Evidence map›Paper›PMID 25748580›Full record

Trial reportBiological psychiatry2015

Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial.

Michael R Irwin, Richard Olmstead, Elizabeth C Breen, Tuff Witarama, Carmen Carrillo, Nina Sadeghi, Jesusa M G Arevalo, Jeffrey Ma, Perry Nicassio, Richard Bootzin and 1 more

Open access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Biological psychiatry, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 128 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
128citing papers in PubMed, 12 pooled it
17.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

128 citing papers in PubMed, 12 syntheses or guidelines pooled it, 214 citations in OpenAlex.

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  11. Health benefits of tai chi: What is the evidence?Canadian family physician Medecin de famille canadien · 2016
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68 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 1 country.

Michael R IrwinCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Psychology, University of California, Los Angeles. Electronic address: mirwin1@ucla.edu.
Richard OlmsteadCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine.
Elizabeth C BreenCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine.
Tuff WitaramaCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience.
Carmen CarrilloCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience.
Nina SadeghiCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience.
Jesusa M G ArevaloCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California.
Jeffrey MaCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California.
Perry NicassioCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine.
Richard BootzinDepartment of Psychology, University of Arizona, Tucson, Arizona.
Steve ColeCousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California.
University of California, Los Angeles · USNeurobehavioral Systems · USUniversity of Arizona · US

Funding

USC/UCLA Center on Biodemography &Population HealthP30AG017265 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI JENNIFER A AILSHIRE · 1999 to 2026
$17.9M
UCLA CLINICAL AND TRANSLATIONAL SCIENCE INSTITUTEUL1RR033176 · NCRR · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2011 to 2011
$15.5M
UCLA OLDER AMERICANS INDEPENDENCE CENTERP30AG028748 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI MOORE, ALISON AHERN · 2006 to 2017
$9.8M
Aging: Sleep and Inflammatory Mechanisms in Depression PreventionR01AG026364 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI IRWIN, MICHAEL R · 2005 to 2015
$5.8M
Sleep, Inflamation, and Depression Occurrence in Breast Cancer SurvivorsR01CA160245 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI IRWIN, MICHAEL R · 2012 to 2016
$3.9M
Chronic Moderate Sleep Restriction in Older Long and Older Average SleepersR01HL095799 · NHLBI · UNIVERSITY OF SOUTH CAROLINA AT COLUMBIA · PI IRWIN, MICHAEL R, JEAN-LOUIS, GIRARDIN · 2011 to 2015
$3.8M
Sleep and Immune Mechanisms in Rheumatoid ArthritisR01HL079955 · NHLBI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI IRWIN, MICHAEL R · 2006 to 2009
$3.0M
Mechanisms of Sleep Disruption HyperalgesiaR01DA032922 · NIDA · JOHNS HOPKINS UNIVERSITY · PI IRWIN, MICHAEL R, SMITH, MICHAEL T · 2012 to 2016
$2.7M
Tai Chi Effects on Chronic Insomnia in Breast Cancer Survivors: Immune MechanismsR01CA119159 · NCI · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI IRWIN, MICHAEL R · 2006 to 2010
$2.2M
Subjective Social Isolation and Sleep Disturbances: Inflammatory Mechanisms in AgR01AG034588 · NIA · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI IRWIN, MICHAEL R · 2009 to 2013
$1.9M
NCI NIH HHS R01 CA119159NCI NIH HHS R01-CA119159NCI NIH HHS R01 CA160245NCRR NIH HHS UL1 RR033176NCRR NIH HHS UL RR 033176NHLBI NIH HHS R01 HL079955NHLBI NIH HHS R01-HL079955NHLBI NIH HHS R01 HL095799NIA NIH HHS P30 AG017265NIA NIH HHS P30-AG017265NIA NIH HHS P30 AG028748NIA NIH HHS P30-AG028748NIA NIH HHS R01 AG026364NIA NIH HHS R01 AG034588NIA NIH HHS R01-AG034588NIDA NIH HHS R01 DA032922
6 · The paper itself

Abstract

backgroundSleep disturbance is associated with activation of systemic and cellular inflammation, as well as proinflammatory transcriptional profiles in circulating leukocytes. Whether treatments that target insomnia-related complaints might reverse these markers of inflammation in older adults with insomnia is not known.

methodsIn this randomized trial, 123 older adults with insomnia were randomly assigned to cognitive-behavioral therapy for insomnia (CBT-I), tai chi chih (TCC), or sleep seminar education active control condition for 2-hour sessions weekly over 4 months with follow-up at 7 and 16 months. We measured C-reactive protein (CRP) at baseline and months 4 and 16; toll-like receptor-4 activated monocyte production of proinflammatory cytokines at baseline and months 2, 4, 7, and 16; and genome-wide transcriptional profiling at baseline and month 4.

resultsAs compared with sleep seminar education active control condition, CBT-I reduced levels of CRP (months 4 and 16, ps < .05), monocyte production of proinflammatory cytokines (month 2 only, p < .05), and proinflammatory gene expression (month 4, p < .01). TCC marginally reduced CRP (month 4, p = .06) and significantly reduced monocyte production of proinflammatory cytokines (months 2, 4, 7, and 16; all ps < .05) and proinflammatory gene expression (month 4, p < .001). In CBT-I and TCC, TELiS promoter-based bioinformatics analyses indicated reduced activity of nuclear factor-κB and AP-1.

conclusionsAmong older adults with insomnia, CBT-I reduced systemic inflammation, TCC reduced cellular inflammatory responses, and both treatments reduced expression of genes encoding proinflammatory mediators. The findings provide an evidence-based molecular framework to understand the potential salutary effects of insomnia treatment on inflammation, with implications for inflammatory disease risk.

Indexed as

Cognitive Behavioral TherapyTai JiAgedBiomarkersC-Reactive ProteinFemaleGene ExpressionGene Expression ProfilingHumansInflammationInflammation MediatorsInterleukin-6MaleMiddle AgedMonocytesSleep Initiation and Maintenance DisordersBiomarkersC-Reactive ProteinInflammation MediatorsInterleukin-6TLR4 protein, humanToll-Like Receptor 4Tumor Necrosis Factor-alphaAgingCognitive-behavioral therapyGene expressionInflammationInsomniaTai chi

Identifiers

PMID25748580
PMCPMC4524803
OpenAlexW2098632554

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.