Tai Chi May Help Older Adults
Manage Chronic Insomnia
A clinical trial from Hong Kong suggests that tai chi (taijiquan) may offer long-term benefits for middle-aged and older adults with chronic insomnia. The study, published in The BMJ, compared tai chi with cognitive behavioral therapy for insomnia, commonly known as CBT-I, which is widely considered the preferred non-drug treatment for chronic sleep problems.
Chronic insomnia is common among middle-aged and older adults and has been linked with increased risk of cardiovascular disease, mental health problems, and cognitive decline. CBT-I can be effective, but access is often limited by cost, availability of trained therapists, and the number of sessions required. Researchers wanted to know whether tai chi, a mind-body exercise widely practiced in Chinese communities, could provide a comparable option for long-term management.
The trial included 200 Chinese adults age 50 and older who had been diagnosed with chronic insomnia. Participants were enrolled at a research center in Hong Kong between May 2020 and July 2022. They were randomly assigned to receive either tai chi or CBT-I. Both interventions were delivered in group sessions for one hour, twice a week, over three months, for a total of 24 sessions.
Researchers measured sleep improvement using the Insomnia Severity Index, a standard scale that evaluates problems such as difficulty falling asleep, staying asleep, waking too early, and the impact of poor sleep on daily life. The participants were assessed immediately after the three-month intervention and again 12 months later, at month 15.
At the three-month mark, CBT-I produced a stronger improvement. The tai chi group had a 6.67-point reduction in insomnia severity scores, while the CBT-I group had an 11.19-point reduction. At that point, tai chi was considered inferior to CBT-I under the study’s statistical criteria.
The longer-term results were different. At month 15, the tai chi group showed a 9.51-point reduction, compared with a 10.18-point reduction in the CBT-I group. At this follow-up, tai chi was considered non-inferior to CBT-I, meaning its benefits were statistically comparable within the trial’s pre-set margin.
The study also reported comparable benefits between the two groups in subjective sleep measures, quality of life, mental health, and physical activity. No adverse events occurred during the intervention period.
The researchers noted that some of tai chi’s long-term benefit may have come from participants continuing to practice after the formal sessions ended. They also cautioned that more research is needed to determine whether the results apply to people in other countries or with different demographic backgrounds.
Even so, the findings support tai chi as a possible long-term, low-risk approach for managing chronic insomnia in middle-aged and older adults, especially where access to CBT-I is limited.
Source basis: BMJ Group’s November 26, 2025 press release and the associated BMJ randomized non-inferiority trial details.
