Tai Chi Chih Compared With Cognitive Behavioral Therapy for the Treatment of Insomnia in Survivors of Breast Cancer: A Randomized, Partially Blinded, Noninferiority Trial

Authors: Irwin, MR et. al.

Source: J Clin Oncol 35(23):2656-2665

ascopubs.org/doi/abs/10.1200/JCO.2016.71.0285

Nearly 30% of breast cancer survivors experience insomnia, which is almost twice the rate of the general population. Insomnia is diagnosed by difficulty falling asleep, frequently waking up and difficulty going back to sleep. This can lead to significant problems during waking hours.

CBT for insomnia emphasizes stimulus control, sleep restriction, sleep hygiene and relaxation to improve sleep. CBT is known to be a more effective treatment than medications for insomnia among breast cancer survivors.

TCC is a mind-body intervention that combines slow physical activity with relaxation to provide a type of meditation. Investigators sought to determine if TCC would be as effective as CBT to treat insomnia in breast cancer survivors.

Female breast cancer survivors who were diagnosed with insomnia were selected and randomized to one of two groups. One group was treated with weekly two-hour sessions of CBT, while the second group was treated with TCC by the same schedule. Symptoms of insomnia were reviewed at 3, 6 and 15 months after treatment end.

Both groups experienced improved quality of sleep, including length of time of continuous sleep and shorter time to sleep onset. As the investigators expected, both treatments were equally effective.

A drawback of CBT is the fact that it may not easily be applied to large communities; it is dependent upon the availability of trained CBT counselors. Instructors of TCC, on the other hand, are often more plentiful and available. The fact that both therapies are equally effective means that the more accessible TCC may be successfully used in larger settings.