Rest Easy: Tai Chi Helps Reduce Insomnia in Breast Cancer Survivors

Roughly 30 percent of all breast cancer survivors suffer from insomnia. But a recent study published in the Journal of Clinical Oncology explains how tai chi can help reduce their number of sleepless nights.

The traditional Chinese exercise focuses on posture, breathing and meditation. Researchers from UCLA compared the Westernized form of the practice called tai chi chih (TCC) with cognitive behavioral therapy for insomnia (CBT-I) — the combining of cognitive therapy, stimulus control, sleep restriction, sleep hygiene and relaxation to improve sleep outcomes — which has been considered the “gold standard” treatment for insomnia.

Their findings concluded that TCC is just as effective as CBT-I.

“Breast cancer survivors often don’t just come to physicians with insomnia. They have insomnia, fatigue and depression,” Michael Irwin, M.D., a professor of psychiatry at UCLA and lead author on the study, said in a statement. “And this intervention, tai chi, impacted all those outcomes in a similar way, with benefits that were as robust as the gold standard treatment for insomnia.”

Common symptoms of insomnia include difficulty sleeping, frequent awakenings, inability to return to sleep, lack of concentration, depression, irritability and headaches.

The study consisted of 90 patients — recruited from the Los Angeles area from April 2008 to July 2012 — who were randomly assigned weekly TCC (45 patients) or CBT-I (45 patients) sessions. They ranged in age from 42 to 83 years. All patients reported troubled sleeping three or more times a week. In addition, they had completed treatment with surgery, radiation and/or chemotherapy at least 6 months before the study, and showed no evidence of cancer recurrence or new primary tumor.

Patients were evaluated at intervals through the treatment, as well as immediately post-treatment and in the follow-up, to determine if they were still suffering from signs of insomnia, as well as fatigue and depression. These evaluations were based on the Pittsburgh Sleep Quality Index as well as clinician-assessed outcomes.

Researchers reported that nearly half of the patients in both the TCC and CBT-I groups “continued to show robust, clinically significant improvement in their insomnia symptoms” at 15 months. TCC showed slightly better improvement, 46.7 percent compared with the 43.7 percent in the CBT-I group.

Additionally, Irwin noted that many of the patients from the TCC group continued to practice the exercise on their own, after the study had concluded.

In a study released in 2014, also conducted by Irwin and colleagues, tai chi reduced inflammation — a commonly seen side effect after treatment — in breast cancer survivors. The authors on this study said that tai chi relaxed the body to a certain point that it helped in reducing inflammation. The form of exercise can also improve muscle strength, flexibility, and balance.

Irwin noted that although cognitive behavioral therapy treats insomnia, there are two limitations: the therapy can be too expensive for some people and there is a shortage of trained professionals in the field.

“Because of those limitations, we need community-based interventions like tai chi,” said Irwin.

He added that there are free or low-cost tai chi classes offered at libraries, community centers or outdoors in parks. For those people who prefer to exercise by themselves, there are instructional videos that can be accessed on YouTube and via smartphone apps.