Tai Chi Versus Conventional Exercise to Alleviate Depression in Insomniacs

The University of Hong Kong420 enrolled

Overview

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.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

TREATMENT

Masking

SINGLE

Enrollment

420

Conditions

Depressive Symptoms Chronic Insomnia

Interventions

Tai ChiBEHAVIORAL

The Tai Chi intervention will be prescribed as a 3-month program with two 1.5-h sessions weekly instructed by qualified Tai Chi instructors.

Conventional exerciseBEHAVIORAL

The conventional exercise intervention will be prescribed as a 3-month program with two 1.5-h sessions of generic fitness training weekly instructed by qualified instructors.

Health Education ControlBEHAVIORAL

Participants in the control group will participate in a health education program delivered by research personnel.

Eligibility

Sex: ALLMin age: 60 Years

Medical Language ↔ Plain English

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.

Locations (1)

LKS Faculty of Medicine, HKU

Hong Kong, Hong Kong

Outcomes

Primary Outcomes

Hospital Anxiety and Depression Scale - Depression

The depression score of the Hospital Anxiety and Depression Scale (HADS-D) will be used to evaluate the severity of depressive symptoms. This consists of a seven-item questionnaire with an overall score ranging from 0 to 21. Higher scores are indicative of more severe depressive symptoms.

Time frame: 3 months (post-intervention)

Hospital Anxiety and Depression Scale - Depression

Time frame: 9 months (6 months post-intervention follow-up)

Secondary Outcomes

Insomnia severity index

The Insomnia Severity Index (ISI) will be used to assess perceived insomnia severity. It consists of a seven-item questionnaire with each item being rated from 0 to 4 on a Likert scale (total score range 0-28). Higher scores are representative of a more severe perception of insomnia.