Tai Chi Versus Conventional Exercise to Alleviate Depression in Insomniacs

Tai Chi Versus Conventional Exercise to Alleviate Depressive Symptoms in Older Insomniacs: A Three-arm Randomized Controlled Trial

This study aims to examine the effectiveness of Tai Chi and conventional exercise in alleviating depressive symptoms in older insomniacs.

Chinese community-dwelling older adults with mild-to-moderate depressive symptoms and chronic insomnia will be recruited.

Eligible participants will be randomized to health education control, Tai Chi or conventional exercise interventions on a 1:1:1 basis after baseline assessment.

All interventions will last for 3 months. Outcomes will be assessed at baseline, at 3 months and at 6 months after the completion of the intervention.

Inclusion Criteria:

• 60 years or older
• Can communicate using Cantonese or Mandarin
• with mild-to-moderate depressive symptoms (HADS-depression score ≥8/21 and PHQ- 9 score ≤14/27)
• Fulfil the Fifth Edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for chronic insomnia including difficulties in initiating or maintaining sleep, early morning awakening with complaint of significant distress or impairment of daytime functioning, sleep difficulty occurring at least three nights per week and present for at least 3 months.

Exclusion Criteria:

• Somatic condition that prevents participation in tai chi or exercise
• Regular moderate-to-vigorous intensity exercise or mind-body training such as tai chi, yoga, qigong or meditation in the past 3 months
• Any form (or combination) of exercises amounting to 180 minutes per week in the past 3 months
• Dementia
• Diagnosis with schizophrenia or other psychotic disorders, bipolar disorders or alcohol/substance use/abuse
• Current usage or planning to use potentially confounding treatments, including herbal supplementations (e.g., St. John's Wort), acupuncture treatment, cognitive behavioral therapy or other psychotherapy, mind-body intervention (e.g., mindfulness training and muscle relaxation training) or muscle relaxants such as carisoprodol, cyclobenzaprine, diazepam
• Current suicidal or self-injurious potential that requires immediate clinical follow-up.