Effect of a Home-Based Simplified Tai Chi Exercise Program on Sleep Quality,Daytime Sleepiness,Quality of Life,and Psychological Well-Being in Egyptian Older Adults: A Quasi-Experimental Study

Abstract

Introduction: Sleep disturbances are common among older adults and can have detrimental effects on their overall well-being. Tai Chi exercise has shown promise in improving sleep quality, quality of life (QoL), and psychological well-being in various populations. Objective: To investigate the effect of a home-based simplified Tai Chi exercise program on sleep quality, daytime sleepiness, QoL, and psychological well-being in Egyptian older adults. Methods: A quasi-experimental design was employed, with 152 participants aged 60 years and above assigned to either an experimental group (n = 87) or a control group (n = 65). Thecontrol group received a health education program to improve their sleeping quality and life-style, while the experimental group received a similar health education program and Tai Chi exercise training program. The participants in the experimental group were instructed to perform 3 months Tai Chi exercise. Data on sleep quality, daytime sleepiness, QoL, generalized anxiety disorder (GAD), and depression symptoms were collected at baseline, and one month, and 3 months post-intervention using validated questionnaires. Repeated measures ANOVA was done to investigate the effectiveness of the intervention programsover 3 time periods. Results: The results showed significant improvements in sleep quality (p < .001), QoL (p < .005), GAD (p < .005), and depression symptoms (p < .005) post-interventions. Also, there were significant difference in the effectiveness of the intervention programs between both the experimental and control groups. The experimental group exhibited greater improvements compared to the control group. Conclusion: The findings support the beneficial effects of a home-based simplified Tai Chi exercise program on sleep quality, QoL, and psychological well-being in Egyptian older adults. These results have important implications for promoting healthy aging and improving overall well-being in this population. Further research is recommended to validate these findings and explore the underlying mechanisms of Tai Chi exercise on the outcomes of interest.

Keywords

Tai Chi exercise sleep quality quality of life generalized anxiety disorder depression symptoms and Egyptian older adults

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References

Abd Allah

E. S.

Abdel-Aziz

H. R.

El-Seoud

A. R. A.

(2014). Insomnia: Prevalence, risk factors, and its effect on quality of life among elderly in Zagazig City, Egypt. Journal of Nursing Education and Practice, 4(8), 52.

Albatineh

A. N.

Al-Taiar

Al-Sabah

Zogheib

(2022). Psychometric properties of the Arabic version of the Pittsburgh sleep quality index in hemodialysis patients. Sleep and Vigilance, 6(2), 323–333. https://doi.org/10.1007/s41782-022-00211-6

AlHadi

A. N.

AlAteeq

D. A.

Al-Sharif

Bawazeer

H. M.

Alanazi

AlShomrani

A. T.

Shuqdar

R. M.

AlOwaybil

(2017). An Arabic translation, reliability, and validation of patient health questionnaire in a Saudi sample. Annals of General Psychiatry, 16(1), 32–39. https://doi.org/10.1186/s12991-017-0155-1

Alvaro

P. K.

Roberts

R. M.

Harris

J. K.

(2013). A systematic review assessing bidirectionality between sleep disturbances, anxiety, and depression. Sleep, 36(7), 1059–1068. https://doi.org/10.5665/sleep.2810

Attal

B. A.

Al-Ammar

F. K.

Bezdan

(2020). Validation of the Arabic version of the Epworth sleepiness scale among the Yemeni medical students. Sleep Disorders, 2020, 6760505. https://doi.org/10.1155/2020/6760505

Brandão

G. S.

Gomes

G. S. B. F.

Callou Sampaio

A. A.

Donner

C. F.

Oliveira

L. V.

Camelier

A. A.

(2018). Home exercise improves the quality of sleep and daytime sleepiness of elderlies: A randomized controlled trial. Multidisciplinary respiratory medicine, 13(1), 2–9. https://doi.org/10.1186/s40248-017-0114-3

Brandão

G. S.

Sampaio

A. A.

Damas Andrade

Fonseca

A. L.

Campos

F. K.

Silva

A. S.

Silva

M. M.

Oliveira-Silva

Vieira

R. P.

Donner

C. F.

Silva

R. A.

Jr. Camelier

A. A.

Oliveira

L. V. F.

Vieira

R. P.

(2021). Home physical exercise improves functional mobility and quality of life in the elderly: A CONSORT‐prospective, randomised controlled clinical trial. International Journal of Clinical Practice, 75(8), Article e14347. https://doi.org/10.1111/ijcp.14347

Buysse

D. J.

Reynolds

C. F.

III. Monk

T. H.

Berman

S. R.

Kupfer

D. J.

(1989). The Pittsburgh sleep quality index: A new instrument for psychiatric practice and research. Psychiatry Research, 28(2), 193–213. https://doi.org/10.1016/0165-1781(89)90047-4

Coons

S. J.

Alabdulmohsin

S. A.

Draugalis

J. R.

Hays

R. D.

(1998). Reliability of an Arabic version of the RAND-36 health survey and its equivalence to the US-English version. Medical Care, 36(3), 428–432. https://doi.org/10.1097/00005650-199803000-00018

10.

