Skip to main content
Top
Published in: Trials 1/2022

Open Access 01-12-2022 | Insomnia | Study protocol

The effects of an integrated mindfulness-based tai chi chuan programme on sleep disturbance among community-dwelling elderly people: protocol for a randomized controlled trial

Authors: Sunny Ho-Wan Chan, Siu-Man Ng, Chong-Ho Yu, Ching-Man Chan, Shu-Mei Wang, Wai-Chi Chan

Published in: Trials | Issue 1/2022

Login to get access

Abstract

Background

Many elderly individuals who experience sleep disturbances would consider complementary and alternative medicine as an alternative therapeutic option in light of the limitations of traditional treatments. Mindfulness-based interventions (MBIs) and Tai Chi Chuan (TCC) are two alternative forms of complementary and alternative medicine. They both share the common feature of a focus on breathing but represent distinct approaches with different mechanisms and philosophical orientations. The trial described in this protocol aims to evaluate the effects of an integrated form of mindfulness-based Tai Chi Chuan (MBTCC) programme and the underlying mechanisms of the beneficial effects over a 12-month follow-up.

Methods

The planned study is a four-armed randomized controlled trial with repeated measures. A total of 256 community-dwelling older adults with sleep problems will be recruited and randomized into four groups: (1) an MBTCC group, (2) an MBI group, (3) a TCC group, and (4) a sleep hygiene education (SHE) control group. The outcome measures in terms of insomnia severity, interoception, sleep-wake pattern, health status, rumination, and hyperarousal level will be collected at four time points: at baseline (T1), after the 8-week intervention (T2), 6 months after the intervention (T3), and 1 year after the intervention (T4). In addition, qualitative evaluation through focus group interviews will be conducted at the end of the 12-month assessment period (T4).

Discussion

This trial will illuminate the synergetic effect of combining both MBIs and TCC on optimizing improvements in sleep disturbance. The findings from this study can provide empirical support for this integrated treatment, which provides an alternative for healthcare professionals in elderly service to select appropriate practices to treat elderly people with sleep disturbance. It can further help to lessen the growing public health burden of sleep disturbances among the elderly living in the community.

