Tai Chi Qigong Improves Sleep in Older Adults with Cognitive Impairment

by | Apr 8, 2019 | 2016, Aging, Brain Health, Cognitive Health, Sleep

Written by Jessica Patella, ND. This study demonstrates the benefits of tai chi Qigong exercise in improving sleep quality among older adults with cognitive impairment.

tai chiCognitive impairment refers to a large range of reduced functioning in remembering, learning, concentrating and making decisions 1,2. At the mild end of the spectrum these changes can occur but without affecting the individual’s daily life, at the other end the person may lose their ability to talk, write or live independently 1,2. An estimated 16 million Americans suffer from cognitive impairment and it is a growing public health concern, especially with the Baby Boomer population 2. One of the biggest complaints in individuals with cognitive impairment is sleep impairment, affecting up to 25% with the diagnosis 1,3. Recent research found practicing tai chi qigong improved sleep quality in older adults with cognitive impairment 1.

Degeneration of the brain in cognitive impairment affects the parts of the brain that regulate the sleep-wake cycle. The most common disturbances are day-night sleep pattern reversals and frequent night-time waking 1,4. Conventional treatments typically include pharmacological agents, but the biggest negative side effects are drowsiness, dizziness, unsteadiness and falls, which are followed by another host of complications if experienced 1,5.

Tai chi qigong (TCQ) is a repetition of simple movements, which helps learning and retention and has shown some improvement in sleep quality in previous research 1,6. The participants in the study were older adults (62-97 y/o) with cognitive impairment (MMSE scores: 15-26; mean score 23.1) that suffered from sleep disturbances 1.

A total of 52 participants were randomly divided to either the tai chi qigong (TCQ) group (n=27) or the control group (n=25). Participants in the TCQ group attended a 60-minute TCQ session, twice a week for 2-months led by a TCQ instructor. Participants were also encouraged to self-practice TCQ and were given a DVD, pictures of the 10 movements and a self-recording logbook. In order to have a “group effect” the control group met once a week for a health talk, but no information about sleep or physical activity was included in these talks 1.

The average attendance rate at the TCQ classes over the 2-months was 70% and the following results were observed:

  • At 2 months an improving trend was observed in the TCQ group compared to placebo for sleep quality, although it did not reach statistical significance; although, significant improvement was seen in the TCQ group for mental health (short form-12 mental health; P<0.001).

At a 6-month follow up, the following reached statistical significance in improvement in the TCQ group only:

  • Sleep Quality (Chinese Pittsburg Sleep Quality Index (CPSQI) global score; P=0.004)
  • Sleep Duration (CPSQI subscale; P=0.004), with an average increase by 48 minutes
  • Habitual Sleep Efficiency (CPSQI subscale; P=0.002), with an average improvement of 9.1%

The TCQ participants also reported better sleep quality and a better quality of life than the control group and asked to continue TCQ after the study period. In conclusion, the low-intensity tai chi qigong exercise showed improvements in sleep quality and mental health in older adults with cognitive decline 1. However, this was a small pilot study without an adequate control group. A more comprehensive study needs to be conducted to confirm results 1.

Source: Chan, Aileen WK, Doris SF Yu, K. C. Choi, Diana TF Lee, Janet WH Sit, and Helen YL Chan. “Tai chi qigong as a means to improve night-time sleep quality among older adults with cognitive impairment: a pilot randomized controlled trial.” Clinical interventions in aging 11 (2016): 1277.

© 2016 Chan et al. This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/).

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Posted April 8, 2019.

Jessica Patella, ND, is a naturopathic physician specializing in nutrition and homeopathic medicine and offers a holistic approach to health. She earned her ND from Southwest College of Naturopathic Medicine in Tempe, AZ, and is a member of the North Carolina Association of Naturopathic Physicians. Visit her website at www.awarenesswellness.com.

References:

  1. Chan AW, Yu DS, Choi K, Lee DT, Sit JW, Chan HY. Tai chi qigong as a means to improve night-time sleep quality among older adults with cognitive impairment: a pilot randomized controlled trial. Clinical interventions in aging. 2016;11:1277.
  2. Control CfD, Prevention. Cognitive impairment: A call for action, now. CDC, Atlanta, GA. 2011.
  3. Rose KM, Lorenz R. Sleep disturbances in dementia: What they are and what to do. Journal of gerontological nursing. 2012;36(5):9-14.
  4. Roth HL. Dementia and sleep. Neurol Clin. 2012;30(4):1213-1248.
  5. Holbrook AM, Crowther R, Lotter A, Cheng C, King D. Meta-analysis of benzodiazepine use in the treatment of insomnia. CMAJ : Canadian Medical Association journal = journal de l’Association medicale canadienne. 2000;162(2):225-233.
  6. Tadros G, Ormerod S, Dobson-Smyth P, et al. The management of behavioural and psychological symptoms of dementia in residential homes: does Tai Chi have any role for people with dementia? Dementia (London, England). 2013;12(2):268-279.