Health Studies
Tai Chi Reduces Insomnia-Related Inflammation in Elderly Patients
Sleep 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.
Cognitive behavioral therapy for insomnia, a multi-component behavioral intervention that provides sleep education, stimulus control (strengthening associations between bed and sleep), and therapy for anxiety-provoking beliefs about sleep, primarily targets sleep behaviors with effects on arousal mechanisms. Cognitive behavioral therapy is an effective treatment for insomnia in older adults and adults, with an efficacy that is better sustained than pharmacotherapy. As a comparison to Cognitive behavioral therapy, Tai Chi is thought primarily to target arousal mechanisms with secondary effects on insomnia which in turn decreases sympathetic activation and related inflammation. Tai Chi improves sleep quality, and reduces inflammation in older adults
Abstract:
Design:
In 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.
Results:
As 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.
Conclusion:
Among 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.
LINK:
Irwin, Michael R, et al. “Cognitive Behavioral Therapy and Tai Chi Reverse Cellular and Genomic Markers of Inflammation in Late-Life Insomnia: a Randomized Controlled Trial.” Biological Psychiatry, U.S. National Library of Medicine, 15 Nov. 2015, www.ncbi.nlm.nih.gov/pubmed/25748580.
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