Trial registration

ClinicalTrials.​gov. NCT05396092. Published on 24 May 2022
Literature
1.
go back to reference Silber MH. Clinical practice. Chronic insomnia. N Engl J Med. 2005;353:803–10.CrossRef Silber MH. Clinical practice. Chronic insomnia. N Engl J Med. 2005;353:803–10.CrossRef
3.
go back to reference Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev. 2011;21:41–53.CrossRef Crowley K. Sleep and sleep disorders in older adults. Neuropsychol Rev. 2011;21:41–53.CrossRef
4.
go back to reference Cutler AJ. The role of insomnia in depression and anxiety: its impact on functioning, treatment, and outcomes. J Clin Psychiatry. 2016;77:e1010.CrossRef Cutler AJ. The role of insomnia in depression and anxiety: its impact on functioning, treatment, and outcomes. J Clin Psychiatry. 2016;77:e1010.CrossRef
5.
go back to reference Luo J, Zhu G, Zhao Q, Guo Q, Meng H, Hong Z, et al. Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai aging study. PLoS One. 2013;8:e81261.CrossRef Luo J, Zhu G, Zhao Q, Guo Q, Meng H, Hong Z, et al. Prevalence and risk factors of poor sleep quality among Chinese elderly in an urban community: results from the Shanghai aging study. PLoS One. 2013;8:e81261.CrossRef
6.
go back to reference Shallcross AJ, Visvanathan PD, Sperber SH, Duberstein ZT. Waking up to the problem of sleep: can mindfulness help? A review of theory and evidence for the effects of mindfulness for sleep. Curr Opin Psychol. 2019;28:37–41.CrossRef Shallcross AJ, Visvanathan PD, Sperber SH, Duberstein ZT. Waking up to the problem of sleep: can mindfulness help? A review of theory and evidence for the effects of mindfulness for sleep. Curr Opin Psychol. 2019;28:37–41.CrossRef
7.
go back to reference Lichstein KL, Nau SD, Wilson NM, Aguillard RN, Lester KW, Bush AJ, et al. Psychological treatment of hypnotic-dependent insomnia in a primarily older adult sample. Behav Res Ther. 2013;51:787–96.CrossRef Lichstein KL, Nau SD, Wilson NM, Aguillard RN, Lester KW, Bush AJ, et al. Psychological treatment of hypnotic-dependent insomnia in a primarily older adult sample. Behav Res Ther. 2013;51:787–96.CrossRef
8.
go back to reference Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Ann Intern Med. 2015;163:191–204.CrossRef Trauer JM, Qian MY, Doyle JS, Rajaratnam SM, Cunnington D. Cognitive behavioral therapy for chronic insomnia: a systematic review and meta-analysis. Ann Intern Med. 2015;163:191–204.CrossRef
9.
go back to reference Epstein DR, Sidani S, Bootzin RR, Belyea MJ. Dismantling multicomponent behavioral treatment for insomnia in older adults: a randomized controlled trial. Sleep. 2012;35:797–805.CrossRef Epstein DR, Sidani S, Bootzin RR, Belyea MJ. Dismantling multicomponent behavioral treatment for insomnia in older adults: a randomized controlled trial. Sleep. 2012;35:797–805.CrossRef
10.
go back to reference Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK, Fletcher ME, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med. 2011;171:887–95.CrossRef Buysse DJ, Germain A, Moul DE, Franzen PL, Brar LK, Fletcher ME, et al. Efficacy of brief behavioral treatment for chronic insomnia in older adults. Arch Intern Med. 2011;171:887–95.CrossRef
11.
go back to reference Pearson N, Johnson L, Nahin R. Insomnia, trouble sleeping, and complementary and alternative medicine: analysis of the 2002 national health interview survey data. Arch Intern Med. 2006;166:1775–82.CrossRef Pearson N, Johnson L, Nahin R. Insomnia, trouble sleeping, and complementary and alternative medicine: analysis of the 2002 national health interview survey data. Arch Intern Med. 2006;166:1775–82.CrossRef
12.
go back to reference Liu Y, Zhang J, Lam SP, Yu MWM, Li SX, Zhou J, et al. Help-seeking behaviors for insomnia in Hong Kong Chinese: a community-based study. Sleep Med. 2016;21:106–13.CrossRef Liu Y, Zhang J, Lam SP, Yu MWM, Li SX, Zhou J, et al. Help-seeking behaviors for insomnia in Hong Kong Chinese: a community-based study. Sleep Med. 2016;21:106–13.CrossRef
13.
go back to reference Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta Books; 1991. Kabat-Zinn J. Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York: Delta Books; 1991.
14.
go back to reference Osypiuk K, Thompson E, Wayne PM. Can tai chi and Qigong postures shape our mood? Toward an embodied cognition framework for mind-body research. Front Hum Neurosci. 2018;12:174.CrossRef Osypiuk K, Thompson E, Wayne PM. Can tai chi and Qigong postures shape our mood? Toward an embodied cognition framework for mind-body research. Front Hum Neurosci. 2018;12:174.CrossRef
15.
