The Effect ofT'ai ChiandQigongTraining on Patients with Obstructive Sleep Apnea: A Randomized Controlled Study

The Science of Tai Chi and Qigong and Whole Person Health Part I: Rationale and State of the Science

The emerging paradigm of whole person health shares many core principles with traditional complementary and integrative health frameworks, including Tai Chi and qigong (TCQ). In the Fall of 2023, the Harvard Medical School Osher Center for Integrative Health hosted the inaugural international conference on The Science of Tai Chi for Whole Person Health: Advancing the Integration of Mind-Body Practices into Contemporary Health Care held at Harvard Medical School. A two-part white paper was written to summarize key conference topics, findings, and issues. Part I presented here summarizes the rationale for the conference and synthesizes the state of evidence for TCQ as rehabilitative and preventive tools for a range of clinical conditions, including falls and balance, cognition, mental health, sleep, cardiorespiratory health, musculoskeletal health, cancer, as well as translational evidence related to the neurophysiology, brain and immune function, and biomarkers of inflammation. The state of science of TCQ, viewed through the lens of traditional East Asian health constructs, is also discussed. Part II of this white paper outlines evidence gaps and opportunities and discusses strategies to address challenges in TCQ research, dissemination, and implementation.

Effects of Chinese traditional ethnic sports on sleep quality among the elderly: a systematic review and meta-analysis

Objective

Sleep disorders affect approximately one-fifth of the global elderly population, with poor sleep quality among old adults linked to an increased risk of chronic conditions such as cardiovascular disease, diabetes, and hypertension. Chinese traditional ethnic sports have garnered significant attention for their potential to enhance sleep quality in older adults; however, the effectiveness of these interventions remains controversial. This meta-analysis sought to evaluate the impact of Chinese traditional sports on the quality of sleep among older adults.

Methods

A systematic search of databases, including Web of Science, Pubmed, Embase, Cochrane, China National Knowledge Infrastructure (CNKI), Wanfang, and China Science and Technology Journal Database (VIP), was conducted to identify randomized controlled trials (RCTs) examining the effects of Chinese traditional ethnic sports on sleep quality in older adults. Two independent researchers screened the literature, extracted relevant data, and conducted a quantitative meta-analysis using Stata17 software. Subgroup analyses were performed, including forest and funnel plot generation, heterogeneity analysis, sensitivity analysis, and publication bias assessment.

Results

A total of ten studies met the inclusion criteria. The meta-analysis revealed that older adults who participated in Chinese traditional ethnic sports showed significantly lower total PSQI score s relative to non-participants (Hedges's g = -0.60, 95% CI [-0.89 to -0.31], P < 0.05). Egger's test suggested no significant publication bias. Sensitivity analyses revealed that the age of participants, intervention mode, frequency, and duration did not substantially affect the combined effect size. Significant improvements were observed in sleep quality (Hedges's g = -1.06, 95% CI [-2.00 to -0.13], P < 0.05), sleep duration (Hedges's g = -0.52, 95% CI [-0.87 to -0.17], P < 0.05), and sleep efficiency (Hedges's g = -0.50, 95% CI [-0.81 to -0.18], P < 0.05).

Conclusion

Chinese traditional ethnic sports are highly effective in improving the sleep quality of older individuals, demonstrating significant benefits in sleep quality, duration, and efficiency. Additionally, these interventions may reduce the reliance on sleep medications.

Efficacy comparison of aerobic exercise, combined exercise, oropharyngeal exercise and respiratory muscle training for obstructive sleep apnea: A systematic review and network meta-analysis

BACKGROUND

Obstructive sleep apnea (OSA) has become a global health concern. Aerobic exercise (AE), combined exercise (CE), respiratory muscle training (RMT), and oropharyngeal exercise (OE) can improve OSA to some extent.

OBJECTIVE

This study aimed to evaluate the efficacy of these four interventions in patients with OSA through a more comprehensive systematic review and network meta-analysis.

METHODS

Web of Science, PubMed and Embase databases were searched for observational studies reporting AE, CE, RMT, and OE for the treatment of OSA. RevMan software (version 5.3) was used to evaluate the quality of the included literatures. Network meta-analysis was performed by using STATA software (version 14.0) with "network" command. The node-splitting analysis was performed for inconsistency test. Sensitivity analysis was assessed. A funnel plot and Egger's test were used to investigate publication bias.