El-Gilany

A.-H.

Saleh

N. M. H.

Mohamed

Elsayed

E. B. M.

(2017). Prevalence of insomnia and its associated factors among rural elderly: A community based study. International Journal of Advanced Nursing Studies, 6(1), 56. https://doi.org/10.14419/ijans.v6i1.7415

11.

Fakhari

(2017). Effects of tai chi exercise on depression in older adults: A randomized controlled trial. Bali Medical Journal, 6(3), 679–683. https://doi.org/10.15562/bmj.v6i3.706

12.

Gehrman

P. R.

Gooneratne

N. S.

(2010). Non-pharmacological treatment of insomnia in the elderly: Cognitive behavioral therapies. In Pandi-Perumal

S. R.

Monti

J. R.

Monjan

A. A.

(Eds.), Principles and practice of geriatric sleep medicine (pp. 384–393). Cambridge University Press. https://doi.org/10.1017/cbo9780511770661.039

13.

Ghaleh

A. T.

Rejeh

Heravi-Karimooi

Kia

P. S.

Tadrisi

S. D.

(2018). Effect of “Tai Chi” on happiness in elderly men. Iranian Journal of Nursing Research, 13(5), 1–7. https://doi.org/10.1142/s0192415x1250019x

14.

Johns

M. W.

(1991). A new method for measuring daytime sleepiness: The epworth sleepiness scale. Sleep, 14(6), 540–545. https://doi.org/10.1093/sleep/14.6.540

15.

Kang

(2021). Sample size determination and power analysis using the G* Power software. Journal of Educational Evaluation for Health Professions, 18, 17. https://doi.org/10.3352/jeehp.2021.18.17

16.

Kittichittipanich

Kusoom

(2019). The effectiveness of Tai Chi exercise in improving balance and preventing falls among older adults. The Open Public Health Journal, 12(1), 465–471. https://doi.org/10.2174/1874944501912010465

17.

Kroenke

Spitzer

R. L.

Williams

J. B.

(2003). The patient health questionnaire-2: Validity of a two-item depression screener. Medical Care, 41(11), 1284–1292. https://doi.org/10.1097/01.mlr.0000093487.78664.3c

18.

Kroenke

Spitzer

R. L.

Williams

J. B.

Monahan

P. O.

Löwe

(2007). Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection. Annals of Internal Medicine, 146(5), 317–325. https://doi.org/10.7326/0003-4819-146-5-200703060-00004

19.

Kurlowicz

Wallace

(1999). The mini-mental state examination (MMSE) (vol. 25, pp. 8–9). SLACK Incorporated Thorofare.

20.

Lee

M. S.

Lee

E. N.

Kim

J. I.

Ernst

(2010). Tai chi for lowering resting blood pressure in the elderly: A systematic review. Journal of Evaluation in Clinical Practice, 16(4), 818–824. https://doi.org/10.1111/j.1365-2753.2009.01210.x

21.

Luik

A. I.

Zuurbier

L. A.

Direk

Hofman

Van Someren

E. J.

Tiemeier

(2015). 24‐hour activity rhythm and sleep disturbances in depression and anxiety: A population‐based study of middle‐aged and older persons. Depression and Anxiety, 32(9), 684–692. https://doi.org/10.1002/da.22355

22.

Mohamed Sobhy Elsayed

Abdallah Moursi Afifi

A Abdelsalam

Elsayed Ibrahim

Awad Mekhamier Gab-Allah

(2022). Effect of tai chi exercises program on the quality of life for osteoarthritis patients. Journal of Nursing Science Benha University, 3(2), 1232–1254. https://doi.org/10.21608/jnsbu.2022.283240

23.

Morin

C. M.

Benca

(2012). Chronic insomnia. Lancet (London, England), 379(9821), 1129–1141. https://doi.org/10.1016/s0140-6736(11)60750-2

24.

Munawir Alhejely

M. M.

Shibli

K. Y.

Hamed Almalki

W. A.

Felemban

G. M. B.

Alluhaybi

H. S.

Majrashi

B. M.

Bakhsh

B. Y.

Felemban

(2023). Influence of lifestyle changes on cardiovascular diseases in Saudi arabia: A systematic literature review. Cureus, 15(6), Article e40075. https://doi.org/10.7759/cureus.40075

25.

Nguyen

M. H.

Kruse

(2012). The effects of Tai Chi training on physical fitness, perceived health, and blood pressure in elderly Vietnamese. Open Access Journal of Sports Medicine, 3(December), 7–16. https://doi.org/10.2147/oajsm.s27329

26.

Rababah

J. A.

(2016). Examining the effect of a Tai chi intervention on psychosocial consequences of driving cessation among older adults. [Doctoral dissertation, Kent State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num.=kent1465298964

27.

Rawtaer

Mahendran

Chan

H. Y.

Lei

Kua

E. H.

(2018). A nonpharmacological approach to improve sleep quality in older adults. Asia-Pacific Psychiatry, 10(2), Article e12301. https://doi.org/10.1111/appy.12301

28.