go back to reference Kanen JW, Nazir R, Sedky K, Pradhan BK. The effects of mindfulness-based interventions on sleep disturbance: a meta-analysis. Adolesc Psychiatry. 2015;5:105–15.CrossRef Kanen JW, Nazir R, Sedky K, Pradhan BK. The effects of mindfulness-based interventions on sleep disturbance: a meta-analysis. Adolesc Psychiatry. 2015;5:105–15.CrossRef
16.
go back to reference Wong SYS, Zhang DX, Li CCK, Yip BHK, Chan DCC, Ling YM, et al. Comparing the effects of mindfulness-based cognitive therapy and sleep psycho-education with exercise on chronic insomnia: a randomised controlled trial. Psychother Psychosom. 2017;86:241–53.CrossRef Wong SYS, Zhang DX, Li CCK, Yip BHK, Chan DCC, Ling YM, et al. Comparing the effects of mindfulness-based cognitive therapy and sleep psycho-education with exercise on chronic insomnia: a randomised controlled trial. Psychother Psychosom. 2017;86:241–53.CrossRef
17.
go back to reference Walther A, Lacker TJ, Ehlert U. Everybody was kung-fu fighting -- the beneficial effects of tai chi qigong and self-defense kung-fu training on psychological and endocrine health in middle aged and older men. Complement Ther Med. 2018;36:68–72.CrossRef Walther A, Lacker TJ, Ehlert U. Everybody was kung-fu fighting -- the beneficial effects of tai chi qigong and self-defense kung-fu training on psychological and endocrine health in middle aged and older men. Complement Ther Med. 2018;36:68–72.CrossRef
18.
go back to reference Wu W-W, Kwong E, Lan X-Y, Jiang X-Y. The effect of a meditative movement intervention on quality of sleep in the elderly: a systematic review and meta-analysis. J Altern Complement Med. 2015;21(9):509–19.CrossRef Wu W-W, Kwong E, Lan X-Y, Jiang X-Y. The effect of a meditative movement intervention on quality of sleep in the elderly: a systematic review and meta-analysis. J Altern Complement Med. 2015;21(9):509–19.CrossRef
19.
go back to reference Tsai PS, Wang SY, Wang M-Y, Su CT, Yang TT, Huang CJ, et al. Psychometric evaluation of the Chinese version of the Pittsburgh sleep quality index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14:1943–52.CrossRef Tsai PS, Wang SY, Wang M-Y, Su CT, Yang TT, Huang CJ, et al. Psychometric evaluation of the Chinese version of the Pittsburgh sleep quality index (CPSQI) in primary insomnia and control subjects. Qual Life Res. 2005;14:1943–52.CrossRef
20.
go back to reference Morin CM, Espie CA. Insomnia: a clinical guide to assessment and treatment. New York: Kluwer Academic/Plenum; 2003. Morin CM, Espie CA. Insomnia: a clinical guide to assessment and treatment. New York: Kluwer Academic/Plenum; 2003.
21.
go back to reference Morin CM, Belleville G, Belanger L, Ivers H. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–8.CrossRef Morin CM, Belleville G, Belanger L, Ivers H. The insomnia severity index: psychometric indicators to detect insomnia cases and evaluate treatment response. Sleep. 2011;34:601–8.CrossRef
22.
go back to reference Mehling WE, Price C, Daubenmier JJ, Acree M, Bartmess E, Stewart A. The multidimensional assessment of interoceptive awareness (MAIA). PLoS One. 2012;7(11):e48230.CrossRef Mehling WE, Price C, Daubenmier JJ, Acree M, Bartmess E, Stewart A. The multidimensional assessment of interoceptive awareness (MAIA). PLoS One. 2012;7(11):e48230.CrossRef
23.
go back to reference Lam CL, Tse EY, Gandek B. Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual Life Res. 2005;14:539–47.CrossRef Lam CL, Tse EY, Gandek B. Is the standard SF-12 health survey valid and equivalent for a Chinese population? Qual Life Res. 2005;14:539–47.CrossRef
24.
go back to reference Trapnell PD, Campbell JD. Private self-consciousness and the five-factor model of personality: distinguishing rumination from reflection. J Pers Soc Psychol. 1999;76:284–304.CrossRef Trapnell PD, Campbell JD. Private self-consciousness and the five-factor model of personality: distinguishing rumination from reflection. J Pers Soc Psychol. 1999;76:284–304.CrossRef
25.
go back to reference Pavlova M, Berg O, Gleason R, Walker F, Roberts S, Regestein Q. Self-reported hyperarousal traits among insomnia patients. J Psychosom Res. 2001;51:435–41.CrossRef Pavlova M, Berg O, Gleason R, Walker F, Roberts S, Regestein Q. Self-reported hyperarousal traits among insomnia patients. J Psychosom Res. 2001;51:435–41.CrossRef
Metadata
Title
The effects of an integrated mindfulness-based tai chi chuan programme on sleep disturbance among community-dwelling elderly people: protocol for a randomized controlled trial
Authors
Sunny Ho-Wan Chan
Siu-Man Ng
Chong-Ho Yu
Ching-Man Chan
Shu-Mei Wang
Wai-Chi Chan
Publication date
01-12-2022
Publisher
BioMed Central
Keyword
Insomnia
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06737-4

Other articles of this Issue 1/2022

Trials 1/2022 Go to the issue