Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial.
Level 2 - randomized trial
Individual randomized controlled trial
PubMed 25748580 · doi:10.1016/j.biopsych.2015.01.010
What was done
In a randomized controlled trial, 123 older adults with insomnia were assigned to cognitive-behavioral therapy for insomnia (CBT-I), tai chi chih (TCC), or an active control (sleep seminar education), receiving weekly 2-hour sessions for 4 months with follow-ups at 7 and 16 months. Researchers evaluated systemic inflammation via C-reactive protein (CRP at baseline, 4, and 16 months), cellular inflammation via TLR-4-activated monocyte production of proinflammatory cytokines (baseline, 2, 4, 7, and 16 months), and leukocyte genome-wide transcriptional profiling at baseline and 4 months.
What was found
Compared to active sleep education control: - CBT-I significantly reduced CRP levels at months 4 and 16 (p < .05), reduced monocyte cytokine production at month 2 (p < .05), and decreased proinflammatory gene expression at month 4 (p < .01). - TCC marginally decreased CRP at month 4 (p = .06), significantly reduced monocyte cytokine production at months 2, 4, 7, and 16 (all ps < .05), and reduced proinflammatory gene expression at month 4 (p < .001). - Both interventions led to reduced activity of NF-κB and AP-1 transcription factors on promoter-based analyses. Specific numerical values for biomarker concentrations and gene fold-changes were not reported in the abstract.
Why it matters
This trial shows that non-pharmacological behavioral and mind-body interventions can alter systemic, cellular, and genomic inflammatory pathways in older adults with insomnia.
Limits
The abstract does not provide exact biomarker concentrations, fold-changes, or confidence intervals. The sample size is modest (123 participants across three arms), restricted to older adults, and evaluated surrogate inflammatory markers rather than downstream clinical health outcomes.
Cited by
- supports A randomized study comparing CBT-I, tai chi, and a sleep seminar showed that CBT-I led to the largest reductions in hs-CRP and improvements in sleep lasting up to 16 months.