RESULTS

Based on 24 studies involving a total of 956 patients with OSA, AE, CE and OE were found to have significant effects on Apnea Hypopnea Index (AHI), Pittsburgh Sleep Quality Index (PSQI) and Epworth Sleepiness Scale (ESS), while RMT had a significant effect solely on PSQI and ESS. In the network meta-analysis, CE was considered most likely to be the effective intervention in improving AHI (SUCRA: 87.8 %), and OE was likely to be the best intervention in improving PSQI (SUCRA: 75.8 %) and ESS (SUCRA: 94.9 %).

CONCLUSIONS

AE, CE and OE all improved AHI, PSQI and ESS, but there was no significant difference in the improvement effect among these three interventions. Considering the complexity of the intervention process and the differences in effects, it is recommended that the effect size and applicability of various interventions should be comprehensively considered when choosing specific interventions. The findings need to be further confirmed based on larger and more rigorous randomized controlled trials so that clinicians could develop better protocols for patients with different needs.

Relationship Between Obstructive Sleep Apnea and Sports-Systematic Review and Meta-Analysis

The primary objective of this research is to analyze and compare the effects of physical activity on patients diagnosed with obstructive sleep apnea (OSA), a condition characterized by repeated episodes of partial or complete obstruction of the upper airway during sleep, leading to disrupted sleep and various health complications. Methods: A systematic and strategic search of 16 peer-reviewed articles was conducted to assess the impact of different types of physical exercise on the apnea-hypopnea index (AHI), a key metric used to quantify the severity of OSA. The selected studies focused on two main exercise modalities: aerobic exercise alone and a combination of aerobic and resistance training. These modalities were examined to determine their respective influences on the AHI among individuals with OSA. Results: The findings revealed that aerobic exercise alone did not significantly alter the apnea-hypopnea index (p = 0.15), suggesting limited effectiveness in reducing the severity of OSA when performed in isolation. However, in patients who engaged in combined physical activity-incorporating both aerobic and resistance exercises-a significant reduction in the AHI was observed (p < 0.01), indicating a more substantial therapeutic effect. Conclusions: This study concludes that a structured exercise program combining aerobic and resistance training produces a significant improvement in the apnea-hypopnea indices of patients with obstructive sleep apnea. These results highlight the potential of combined exercise regimens as a non-pharmacological intervention that could complement traditional OSA treatments, offering a viable approach to managing the condition and improving patient outcomes. Future research should aim to explore the optimal exercise intensity, duration, and frequency to maximize these benefits.

Improving Memory Through Better Sleep in Community-Dwelling Older Adults: A Tai Chi Intervention Study

OBJECTIVES

The relationship between sleep and memory has been well documented. However, it remains unclear whether a mind-body exercise, that is, Tai Chi exercise, can improve memory performance in older adults by improving their subjective and objective sleep.

METHODS

A randomized controlled trial was conducted with participants (M = 67.36, 56-79 years) randomly assigned to Tai Chi and control groups. The primary outcomes were sleep, both subjectively reported and objectively assessed by actigraphy, and memory performance, as well as the mediating role of sleep in memory improvement with Tai Chi practice.

RESULTS

Tai Chi exercise led to improvements in subjective sleep, as indicated by Insomnia Severity Index (ISI) (p < .001, Cohen's d = 0.62) and daytime dysfunction of the Pittsburgh sleep quality index (PSQI) (p = .02, Cohen's d = 0.80), and in actigraphy-assessed sleep onset latency (p < .01, Cohen's d = 0.61), as well as improved memory performance on digit span forward (p < .001, Cohen's d = 1.20) and visual spatial memory tasks (p < .01, Cohen's d = 0.83) compared to the control group. Importantly, Tai Chi practice improved digit span forward memory performance through parallel mediation of both subjective sleep (i.e., daytime dysfunction of the PSQI) and objective sleep (i.e., sleep onset latency; b = 0.29, p < .01).

DISCUSSION

Our findings uncovered the potential benefits of Tai Chi exercise in relation to both subjective and objective sleep in older adults, in turn, how sleep changes played a role in the link between Tai Chi exercise and memory changes in older adults.

Optimal exercise dose and type for improving sleep quality: a systematic review and network meta-analysis of RCTs

Background

A substantial amount of research has explored the intricate relationship between exercise and sleep quality, consistently confirming that exercise can effectively enhance sleep quality. Nevertheless, previous studies have yet to conclusively determine which specific exercise program is most efficacious in improving sleep quality. To address this gap, the present study systematically evaluated the differential effects of various types of exercise, as well as exercise dosages (including duration, intervention period, frequency, and intensity), on sleep outcomes using a network meta-analysis approach. This endeavor aims to provide evidence-based support for the development of scientifically effective exercise programs tailored to improve sleep quality.

