Tai Chi Improves Sleep Quality in Healthy Adults and Patients with Chronic Conditions: A Systematic Review and Meta-analysis
|Gowri Raman1, Yuan Zhang2, Vincent J Minichiello3, Carolyn D’Ambrosio4 and Chenchen Wang5*|
|1Center for Clinical Evidence Synthesis, Institute for Clinical Research and Health Policy Studies, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA|
|2School of Nursing, University of Massachusetts, Lowell, MA, USA|
|3Department of Family Medicine, University of Wisconsin, Madison, WI, USA|
|4Pulmonary, Critical Care and Sleep Medicine Division, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA|
|5Center for Integrative Medicine, Division of Rheumatology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA|
|Corresponding Author :||Chenchen Wang
Division of Rheumatology
Tufts Medical Center, Box 406
Tufts University School of Medicine Boston
MA 02111, USA
E-mail: [email protected]
|Received August 27, 2013; Accepted September 09, 2013; Published September 15, 2013|
|Citation: Raman G, Zhang Y, Minichiello VJ, D’Ambrosio C, Wang C (2013) Tai Chi Improves Sleep Quality in Healthy Adults and Patients with Chronic Conditions: A Systematic Review and Meta-analysis. J Sleep Disord Ther 2:141. doi:10.4172/2167-0277.1000141|
|Copyright: © 2013 Raman G, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
Background: Physical activity and exercise appear to improve sleep quality. However, the quantitative effects of Tai Chi on sleep quality in the adult population have rarely been examined. We conducted a systematic review and meta-analysis evaluating the effects of Tai Chi on sleep quality in healthy adults and disease populations.
Methods: Medline, Cochrane Central databases, and review of references were searched through July 31, 2013. English-language studies of all designs evaluating Tai Chi’s effect on sleep outcomes in adults were examined. Data were extracted and verified by 2 reviewers. Extracted information included study setting and design, population characteristics, type and duration of interventions, outcomes, risk of bias and main results. Random effect models meta-analysis was used to assess the magnitude of treatment effect when at least 3 trials reported on the same sleep outcomes.
Results: Eleven studies (9 randomized and 2 non-randomized trials) totaling 994 subjects published between 2004 and 2012 were identified. All studies except one reported Pittsburg Sleep Quality Index. Nine randomized trials reported that 1.5 to 3 hour each week for a duration of 6 to 24 weeks of Tai Chi significantly improved sleep quality (Effect Size, 0.89; 95% Confidence Interval [CI], 0.28 to 1.50), in community-dwelling healthy participants and in patients with chronic conditions. Improvement in health outcomes including physical performance, pain reduction, and psychological well-being occurred in the Tai Chi group compared with various controls.
Limitations: Studies were heterogeneous and some trials were lacking in methodological rigor.
Conclusions: Tai Chi significantly improved sleep quality in both healthy adults and patients with chronic health conditions, which suggests that Tai Chi may be considered as an alternative behavioral therapy in the treatment of insomnia. High-quality, well-controlled randomized trials are needed to better inform clinical decisions.