Effect of five traditional Chinese medicine exercises on insomnia: A systematic review and network meta-analysis

Background:
Insomnia has become a significant public health issue. Traditional Chinese medicine (TCM) exercises are used in the treatment of insomnia. The purpose of this study was to compare the effectiveness of five TCM exercise regimens (yijinjing, wuqinxi, liuzijue, baduanjin, and taijiquan) as an intervention for insomnia.

Method:
We searched six databases-China National Knowledge Infrastructure, Wanfang, PubMed, Embase, Cochrane Library, and Web of Science-for relevant articles, published in English or Chinese, from their inception till April 2024. Data from the included literature were analyzed and evaluated using a network meta-analysis of random effects with a frequency-based framework.

Results:
A total of 50 papers were included, comprising 4226 patients with insomnia. The results of the direct comparison of the five TCM exercises (yijinjing, wuqinxi, liuzijue, baduanjin, and taijiquan) with the control group indicated that all five TCM exercises were able to improve insomnia (p < 0.05). In the indirect comparison between the five TCM exercises, there was a significant difference between liuzijue and wuqinxi (p < 0.05), and taijiquan (p < 0.05). We used the areas under the receiver operating curves to rank the effectiveness of the five TCM exercises in treating insomnia as follows: liuzijue (Surface Under the Cumulative Ranking Curve, SUCRA = 96.4%) > yijinjing (SUCRA = 72.6%) > baduanjin (SUCRA = 55.1%) > taijiquan (45%) > wuqinxi (SUCRA = 30.9%).

Conclusion:
The studied TCM exercises can be used as an effective treatment for insomnia, and liuzijue is the most effective of the studied options.

Keywords: Health; Insomnia; Liuzijue; Sleep quality; Traditional Chinese medicine exercise.

PMID: 39642468 DOI: 10.1016/j.jpsychires.2024.12.004