Rudnicka

Napierała

Podfigurna

Męczekalski

Smolarczyk

Grymowicz

(2020). The world health organization (WHO) approach to healthy ageing. Maturitas, 139(September), 6–11. https://doi.org/10.1016/j.maturitas.2020.05.018

29.

Saleh

(2008). Reliability and validity of Arabic version of epworth sleepiness scale. Journal of Sleep and Sleep Disorders Research, 31(Abstract Suppl), A336.

30.

Tajik

Rejeh

Heravi-Karimooi

Samady Kia

Tadrisi

S. D.

Watts

T. E.

Griffiths

Vaismoradi

(2018). The effect of tai chi on quality of life in male older people: A randomized controlled clinical trial. Complementary Therapies in Clinical Practice, 33(November), 191–196. https://doi.org/10.1016/j.ctcp.2018.10.009

31.

Tamura

Tanaka

(2017). Effects of sleep management with self-help treatment for the Japanese elderly with chronic insomnia: A quasi-experimental study. Journal of Behavioral Medicine, 40(4), 659–668. https://doi.org/10.1007/s10865-017-9836-0

32.

Tanaka

Tamura

(2016). Sleep education with self-help treatment and sleep health promotion for mental and physical wellness in Japan. Sleep and Biological Rhythms, 14(December), 89–99. https://doi.org/10.1007/s41105-015-0018-6

33.

Tawalbeh

L. I.

Ahmad

M. M.

(2014). The effect of cardiac education on knowledge and adherence to healthy lifestyle. Clinical Nursing Research, 23(3), 245–258. https://doi.org/10.1177/1054773813486476

34.

Tawalbeh

L. I.

Tubaishat

Batiha

A.-M.

Al-Azzam

AlBashtawy

(2015). The relationship between social support and adherence to healthy lifestyle among patients with coronary artery disease in the north of Jordan. Clinical Nursing Research, 24(2), 121–138. https://doi.org/10.1177/1054773813501194

35.

Varrasse

Gooneratne

(2015). Exercise and sleep in community-dwelling older adults. Current Sleep Medicine Reports, 1(4), 232–240. https://doi.org/10.1007/s40675-015-0028-6

36.

Wang

Bannuru

Ramel

Kupelnick

Scott

Schmid

C. H.

(2010). Tai chi on psychological well-being: Systematic review and meta-analysis. BMC Complementary and Alternative Medicine, 10(1), 1–16. https://doi.org/10.1186/1472-6882-10-23

37.

Wang

Lan

Zhang

Pan

(2020). Effectiveness of tai chi exercise on overall quality of life and its physical and psychological components among older adults: A systematic review and meta-analysis. Brazilian Journal of Medical and Biological Research, 53(10), Article e10196. https://doi.org/10.1590/1414-431x202010196

38.

Wang

Lee

E.-K. O.

Benson

Fricchione

Wang

Yeung

A. S.

(2014). The effects of tai chi on depression, anxiety, and psychological well-being: A systematic review and meta-analysis. International Journal of Behavioral Medicine, 21(4), 605–617. https://doi.org/10.1007/s12529-013-9351-9

39.

Wang

Yang

Wang

(2021). The role of sleep disorders in cardiovascular diseases: Culprit or accomplice? Life Sciences, 283(October), 119851. https://doi.org/10.1016/j.lfs.2021.119851

40.

Ware

J. E.

Jr. Sherbourne

C. D.

(1992). The MOS 36-item short-form health survey (SF-36): I. Conceptual framework and item selection. Medical Care, 30(6), 473–483. https://doi.org/10.1097/00005650-199206000-00002

41.

World Health Organization. (2020). Ageing. WHO.

42.

Yang

Klupp

Cao

Liu

Bensoussan

Kiat

Karamacoska

Chang

(2022). Does tai chi improve psychological well-being and quality of life in patients with cardiovascular disease and/or cardiovascular risk factors? A systematic review. BMC Complementary Medicine and Therapies, 22(1), 3–19. https://doi.org/10.1186/s12906-021-03482-0

43.

Yang

Gong

Luo

Lin

Wang

(2023). Effects of tai chi on sleep quality as well as depression and anxiety in insomnia patients: A meta-analysis of randomized controlled trials. International Journal of Environmental Research and Public Health, 20(4), 3074. https://doi.org/10.3390/ijerph20043074

44.

Yang

P. Y.

K. H.

Chen

H. C.

Chien

M. Y.

(2012). Exercise training improves sleep quality in middle-aged and older adults with sleep problems: A systematic review. Journal of Physiotherapy, 58(3), 157–163. https://doi.org/10.1016/s1836-9553(12)70106-6

45.

Yousuf

Harvey

Al Sharei

Albakri

Alabdallat

(2022). Patient health questionnaire-9 and generalized anxiety discorders-7: Arabic version reliability in Jordan. Jordan Medical Journal, 56(3), 1–11. https://doi.org/10.35516/jmj.v56i3.362

46.

Zheng

Huang

Liu

Tao

Chen

(2015). Tai chi chuan for the primary prevention of stroke in middle-aged and elderly adults: A systematic review. Evidence-Based Complementary and Alternative Medicine, 2015, 742152. https://doi.org/10.1155/2015/742152