When I was in college, I took a class in Tai Chi Chih (TCC). Unbelievably, that was considered a physical education elective and it was like no other class in that department. As a pre-med student and animal physiology undergraduate, it was a tremendous stress reducer to attend that twice each week.
For those not familiar with this therapy, TCC is a movement meditation and is considered a Chinese martial art form practiced for both its defense training and its health benefits. A recent study noted in the Journal of Clinical Oncology found that it could be as effective as cognitive behavioral therapy (CBT) for improving insomnia among survivors of breast cancer.1
Studies have indicated that up to 30% of breast cancer survivors suffer from insomnia, and that CBT is the customary treatment. The purpose of this study was to determine if TCC, a mind-body intervention that consists of slow physical activity and relaxation, could produce similar outcomes as can CBT.
The study was partially blinded and involved 90 breast cancer survivors with insomnia to participate. In this study, insomnia was defined as sleep difficulty three times or more per week for longer than 3 months. Primary outcome was insomnia treatment response at 15 months using the Pittsburgh Sleep Quality Index. Secondary outcomes were clinician-assessed remission of insomnia; sleep quality; total sleep time, sleep onset latency, sleep efficiency, and awake after sleep onset, derived from sleep diaries; polysomnography; and symptoms of fatigue, sleepiness, and depression.
Insomnia remission was similar between groups. The proportion of participants who showed insomnia treatment response at 15 months was in 43.7% of patients in the CBT arm and 46.7% in the TCC arm. For secondary outcomes, insomnia remission was 46.2% and 37.9% in CBT and TCC, respectively.
Future research should focus on fully blinded studies with less bias than other studies I was able to find on this subject. However, there is modest evidence in Chinese studies that quality of life is improved for cancer patients and that it can safely be added as an adjunct therapy for patients in treatment and survivorship.2
We all have patients that have symptoms with treatment or anxiety about their diagnosis. Many cancer centers have now included complementary therapies such as yoga, nutrition, and Reiki as part of the healing journey towards survivorship. Adding Tai Chi Chih to these programs may help our patients sleep better and remain focused on the future.
- 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. J Clin Oncol. 2017 May 10:JCO2016710285.
- Tao W, Luo X, Cui B, et al. Practice of traditional Chinese medicine for psycho-behavioral intervention improves quality of life in cancer patients: A systematic review and meta-analysis. Oncotarget. 2015 Nov 24; 6(37): 39725–39739.