THE ARISING · Longevity & Healthspan
Tai Chi and Exercise Classes Barely Moved Sleep in Older Cancer Survivors
A tai chi and qigong class and an exercise class matched to it in intensity produced only small changes in sleep among older male cancer survivors, and neither differed significantly from usual care.
The evidence comes from a secondary sleep-outcome analysis of a randomized controlled trial in Brain Medicine, led by Evelyn Arana-Chicas and colleagues. It enrolled 113 male cancer survivors aged 55 and older. Their average age was 69, and 87% had prostate cancer. Participants were randomized to tai chi and qigong, to the intensity-matched exercise class, or to usual care. Both classes met twice a week for 12 weeks, and follow-up ran through 12 months.
Participants were selected for clinically significant fatigue, not sleep disturbance.
Sleep was measured with the Pittsburgh Sleep Quality Index, a questionnaire on which lower scores mean better sleep. At three months after the program, the primary sleep-assessment time point, sleep quality did not differ significantly between groups. No pairwise comparison of global sleep quality reached significance at any time point.
Within groups, the picture was a little more detailed. The exercise group improved from baseline at the six-week midpoint (mean change −1.20), one week after the program (−0.82) and three months after it (−1.04). The tai chi and qigong group moved in the same direction, by −0.70, −0.65 and −0.59, but those changes were not statistically significant. Every change fell below the three-point threshold the authors use for a clinically meaningful difference. By 12 months, no significant effects remained.
Two other results stood out. Sleep efficiency, the share of time in bed spent asleep, improved more in the exercise group than in the tai chi and qigong group at three months (p = 0.04). This exploratory subscale result involved multiple comparisons and may be a chance finding. At 12 months, 62% of the tai chi and qigong group had a questionnaire score of 5 or below, the study's definition of remission of sleep disturbance. The figures were 47% in the exercise group and 43% in the usual care group, and the differences were not significant. The authors say the trial had limited statistical power. Attendance was similar in both classes, at 78.4% for tai chi and qigong and 76.8% for exercise.
The authors conclude that gentle movement practices and conventional exercise may both offer feasible nonpharmacologic options, while calling for standardized delivery and larger trials. This trial did not demonstrate a clear benefit in overall sleep quality.
The trial found no clear difference in global sleep quality between the two classes in this group of mostly White, mostly prostate cancer survivors. Next to watch are adequately powered trials in more diverse groups, with sleep tracked by devices as well as questionnaires.