Can Tai Chi Help Older Adults Sleep Better?

Mindfulness meditation, massage, yoga, lavender oil, magnesium supplements... these are just some of the natural remedies people use to try to improve their sleep. Now, it seems we can add tai chi to the list, following a randomized clinical trial that found the ancient Chinese martial art was associated with modest sleep improvements in people over 60.

The study, published in JAMA Network Open, took place over four years at a single research unit in Hong Kong. Researchers randomly assigned 105 participants to 12 weeks of tai chi, 105 to 12 weeks of exercise, and 110 to a no-intervention control group. Every participant had chronic insomnia before the study began, and was 60 years or older.

Actigraphy, a non-invasive technique used to assess cycles of activity and rest over several days or weeks, was used to assess the participants’ sleep. Researchers also used the Pittsburgh Sleep Quality Index score, Insomnia Severity Index score, and the participants’ own reports in a seven-day sleep diary, performing assessments at the start of the trial, immediately after the trial, and 24 months after the trial.

Both conventional exercise and tai chi were associated with modest sleep improvements, and these were sustained for 24 months. Those improvements included improved sleep efficiency and fewer and shorter awakenings during the night. Notably, tai chi was just as effective as conventional exercise in making sleep improvements.

Previous research, published in 2013, found that tai chi is the ideal exercise for older adults and has been shown to significantly improve sleep quality.

What Happens to Sleep Habits As We Age?

Research shows that changing sleep patterns are a normal part of the aging process. “As people age, they naturally tend to go to sleep earlier but sleep for shorter periods of time at night,” says Naueen Safdar, MD, medical director at EHE Health. “Older adults are more likely to nap during the day and wake up more frequently during the night.”

According to the Sleep Foundation, these changes occur because of changing circadian rhythms—older people usually have less exposure to direct sunlight, which affects the production of hormones such as melatonin and cortisol. This disrupts the natural circadian rhythms, leading to sleep deterioration. Although it’s a common part of the aging process, it can have a negative impact on a person’s health and well-being, Safdar says.

Mental and physical health issues, like anxiety or heart disease, also can negatively affect sleep patterns, Safdar adds. Plus, the medications prescribed for these conditions also can impact sleep.

Lifestyle Changes for Better Sleep

A commitment to making small lifestyle changes can result in a marked improvement in sleep quality, and exercise is an important one. “A healthy, active lifestyle is essential for good sleep,” Safdar says. However, many seniors are unable to do certain forms of exercise, and that's where tai chi comes in.

This gentle form of exercise improves sleep patterns in healthy older adults as well as those with chronic health issues. Tai chi even is considered an alternative form of behavioral therapy that can be used to treat insomnia in most individuals. It is just as effective as other forms of intense exercise that may not be appropriate for older people.

Board-certified tai chi and qi gong instructor Victoria Wesseler, who has been teaching for 11 years, says one of the most incredible healing aspects of tai chi can be found in the deep breathing technique that is referred to as abdominal breathing, or dan tian breathing.

"This type of breathing relaxes both the mind and the body and, when performed consistently over time, can actually calm a racing mind, reduce the level of cortisol in our body, and reduce physical pain levels," Wesseler says.

Couple that with the slow, relaxed body movements of tai chi that strengthen and heal the body, and Wesseler says you have the perfect process for helping the body and mind reach that much-needed relaxed state for an optimal night of sleep.

Practitioners of traditional Chinese medicine believe that tai chi helps strengthen the body's qi (that's our "vital energy," explains Wesseler). "When the mind is in turmoil due to stress, anxiety, depression and/or pain, it is believed that the qi in the body stagnates and that impairs the ability of the body to relax and fall and stay asleep," Wesseler says.

"The practice of tai chi improves the quality and movement of the qi in the body. The stronger the qi, the more an individual's body is in balance, able to relax and experience the desired good night's sleep," Wesseler explains.

Susan Schuler, a Taoist Tai Chi instructor in Brandon, Florida, agrees that tai chi is profoundly beneficial for health. "It helps the mind be calm and clear yet creative and dynamic, and the spirit be light and peaceful yet grounded and resilient," she says. "Practicing quietly is a deep form of meditation that not only reduces stress but helps us feel joyful. Physically it makes us stronger, yet supple, balanced, and energetic."

Schuler refers to a survey of Taoist Tai Chi Society members (mainly older people), which found that 25% of respondents felt less stress, anxiety, and depression. Also, 29% reported improvements in their muscular issues and circulation, and more than 50% saw improved coordination.

Tai Chi Can Offer Huge Benefits at Any Age

The health and wellbeing benefits of tai chi for older adults are well documented, but it's a misconception that it's solely for the elderly or the infirm.

"Unfortunately, this is a stereotype of many people in the Western world, and it couldn't be farther from the truth," Wesseler says. "The slow gentle moves of tai chi are deceptively healing, strengthening, and restoring for people of all ages. In my opinion, tai chi should be a regular part of everyone's exercise program at every age." Harvard Medical School calls the practice "medication in motion."

"Despite what looks like a gentle exercise, tai chi is a low impact aerobic activity and burns as many calories as a brisk walk," Wesseler explains. "It provides healing and support for those with many age-related issues such as memory loss, dementia, arthritis, heart disease, diabetes, Parkinson's disease, chemo brain (a common term used by cancer survivors to describe cognitive problems that can occur during and after cancer treatment), and back and spinal problems."