efficacy trial. SLEEP 2014;37(9):1543-1552.

Expand  Table of Contents
ADVERTISEMENT
Classifieds View SLEEP 2011 Poster Presentations Online