Methods

Through the Web of Science, PubMed, Cochrane Library, Embase, and Scopus databases, we conducted a search for randomized controlled trials investigating the effects of exercise interventions on sleep, with a search cutoff date of April 30, 2024. We rigorously selected the literature according to the PICOS principle, and two independent researchers extracted the data. We would like to change this passage to: Bias risk assessment was conducted using the RevMan 5.4 software, and traditional meta-analysis and network meta-analysis were performed using Stata 17.0 software to generate forest plots, network evidence plots, and funnel plots. Furthermore, we adopted the surface under the cumulative ranking curve (SUCRA) to evaluate and rank the intervention effects of different exercise types and dosages on sleep quality. To verify the robustness of our study results, we performed a sensitivity analysis using the leave-one-out method.

Results

The study strictly adhered to the PRISMA guidelines and included 58 RCT papers with a total of 5,008 participants. The network meta-analysis revealed significant variations in the impact of exercise frequency on sleep outcomes when compared to the control group. Interventions of 1-2 times per week [SMD = -0.85, 95% CI (-1.43, -0.26)], 3 times per week [SMD = -0.45, 95% CI (-0.80, -0.11)], and 4 times per week [SMD = -1.09, 95% CI (-1.92, -0.26)] demonstrated the most notable effects. Interventions lasting ≤30 min and 60-65 min were significantly more effective than the control group, with ≤30 min proving significantly more effective than 40-55 min [SMD = 0.75, 95% CI (0.01, 1.49)]. Interventions lasting 9-10 weeks [SMD = -1.40, 95% CI (-2.37, -0.44)], 12-16 weeks [SMD = -0.55, 95% CI (-0.90, -0.20)], and ≥ 24 weeks [SMD = -0.71, 95% CI (-1.31, -0.10)] were all significantly more effective than the control group. Additionally, the 9-10 weeks intervention period was found to be significantly more effective than the 6-8 weeks period [SMD = -1.21, 95% CI (-2.37, -0.04)]. Furthermore, interventions of moderate intensity [SMD = -1.06, 95% CI (-1.52, -0.61)] and high intensity [SMD = -1.48, 95% CI (-2.55, -0.40)] exercise interventions yielded significantly greater benefits compared to the control group. Specifically, high intensity interventions [SMD = -1.97, 95% CI (-3.37, -0.56)] and moderate intensity [SMD = -1.55, 95% CI (-2.57, -0.54)] exercise interventions were found to be significantly more effective than moderate-high intensity interventions. In terms of exercise types, aerobic exercise [SMD = -0.56, 95% CI (-0.86, -0.27)], traditional Chinese exercises [SMD = -0.57, 95% CI (-0.97, -0.18)], and combined exercise [SMD = -0.99, 95% CI (-1.66, -0.32)] interventions all produced significant improvements compared to the control group. The study determined that the most effective combination of exercise prescription elements for enhancing sleep quality includes a frequency of 4 times per week (SUCRA = 84.7), a duration of ≤30 min (SUCRA = 92.2), a period of 9-10 weeks (SUCRA = 89.9), and high-intensity (SUCRA = 92.9) combined exercise (SUCRA = 82.7).

Conclusion

The current evidence indicates that combined exercise with a frequency of 4 times per week, a duration of ≤30 min, a period of 9-10 weeks, and high intensity is most effective for improving sleep quality. Nevertheless, due to the limited number of studies included, further research is needed to enhance the reliability of the findings.

Systematic review registration

https://www.crd.york.ac.uk/prospero/, identifier: CRD42024555428.

The effects of exercise programs on sleep architecture in obstructive sleep apnea: a meta-analysis of randomized controlled trials

OBJECTIVES

Exercise is an effective intervention for obstructive sleep apnea (OSA). However, the effects of exercise on objective sleep architecture in patients with OSA remain unknown. This meta-analysis aimed to collect data from randomized controlled trials of exercise interventions in patients with OSA, with a specific focus on objective sleep parameters derived from polysomnography.

METHODS

Randomized control trials that targeted patients with OSA aged >18 years, measured sleep using polysomnography after exercise programs, and reported the proportion of sleep stages were included for meta-analysis. Bias was assessed using the revised Cochrane risk-of-bias tool and funnel plots. The random effects model was applied.

