Nights watching the clock tick by, waking up suddenly before dawn, days idling… For millions of people, insomnia has become a forced way of life. In France, between 15 and 20% of the population are affected by this disorder, with an increased risk of depression, cardiovascular disease or cognitive decline.
Faced with this chronic insomniadoctors mainly have cognitive-behavioral therapy (CBT) and limited courses of sleeping pills, the benefit of which often remains modest. A study published in the medical journal BMJ by the University of Hong Kong, however, shakes up this arsenal by showing that a gentle martial art,
tai chicould do at least as well as the reference psychotherapy in the long term. And the numbers speak for themselves.
Tai chi and chronic insomnia: what the BMJ study reveals
Hong Kong researchers started from a serious observation: chronic insomnia affects up to 22% of middle-aged and older adults worldwide, and its treatment costs around 150 billion dollars, or nearly 130 billion euros, each year in the United States. CBT is considered first-line treatment due to its effectiveness and lack of adverse effects, but access remains limited, with few trained therapists and high costs.
To test the effectiveness of tai chithe team recruited 200 Chinese adults aged 50 and older, all diagnosed with chronic insomnia according to the DSM-5. They were randomly divided into two groups: one followed a Yang-style tai chi program, the other classic CBT. In both cases, participants benefited from 24 one-hour sessions, two sessions per week for three months. By the third month, the average score on the Insomnia Severity Index (ISI) had fallen by 6.67 points in the tai chi group, compared to 11.19 points in the CBT group, a sign that the therapy remained more effective in the short term.
At 15 months, tai chi as effective as therapy… and longer lasting than sleeping pills
The story becomes different when you look at the results from a distance. Fifteen months after the start of treatment, the average reduction in the severity of insomnia reached 9.51 points on the ISI among practitioners of tai chicompared to 10.18 points among those who followed CBT, a difference of only 0.68 points. Tai chi was then judged “non-inferior” to CBT, that is to say clinically equivalent for the control of long-term insomnia.
The remission rates illustrate this progressive catch-up. At three months, 56.1% of participants in the tai chi group no longer met the criteria for insomnia, compared to 83.3% in the CBT group. At the fifteenth month, the curves were clearly similar: 76.5% remission in the tai chi group, 63.4% in the TCC group. The authors note that the remission and response rates to treatment increased by approximately 55% in the tai chi group between the end of the program and the 15-month follow-up, proof of an effect which continues to consolidate over time.
Why tai chi is becoming a real option for insomnia
Beyond sleep itself, the two approaches provided comparable benefits on quality of life, mental health, physical activity and even balance and lower limb function. No adverse events were reported in either group. The researchers add that approximately 37% of participants in the group tai chi
continued to practice after the end of the study, compared to only 16% in the CBT group, which could contribute to the stability of the results in the long term. “Our study supports tai chi as an alternative therapeutic approach for the long-term management of chronic insomnia in middle-aged and elderly adults.“, write the authors.
In practice, this strategy fills a void. Many patients do not have access to structured CBT and are left with sleep hygiene advice or sleeping pills prescribed for short periods of time, which often provide limited benefit. Conversely, the tai chi is presented as an inexpensive body-mind exercise, accessible in groups, without medication or side effects identified, suitable even for older people who are not very athletic. The sessions tested in the trial followed a simple pattern: 10 minutes of breathing and relaxation, 45 minutes of slow, linked movements, then 5 minutes of returning to calm.
The authors acknowledge several limitations, however: almost all of the 200 participants were aged 60 or older, and the study was conducted at a single center in Hong Kong. Further work will need to clarify whether these results are found in younger adults or in other countries, including Europe. For now, the main message remains clear for those over 50 who accumulate sleepless nights: add a structured program of tai chi to care offers a concrete avenue for better sleep, where current treatments still too often leave patients alone with their fatigue.