Tai Chi Effective, Affordable Alternative to CBT-I for Insomnia in Breast Cancer Survivors

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The practice of tai chi may provide an alternate treatment for insomnia in breast cancer survivors.
The practice of tai chi may provide an alternate treatment for insomnia in breast cancer survivors.

Tai chi, a slow-moving form of meditation, is as effective as cognitive behavioral therapy for insomnia (CBT-I) for the treatment of insomnia in breast cancer survivors. Approximately 30% of breast cancer survivors suffer from insomnia, which may place them at higher risk for depression, fatigue, and a heightened risk of disease.1,2

The worry about falling asleep makes it even harder for many people suffering from insomnia to fall asleep. For this reason, cognitive behavioral therapy is often used to treat insomnia. CBT-I trains patients to identify and actively change negative thoughts. However, the number of trained cognitive therapy professionals is limited, and the therapy can be expensive for some patients.

Tai chi offers an alternative option that can be practiced at a low cost in community settings such as libraries, community centers, or at parks. For the technology savvy patient, there are even free instructional videos online. An earlier study found that tai chi relaxed the body, slowed breathing, and reduced inflammation in breast cancer survivors, which may in turn lower the risk of relapse. Researchers expanded on this by comparing the effectiveness of tai chi with cognitive behavioral therapy in relieving insomnia.

For this study, the investigators enrolled 90 breast cancer survivors aged 42 to 83 years who reported having trouble sleeping 3 or more times per week and also reported feeling depressed or fatigued during the day. The participants were divided into 2 groups. One group practiced a form of tai chi called tai chi chih. The second group practiced CBT-I. Both groups attended weekly sessions for 3 months and were evaluated for a total of 12 months. Approximately half of the participants in each group, 46.7% in the tai chi group and 43.7% in the CBT-I group, showed improvement after 15 months.

"Breast cancer survivors often don't just come to physicians with insomnia. They have insomnia, fatigue, and depression," said Michael Irwin, MD, professor of psychiatry at University of California Los Angeles, director of the Cousins Center for Psychoneuroimmunology at the Semel Institute for Neuroscience and Human Behavior, and lead investigator of the study. "And this intervention, tai chi, impacted all those outcomes in a similar way, with benefits that were as robust as the gold standard treatment for insomnia."

References

1. Irwin MR, Olmstead R, Carrillo C, et. al. Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial. The Journal of Clinical Oncology. 2017 May 10. doi: 10.1200/JCO.2016.71.0285 [Epub ahead of print]

2. University of California – Los Angeles. Tai chi relieves insomnia in breast cancer survivors [news release]. Los Angeles, CA: UCLA; May 10, 2017. https://www.eurekalert.org/pub_releases/2017-05/uoc--tcr050917.php. Accessed June 1, 2017.

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