RESULTS

Six studies with a total of 236 patients were included in the meta-analysis. There were no significant differences in the total sleep time (TST), sleep efficiency, sleep onset latency, stage N1 sleep, or rapid eye movement sleep between the exercise and control groups. Participation in an exercise program lasting >12 weeks significantly decreased stage N2 and increased stage N3 sleep as observed in the subgroup analysis. Although this tendency did not reach statistical significance in the total-group analysis, it was significant after excluding the possible confounding effects of heart disease.

CONCLUSIONS

The exercise program decreased N2 and increased N3 proportions over the TST among patients with OSA, which may correspond to subjective sleep quality. The beneficial effects were significant when the program lasted >12 weeks and after excluding the confounding effects of heart disease. Exercise program duration should be considered when providing clinical advice.

The effects of Tai Chi exercise on sleep quality among the elderly: a study based on polysomnographic monitoring

Background

Sleep disorders contribute to an increased risk of depression, cardiovascular issues, and various other diseases among older individuals. Consequently, enhancing the sleep quality of this demographic population has become a pressing concern. The objective of this study was to investigate the influence of an 8-week Tai Chi exercise intervention in the sleep quality of older adults.

Methods

Sixty individuals aged 60 years and above, recruited from the community around Southwest University in Beibei District, Chongqing City, were randomly assigned to either a control group (30 participants) or an intervention group (30 participants). The control group adhered to their normal daily routines during the 8-week experimental period, while the intervention group engaged in a 60-min Tai Chi practice three times a week for 8 weeks. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), the Insomnia Severity Index (ISI), and the Epworth Sleepiness Scale (ESS). Additionally, the Polysomnographic Sleep Quality Monitoring System (PSG) was employed to monitor the sleep process before and after the Tai Chi intervention.

Results

After the experiment, significant differences were observed in PSQI and IEI scores between the intervention and control groups (p < 0.05). In the experimental group, the pre-post comparisons revealed a significant increase in time spent in bed (p < 0.05), total sleep time (p < 0.05), and non-REM sleep stage 2 (p < 0.05).

Conclusion

The findings indicate that Tai Chi exercise may improve subjective reported sleep quality. In addition, Tai Chi exercise may alleviate general drowsiness, extend sleep duration, and optimize the sleep process and structure. Consequently, Tai Chi exercise may be a suitable exercise to improve sleep quality in older individuals.

Effects of different Chinese traditional exercises on sleep quality and mental health of adults: systematic review and meta-analysis

OBJECTIVE

To evaluate the effects of traditional Chinese exercises on sleep quality and mental health in adults with different health statuses. METHOD   : This review was registered a priori (CRD42023382188) and executed according to PRISMA statement guidelines. We searched the databases CNKI, China Biology Medicine disc (CBM), Wangfang, PubMed, Web of Science, and Embase from the date of database creation to March 2023. Two researchers independently screened the literature, extracted the data, evaluated the methodological quality of the included literature, and then used Revman 5.4 and Stata 17.0 for the corresponding statistical analysis and graphing.

RESULTS

Thirty-four randomized controlled trials (RCTs) were included, with a total sample of 2563 adults (1276 in the experimental group and 1287 in the control group). The meta-analysis results showed that traditional Chinese exercise significantly improved sleep quality in different groups [WMD =  - 1.58, 95% CI =  - 2.17, - 1.00, P < 0.00001] and that Badaanjin was better than Taijiquan in improving sleep quality. For mental health, traditional Chinese exercise had good effects on anxiety [WMD =  - 1.66, 95% CI =  - 2.64, - 0.69, P = 0.0009] and depression [WMD =  - 1.67, 95% CI =  - 3.23, - 0.11, P = 0.04].

CONCLUSION

Traditional Chinese exercises can improve the quality of sleep and mental health in different groups of people and are highly recommended for good health effects.

Effects of mind-body exercise on body constitution and circadian rhythm in people with suboptimal health status

BACKGROUND

Suboptimal health status (SHS) is a dynamic state in which people have not been diagnosed with a disease but tend to develop diseases. People with SHS are more prone to conditions such as cardiovascular disease and metabolic syndrome. Suitable interventions in people with SHS can prevent disease development. SHS is correlated with traditional Chinese medicine (TCM)-based constitutions, including Yang-Xu (yang deficiency), Yin-Xu (yin deficiency), and stasis types. The circadian rhythm is a potential biomarker of health and metabolism. Baduanjin exercise, a kind of mind-body exercise, has been regarded to adjust body constitution and metabolism, but few studies have evaluated the effects of Baduanjin exercise on body constitution and circadian rhythms. Therefore, this randomized controlled trial investigated the effects of Baduanjin exercise on body constitution and circadian rhythms in people with SHS.

