Having trouble falling or staying asleep is a common problem as people age. Chronic insomnia affects many middle aged and older adults, often lasting for years and harming overall health. New research from Hong Kong suggests that an ancient practice, tai chi, may help people sleep just as well as standard talk therapy over the long term.
In a study published in the BMJ, researchers found that tai chi matched cognitive behavioral therapy for insomnia in easing sleep problems when people were followed for more than a year. The findings suggest that slow, gentle movement may be a powerful and practical tool for better sleep.
What Tai Chi?
Tai chi is a low impact martial art that originated in China and is often described as meditation in motion. It combines slow, flowing movements with controlled breathing and focused attention. Unlike many forms of exercise, tai chi is gentle and adaptable, making it suitable for people who are inactive, older, or not physically fit.
According to experts, tai chi does not aim to exhaust the body. Instead, it blends physical movement with mental calm, which may be important for sleep and overall well being.
The research was led by Parco Siu, a professor of kinesiology at Hong Kong University. His team recruited 200 adults aged 50 and older in Hong Kong who had already been diagnosed with chronic insomnia.
All participants could walk unassisted, were not shift workers, and had no medical conditions that would interfere with sleep. None were already doing aerobic exercise or mind body practices.
Participants were divided into two equal groups. One group received cognitive behavioral therapy for insomnia, commonly known as CBT I. The other group practiced tai chi using the 24 form Yang style. Both groups met twice a week for one hour over three months.
Researchers used a standard tool called the Insomnia Severity Index to track changes in sleep. This index measures difficulty falling asleep, staying asleep, waking too early, trouble returning to sleep, and how sleep problems affect daily life. Lower scores indicate better sleep.
Sleep outcomes were measured right after the three month programs ended and again about 15 months later.
The Results and Key Statistics
At the three month mark, CBT I showed stronger short term results. People in the tai chi group saw their insomnia scores drop by just under 7 points on average, while the CBT I group saw an average drop of about 11 points.
However, the picture changed over time. When participants were checked again roughly a year later, the difference between the two groups had nearly disappeared. Tai chi participants showed an average drop of about 9.5 points, while the CBT I group showed a drop of about 10 points.
By the long term follow up, both groups had similar improvements in sleep quality, sleep duration, quality of life, mental health, and physical activity levels.
Why Tai Chi May Work Over Time
Researchers believe tai chi may grow more effective because people are more likely to keep doing it. In the follow up period, 31 of the tai chi participants continued practicing on their own, even if less often. In contrast, only 13 people from the CBT I group reported continuing to use the skills they learned in therapy.
Tai chi is easy to access, does not require a therapist, and can be practiced in groups or alone. This makes it easier to maintain as part of daily life.
The slow movements, breathing control, and mental focus may help calm the nervous system, reduce stress, and prepare the body for sleep. The combination of gentle physical activity and mental relaxation may explain why benefits build over time.
“Our study supports tai chi as an alternative treatment approach for the long term management of chronic insomnia in middle aged and older adults,” the researchers concluded.
They also noted that access to CBT I can be limited by cost, long wait times, and a shortage of trained therapists. Tai chi, by contrast, is widely available and suitable even for people who are inactive or unfit.
While CBT I remains a proven first line treatment with minimal side effects, the study suggests tai chi could serve as an effective alternative or supplement, especially for long term sleep improvement.
What This Means for People With Insomnia
Chronic insomnia increases the risk of heart disease, mental health problems, and cognitive decline. Professional medical care remains important, but this research suggests that tai chi may offer a practical and lasting way to improve sleep.
For many middle aged and older adults, signing up for tai chi classes or continuing the practice at home may be a simple step toward better rest and better health over time.
