Adequate sleep is critical for optimum human functioning. Insomnia is a common sleep disorder affecting 30% of adults in the United States, with 10% having insomnia severe enough to cause daytime consequences. Considerable evidence suggests that short-term sleep deprivation can negatively impact an individual’s alertness, mood, attention, and ability to concentrate, whereas long-term sleep deprivation is associated with chronic fatigue, obesity and diabetes, cardiovascular diseases, and increased mortality.  Poor or deprived sleep can result in increased workplace injuries and accidents, reduced work efficiency, poor employee physical and mental health, and an increased economic loss to the society. Each year, insomnia associated with lost productivity in the workplace is estimated to cost 63.2 billion U.S. dollars.

Insomnia may stem from somatized tension or anxiety, and therefore, Tai Chi practice may be a logical therapeutic approach for people seeking to improve their sleep quality. 

From our review and meta-analysis, we understand that Tai Chi has been useful in treating insomnia and improving sleep quality in both adults and the elderly population, in both healthy people and people with chronic medical problems, as well as in people from different countries. Insomnia causes many negative health and economic outcomes and it is prevalent as both a solitary condition and as co-morbidity in a variety of other diseases. Therefore, it is important to explore an inexpensive and effective way, such as Tai Chi, to treat insomnia and to improve sleep quantity and quality in various populations.

Medline, Cochrane Central databases, and review of references were searched through July 31, 2013. English-language studies of all designs evaluating Tai Chi's effect on sleep outcomes in adults were examined. Data were extracted and verified by 2 reviewers. Extracted information included study setting and design, population characteristics, type and duration of interventions, outcomes, risk of bias and main results. Random effect models meta-analysis was used to assess the magnitude of treatment effect when at least 3 trials reported on the same sleep outcomes. 

Eleven studies (9 randomized and 2 non-randomized trials) totaling 994 subjects published between 2004 and 2012 were identified. All studies except one reported Pittsburg Sleep Quality Index. Nine randomized trials reported that 1.5 to 3 hour each week for a duration of 6 to 24 weeks of Tai Chi significantly improved sleep quality (Effect Size, 0.89; 95% confidence interval [CI], 0.28 to 1.50), in community-dwelling healthy participants and in patients with chronic conditions. Improvement in health outcomes including physical performance, pain reduction, and psychological well-being occurred in the Tai Chi group compared with various controls. 

Tai Chi significantly improved sleep quality in both healthy adults and patients with chronic health conditions, which suggests that Tai Chi may be considered as an alternative behavioral therapy in the treatment of insomnia. High-quality, well-controlled randomized trials are needed to better inform clinical decisions.