METHODS

Seventy-six participants with SHS were divided into the Baduanjin exercise and control groups (watching a Baduanjin video), with the interventions lasting 12 weeks. The Body Constitution Questionnaire (BCQ), SHS Questionnaire-25 (SHSQ-25), and actigraphy for circadian rhythm measurement were conducted.

RESULTS

The scores of SHSQ-25, Yang-Xu, Yin-Xu, and BCQ stasis decreased significantly after 12 weeks in the Baduanjin exercise group, but not in the control group. Interdaily stability of the circadian rhythm increased significantly in the Baduanjin exercise group but not in the control group.

CONCLUSION

This is the first report of improved health status, modulated body constitution, and increased interdaily stability of the circadian rhythm in participants with SHS who practiced Baduanjin exercise.

The Effect of Moving Meditation Exercise on Depression and Sleep Quality of the Elderly: A Randomized Controlled Study

The aim of the present study was to determine the effect of moving meditation exercise training on depression level and sleep quality in the elderly individuals. The present research was carried out between March 2021 and June 2022 as a randomized control group pretest-posttest design. The study sample consisted of 114 individuals 65 years of age and older who were registered to 2 family health centers in a province. The Introductory Information Form, Katz Activities of Daily Living Scale (Katz ADL), International Physical Activity Questionnaire, Geriatric Depression Scale, and Pittsburgh Sleep Quality Index were used in the study. After the 6-week intervention, participants who were in the moving meditation exercise group had lower depression and had good Sleep Quality intensity scores than those in the control group. The average depression, subjective sleep quality, sleep disorder, and overall sleep quality significantly decreased over time in the moving meditation exercise group (P < .05). Moving meditation exercise may reduce the depression level of elderly individuals and improve sleep quality. These results show that moving meditation exercise can be a supportive method for traditional treatments. In consideration of the growing health economy, it may be recommended that nurses incorporate this exercise in their professional practice and compare long-term results with other complementary practices in the Turkish population.

Integrative Approach to Managing Obstructive Sleep Apnea

Conventional therapies for obstructive sleep apnea (OSA), including CPAP and oral appliances, offer the best opportunity for symptomatic improvement and reduction in OSA overall health impact. Integrative medicine brings conventional and complementary approaches together in a coordinated way. With rising obesity rates, weight loss and lifestyle programs seem to be the most favorable integrative methods to combine with conventional OSA therapies. Complementary and integrative approaches to OSA management are varied and, in conjunction with conventional methods, may offer some reduction in the apnea-hypopnea index.

Effectiveness of Taijiquan in treating insomnia: A systematic review and meta-analysis of randomized controlled studies

BACKGROUND

Sleep efficiency of <80% based on actigraphy was defined as insomnia as self-reported difficulty falling asleep or waking up at night three to four times per week. It is known that adequate sleep is very important for human wellbeing, affecting people's work and life, insomnia will seriously damage our daily life. There is no recognized non-drug treatment. Studies have found that Taijiquan has a positive effect on insomnia patients. This systematic review and meta-analysis will evaluate the effect of Taijiquan on insomnia.

METHODS

To find all randomized controlled trials exploring the effects of Taijiquan on insomnia patients in Chinese and English, eight databases (Pubmed, Embase, Cochrane library, Web of Science, CNKI, CBM, VIP, and Wanfang Data) were searched. The retrieval time is from database construction to October 2021. Searches were conducted in both English and Chinese language. A meta-analysis by mean difference (MD) and 95% confidence interval (CI) was performed with RevMan 5.3. The risk of bias for each study was accounted for according to the Cochrane Handbook. Our primary outcome was Pittsburg Sleep Quality Index. We explored sources of heterogeneity by comparing effect sizes across different types of etiology, country, control group, and intervention type. The protocol was pre-registered with PROSPERO, CRD42021284511.

RESULTS

Twenty-one RCTs published between 2004 and 2021 with 2,022 participants were included in this study. Twenty-one randomized controlled studies showed that Tai Chi significantly improved PSQI scores in patients with cancer, muscle fibrosis, and sub-health insomnia [MD = -1.16, 95% CI (-1.62, -0.71), P < 0.01]; There is insufficient evidence of improvement in patients with cerebrovascular disease [MD = -0.54, 95% CI (-1.58, 0.51), P = 0.31]; 8-form, 10-form or 24-form Yang's Taijiquan had the same effect in improving PSQI [MD = -1.33, 95% CI (-1.85, -0.81), P < 0.01]. When there is no treatment, exercise, exercise and health education as the control, taijiquan has a significant effect on insomnia treatment, and there is no difference in efficacy compared with cognitive behavioral therapy and health education (usual care) alone.

