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Tai Chi Comparable to the Gold Standard for Treating Insomnia in Breast Cancer Survivors

May 23, 2017 -
Several researchers from University of California Los Angeles compared Cognitive behavioral therapy for insomnia (CBT-I), the gold standard for behavioral treatment of insomnia, and Tai Chi Chih (TCC), a movement meditation, for the treatment of insomnia in survivors of breast cancer.

This was a randomized, partially blinded, non-inferiority trial that involved survivors of breast cancer with insomnia who were recruited from the Los Angeles community from April 2008 to July 2012. After a 2-month phase-in period with repeated baseline assessment, participants were randomly assigned to 3 months of CBT-I or TCC and evaluated at months 2, 3 (post-treatment), 6, and 15 (follow-up).

Primary outcome was insomnia treatment response, which is marked clinical improvement of symptoms by the Pittsburgh Sleep Quality Index-at 15 months. Secondary outcomes included clinician-assessed remission of insomnia; sleep quality; and symptoms of fatigue, sleepiness, and depression.

Of 145 participants who were screened, 45 were randomly assigned to the CBT-I group and another 45 to the TCC group. The proportion of participants who showed insomnia treatment response at 15 months was 43.7% and 46.7% in CBT-I and TCC, respectively. Tests of non-inferiority showed that TCC was non-inferior to CBT-I at 15 months and at months 3 and 6. For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT-I and TCC, respectively. CBT-I and TCC groups showed robust improvements in sleep quality, sleep diary measures, and related symptoms.

Conclusion: CBT-I and TCC produce clinically meaningful improvements in insomnia. TCC, a mindful movement meditation, was found to be statistically non-inferior to CBT-I. This study is published in the May, 2017 issue of Journal of clinical oncology.




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