Breast cancer, insomnia & Tai Chi

A remarkable 30 percent of breast cancer survivors suffer from insomnia. For these women, lack of sleep may also be a precursor to depression, anxiety and a heightened risk of disease.

Cognitive behavioral therapy is the usual prescription. CBT, sometimes called “talk therapy,” is used to treat many mental sicknesses, including post-traumatic stress disorder and eating disorders. It's effective, but it's also expensive.

But recent research out of UCLA has pinpointed another, vastly less expensive therapy that the scientists say is as effective for breast cancer survivors as CBT: tai chi.

Tai chi was developed in 12th century China. It started out as a martial art (and some forms are still taught as such) but today is known more for its slower forms. These have given the exercise the nickname of “meditation in motion.” The ancient art has been medically proven to benefit practitioners' balance, flexibility, muscle strength and aerobic conditioning.

The new UCLA study indicates that tai chi also promotes significant improvements in sleep health in breast cancer survivors with insomnia, with additional benefits of improving depressive symptoms and fatigue.

The scientists tested tai chi's effects on 90 breast cancer survivors, aged 42 to 83, who had trouble sleeping three or more times per week and who also reported feeling fatigue and depressed during the daylight hours. They randomly assigned each participant in the study to weekly cognitive behavioral therapy sessions or weekly tai chi instruction for three months. The tai chi group was taught tai chi chih, a non-violent form of the practice developed in the U.S. during the 20th century.

The study participants were evaluated periodically over the next year to determine their progress in fighting insomnia as well as their depression and fatigue. At 15 months, 46.7 percent of the tai chi group and 43.7 percent of the behavioral therapy group continued to show robust, clinically significant improvement in their insomnia symptoms.

"Breast cancer survivors often don't just come to physicians with insomnia. They have insomnia, fatigue and depression," said Dr. Michael Irwin, the study's lead author and a UCLA professor of psychiatry. "And this intervention, tai chi, impacted all those outcomes in a similar way, with benefits that were as robust as the gold standard treatment for insomnia."

Many of the tai chi participants continued to practice on their own after the study concluded, Irwin noted. "They often are seeking health-promoting activities because they recognize that the mindfulness approach, or health-based lifestyle interventions, may actually protect them," he said.

The research has been published in the Journal of Clinical Oncology.