CONCLUSIONS

The results of the study showed that Taijiquan significantly improved sleep quality in healthy adults and patients with chronic diseases, which suggests that Taijiquan may be considered as an alternative behavioral therapy in the treatment of insomnia. In the future, more high-quality, well-controlled randomized trials are needed to better inform clinical decisions.

Integrative Approach to Managing Obstructive Sleep Apnea

Conventional therapies for obstructive sleep apnea (OSA), including CPAP and oral appliances, offer the best opportunity for symptomatic improvement and reduction in OSA overall health impact. Integrative medicine brings conventional and complementary approaches together in a coordinated way. With rising obesity rates, weight loss and lifestyle programs seem to be the most favorable integrative methods to combine with conventional OSA therapies. Complementary and integrative approaches to OSA management are varied and, in conjunction with conventional methods, may offer some reduction in the apnea-hypopnea index.

Effects of Exercise on Patients with Obstructive Sleep Apnea: A Systematic Review and Meta-Analysis

With exercise being more frequently utilized in treatment for obstructive sleep apnea (OSA), a systematic review of the intervention efficacy of exercise on OSA is necessary. PubMed, EBSCO, Web of Science, VIP, and CNKI databases were searched to collect randomized controlled trials (RCTs) of exercise applied to OSA from January 2000 to January 2022. The literature screening, data extraction, and risk of bias assessment of included studies were conducted independently by two reviewers. Meta-analysis was then performed using Rev Man 5.4 software. A total of 9 RCTs were included, including 444 patients. Compared with the control group, exercise made an improvement in apnea-hypopnea index (AHI) [MD = -6.65, 95% CI (-7.77, -5.53), p < 0.00001], minimum oxygen saturation (SaO_2min%) [MD = 1.67, 95% CI (0.82, 2.52), p = 0.0001], peak oxygen uptake (VO_2peak) [SMD = 0.54, 95% CI (0.31, 0.78), p < 0.00001], Pittsburgh sleep quality index (PSQI) [MD = -2.08, 95% CI (-3.95, -0.21), p = 0.03], and Epworth Sleepiness Scale (ESS) values [MD = -1.64, 95% CI, (-3.07, -0.22), p = 0.02]. However, there were no significant changes in body mass index (BMI). As for the results of subgroup analysis, aerobic exercise combined with resistance exercise [MD = -7.36, 95% CI (-8.64, -6.08), p < 0.00001] had a better effect on AHI reduction than aerobic exercise alone [MD = -4.36, 95% CI (-6.67, -2.06), p = 0.0002]. This systematic review demonstrates that exercise reduces the severity of OSA with no changes in BMI, and the effect of aerobic exercise combined with resistance training is better than aerobic exercise alone in AHI reduction. Exercise also improves cardiopulmonary fitness, sleep quality, and excessive daytime sleepiness.

Mindfulness-Based Movement Intervention to Improve Sleep Quality: A Meta-Analysis and Moderator Analysis of Randomized Clinical Trials

(1) Background: Given that the most effective dose, optimal type, and most beneficial population for improving sleep with mindfulness-based movement (MBM) remains unknown, we conducted a systematic review and meta-analysis with moderator analysis of randomized controlled trials (RCTs) to assess these effects. (2) Methods: Three electronic databases (PubMed, Web of Science, and EBSCO) were systematically searched for RCTs published through August 2021 for analysis. The risk of bias of the included studies was assessed with Review Manager 5.3, and the meta-analysis was performed in Stata 16.0. (3) Results: A meta-analysis of 61 RCTs with 2697 participants showed that MBM significantly improved sleep quality compared to controls (SMD = −0.794; 95% CI: −0.794 to −0.994, p < 0.001, I2 = 90.7%). Moderator analysis showed that a long-term MBM (SMD = −0.829; 95% CI: 0.945 to 0.712; p < 0.001) had a larger effect size on sleep than a short-term MBM (SMD = −0.714; 95% CI: 0.784 to 0.644; p < 0.001). Practicing at least twice per week (SMD = −0.793; 95% CI: −0.868 to −0.718; p < 0.001) was more effective compared to practicing once per week (SMD = −0.687; 95% CI: −0.804 to −0.570; p < 0.001). Studies with a total intervention time of more than 24 h also revealed better sleep quality improvement (SMD = −0.759; 95% CI: −0.865 to −0.653; p < 0.001). In addition, the healthy population and older adults gained more from MBM than the patients and younger adults. (4) Conclusions: MBM can effectively improve subjective sleep quality, and the optimal intervention dose of MBM can be utilized in future intervention studies to treat or improve sleep disturbance (MBM more than twice a week for more than three months, with a total intervention time of more than 24 h).

