ArticleBMJ (Clinical research ed.)2025
Tai chi or cognitive behavioural therapy for treating insomnia in middle aged and older adults: randomised non-inferiority trial.
Article in BMJ (Clinical research ed.), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04384822 (Efficacy of Tai Chi Versus Cognitive Behavioral Therapy for Insomnia), which is not on this map. Cited by 9 papers, 3 of them syntheses that pooled 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.
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.
Efficacy of Tai Chi Versus Cognitive Behavioral Therapy for Insomnia (CBT-I) to Treat Chronic Insomnia in Older Adults: A Randomized Controlled Non-inferiority Trial
Who cites it
9 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Dose-response relationship between physical activity and subjective sleep quality in patients with insomnia: a systematic review and Bayesian meta-analysis of randomized controlled trials.The international journal of behavioral nutrition and physical activity · 2026Pooled it
- Effects of traditional Chinese mind-body exercises on depressive symptoms in middle-aged and older adults: a multilevel meta-analysis with exploratory dose-response and machine learning analyses.Frontiers in psychology · 2026Pooled it
- Effect of Tai Chi on sleep quality of cancer patients: a systematic review and meta-analysis.Frontiers in neurologyPooled it
- Effects of unsupervised campus HIIT on fitness and sleep in sedentary male students: a randomized controlled trial.BMC public health · 2026Trial
- Developing a Traditional Chinese Medicine-Based Lifestyle Content Framework for Insomnia: A Modified Delphi Study.Healthcare (Basel, Switzerland) · 2026Article
- Effects of Tai Chi Qigong on sleep quality in older male cancer survivors: A randomized controlled clinical trial.Brain medicine : from neurons to behavior and better health · 2026Article
- Clinical evidence on integrated Chinese-Western medicine for depressive disorder.Integrative medicine research · 2026Article
- Association of Healthy Lifestyle with Insomnia Among Chinese Older Adults: A Cross-Sectional Study.Clocks & sleep · 2026Article
- Electroacupuncture Attenuates Neuroinflammation in PCPA-Induced Insomnia Rats by Suppressing the TLR4/MyD88/NF-κB p65 Pathway and M1 Microglial Activation.Neuropsychiatric disease and treatment · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo assess whether tai chi is non-inferior to cognitive behavioural therapy for insomnia (CBT-I), the first line treatment, for managing chronic insomnia in middle aged and older adults.
designRandomised, assessor masked, non-inferiority trial.
settingA single research site in Hong Kong with participants recruited from the local community between 18 May 2020 and 14 July 2022.
participantsChinese participants aged ≥50 years with chronic insomnia diagnosed according to the
interventionsTai chi and CBT-I interventions were delivered in group format over three months, consisting of one hour sessions twice a week for a total of 24 sessions.
main outcome measuresThe primary outcome was the change in perceived insomnia severity measured by the Insomnia Severity Index after the intervention (month 3) and at 12 month follow-up (month 15). To assess whether tai chi is non-inferior to CBT-I, a threshold of four points was used as the margin of non-inferiority.
results200 participants were randomised (1:1) to receive tai chi (n=100) or CBT-I (n=100). The per protocol principle was adopted. At month 3, the tai chi group showed a reduction of 6.67 (95% confidence interval 5.61 to 7.73) in Insomnia Severity Index scores, while the CBT-I group had a reduction of 11.19 (10.06 to 12.32), resulting in a between group difference of 4.52 (-∞ to 5.81). Tai chi was deemed inferior to CBT-I at month 3 because the upper confidence limit exceeded the non-inferiority margin. At month 15, the reductions for tai chi and CBT-I were 9.51 (8.47 to 10.54) and 10.18 (8.97 to 11.40), respectively, with a between group difference of 0.68 (-∞ to 2.00). At this point, tai chi was considered non-inferior to CBT-I because the upper confidence limit fell within the non-inferiority margin. Results from the intention-to-treat analysis were consistent with the per protocol findings. No adverse events occurred during the intervention period.
conclusionTai chi was inferior to CBT-I at month 3 but non-inferior at month 15. This finding supports the use of tai chi as an alternative approach for the long term management of chronic insomnia in middle aged and older adults.
trial registrationClinicalTrials.gov NCT04384822.
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