Obstructive Sleep Apnea Syndrome: The Effect of Acute and Chronic Responses of Exercise

Obstructive Sleep Apnea Syndrome (OSAS) is a sleep disorder with high prevalence in general population, but alarmingly low in clinicians' differential diagnosis. We reviewed the literature on PubMed and Scopus from June 1980–2021 in order to describe the altered systematic pathophysiologic mechanisms in OSAS patients as well as to propose an exercise program for these patients. Exercise prevents a dysregulation of both daytime and nighttime cardiovascular autonomic function, reduces body weight, halts the onset and progress of insulin resistance, while it ameliorates excessive daytime sleepiness, cognitive decline, and mood disturbances, contributing to an overall greater sleep quality and quality of life.

Effect of exercise training on body composition in patients with obstructive sleep apnea: a systematic review and meta-analysis

Reduction in adiposity is considered a cornerstone in the treatment of obstructive sleep apnea (OSA). Exercise training is one of the interventions used in the treatment of OSA. However, it remains unclear whether exercise training alleviates OSA by improving body composition. This study aimed to verify the effect of exercise training on body composition and the apnea-hypopnea index (AHI) in patients with OSA. This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in PROSPERO. PubMed/Medline, Scopus, and Cochrane databases were used for systematic review. Analyses were performed using Review Manager software (version 5.3; R Foundation for Statistical Computing, Vienna, Austria). Exercise training significantly reduced body mass index (mean difference = -0.55 kg/m²; 95% CI = -0.95 to -0.15), body fat percentage (mean difference = -1.19%; 95% CI = -2.03 to -0.35), neck circumference (mean difference = -0.55 cm; 95% CI = -1.08 to -0.02), total body weight (mean difference = -2.13 kg; 95% CI = -4.30 to 0.04), and AHI -8.06 events/hour; 95% CI = -10.47 to -5.66). Although body composition was improved by exercise, this improvement was clinically small. Moreover, improvement in AHI by exercise may not be entirely due to improvements in adiposity. PROSPERO #: CRD42020210509.

Effects of Center-Based Delivery of Tai Chi and Qi Gong Group Classes on Self-Reported Symptoms in Cancer Patients and Caregivers

Background: There is increasing interest in complementary approaches such as Tai Chi (TC) and Qi Gong (QG) in oncology settings. We explored the effects of TC/QG delivered in group classes at a comprehensive cancer center. Methods: Patients and caregivers who participated in TC or QG completed assessments before and after an in-person group class. Assessments included questions about expectancy/satisfaction and common cancer symptoms (Edmonton Symptom Assessment Scale [ESAS]). ESAS distress subscales analyzed included global (GDS), physical (PHS), and psychosocial (PSS). Results: Three hundred four participants (184 patients, 120 caregivers) were included in the analysis. At baseline, caregivers had a greater expectancy for change in energy level as a result of class participation compared with patients (22.9% vs 9.9%). No significant difference was observed between baseline patient and caregiver PSS. Clinically significant improvement in well-being was observed among patients in TC classes (1.0) and caregivers in QG classes (1.2). For fatigue, patients (1.4) and caregivers (1.0) participating in QG experienced clinically significant improvement. Both TC and QG classes were associated with clinically significant improvements (ESAS GDS decrease ≥3) in global distress for patients (TC = 4.52, SD= 7.6; QG = 6.05, SD = 7.9) and caregivers (TC = 3.73, SD = 6.3; QG = 4.02, SD = 7.8). Eighty-nine percent of participants responded that their expectations were met. Conclusions: Patients and caregivers participating in TC or QG group classes were satisfied overall and experienced significant improvement in global distress. Additional research is warranted to explore the integration of TC and QG in the delivery of supportive cancer care.

Effect of exercise training on improving sleep disturbances: a systematic review and meta-analysis of randomized control trials

OBJECTIVES

Exercise training has beneficial effects on various aspects of health. This study aimed to investigate the effect of exercise training on the improvement of sleep disturbances using systematic review and meta-analysis of randomized control trials.

METHOD

Four indexes of scientific information including PubMed, Web of Science, Scopus, and the Cochrane library were selected and all manuscripts of these sources were searched in English until January 2021. The studies were screened and finally, the studies were entered into meta-analysis and the Standardized Mean Difference (SMD) was calculated, and the analyzes were performed based on the random effects method. Publication bias and heterogeneity were examined in all analyzes.

RESULT

A total of 32 studies were included in the meta-analysis. Meta-analysis showed that exercise training is effective in improving sleep quality (SMD = -0.85 and confidence interval (CI) was -1.16-0.54; P < 0.001). Exercise training improving insomnia (SMD = -0.87 and CI was -1.68-0.06; P = 0.036). Exercise training improves sleepiness (SMD = -0.38 and CI was -0.68-0.07; P = 0.016), obstructive sleep apnea (SMD = -0.40 and CI was -0.67-0.14; P = 0.003) and restless legs syndrome (SMD = -1.02 and CI was -1.56-0.49; P < 0.001).

DISCUSSION

Exercise training has beneficial effects on a variety of sleep disturbances and therefore it can be said that providing the necessary conditions for exercise training can play a major role in promoting health, especially since this type of intervention is a non-pharmacological intervention.

The effect of qigong for pulmonary function and quality of life in patients with covid-19: A protocol for systematic review and meta-analysis

BACKGROUND

Qigong is a traditional Chinese exercise method for health care, keeping fit and getting rid of diseases. It has the advantages of simple operation and few side effects. Corona Virus Disease 2019 (COVID-19) is an acute respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-COV-2). Its clinical manifestations mainly include fever, fatigue, and dry cough. Clinical practice showed that Qigong had some therapeutic effects on pulmonary dysfunction caused by novel Coronavirus, but there was lacking in evidence of evidence-based medicine. The purpose of this protocol is to systematically evaluate the effects of Qigong on lung function and quality of life in COVID-19 patients, and to add evidence to evidence-based medicine for the clinical application of Qigong therapy.

METHODS

Use computer to retrieve English database (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese database (China Knowledge Network (CNKI), Wanfang Database, VIP Information Chinese Journal Service Platform (VIP), Chinese Biomedical Database). In addition, we manually retrieve randomized controlled clinical research from Baidu academic and Google academic from its establishment to July 2020. Two researchers independently extracted and evaluated the quality of the data included in the study, using RevMan5.3 to do meta-analyses of articles included, without language restrictions.

RESULTS

This research evaluated the effectiveness and safety of Qigongs influence on patients pulmonary function and life quality by index such as 6-minute walk distance (6MWD), Forced expiratory volume in 1 second (FEV1), Forced vital capacity (FVC), Forced expiratory volume in 1 second/Forced vital capacity (FEV1/FVC), Forced expiratory volume in 1 second/prediction (FEV1/PRE), Self-rating anxiety scale (SAS), etc. CONCLUSIONS:: This study will provide reliable evidence-based evidence for the clinical application of Qigong in the treatment of COVID-19.

PROSPERO REGISTRATION NUMBER

CRD42020191877.

Effects of Whole-Body Vibration Exercises on Parameters Related to the Sleep Quality in Metabolic Syndrome Individuals: A Clinical Trial Study

Metabolic syndrome (MetS) is an undesirable clinical condition with physiological, biochemical, clinical, and metabolic factors that contribute to increased cardiovascular risks (CR). A poor sleep quality might be found in obese and MetS individuals. Whole-body vibration (WBV) exercise has been used on the management of MetS individuals. This clinical trial investigated the effect of WBV exercise on parameters related to the sleep quality in MetS individuals. After randomization, nine individuals (seven women and two men) were exposed to a fixed frequency (FF) and ten individuals (eight women and two men) were exposed to a variable frequency (VF). Both groups performed the protocol twice a week, for 6 weeks. All of the evaluations were performed before the first and after the last sessions. Anthropometric and cardiovascular parameters were measured before and after the 6-week intervention. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and Berlin Questionnaire were also used to evaluate the quality of the sleep. A significant (p ≤ 0.05) reduction of the waist circumference in the VFG and an increase of the heart rate were found in the FFG and VFG group. The score of the PSQI of the both groups decreased significantly (p = 0.01). The score of the ESS decreased (p = 0.04) only in the VF group. The scores of the Berlin Questionnaire were not altered in both groups. In conclusion, WBV intervention was capable in interfering with physiological mechanisms with effects on the WC and HR, leading to the improvement of the quality of sleep in MetS individuals. WBV exercise might be an important clinical intervention to the management of some factors associated with poor quality of sleep (FFG and VFG) and in the daytime sleepiness in MetS individuals with variable frequencies (5–16 Hz) (VFG).