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Biol Psychiatry. 2015 Nov 15;78(10):721-9. doi: 10.1016/j.biopsych.2015.01.010. Epub 2015 Feb 4.

Cognitive behavioral therapy and tai chi reverse cellular and genomic markers of inflammation in late-life insomnia: a randomized controlled trial.

Author information

1
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Psychology, University of California, Los Angeles. Electronic address: mirwin1@ucla.edu.
2
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine.
3
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience.
4
Cousins Center for Psychoneuroimmunology, UCLA Semel Institute for Neuroscience; Department of Psychiatry and Biobehavioral Sciences, UCLA David Geffen School of Medicine; Department of Medicine, UCLA David Geffen School of Medicine, Los Angeles, California.
5
Department of Psychology, University of Arizona, Tucson, Arizona.

Abstract

BACKGROUND:

Sleep disturbance is associated with activation of systemic and cellular inflammation, as well as proinflammatory transcriptional profiles in circulating leukocytes. Whether treatments that target insomnia-related complaints might reverse these markers of inflammation in older adults with insomnia is not known.

METHODS:

In this randomized trial, 123 older adults with insomnia were randomly assigned to cognitive-behavioral therapy for insomnia (CBT-I), tai chi chih (TCC), or sleep seminar education active control condition for 2-hour sessions weekly over 4 months with follow-up at 7 and 16 months. We measured C-reactive protein (CRP) at baseline and months 4 and 16; toll-like receptor-4 activated monocyte production of proinflammatory cytokines at baseline and months 2, 4, 7, and 16; and genome-wide transcriptional profiling at baseline and month 4.

RESULTS:

As compared with sleep seminar education active control condition, CBT-I reduced levels of CRP (months 4 and 16, ps < .05), monocyte production of proinflammatory cytokines (month 2 only, p < .05), and proinflammatory gene expression (month 4, p < .01). TCC marginally reduced CRP (month 4, p = .06) and significantly reduced monocyte production of proinflammatory cytokines (months 2, 4, 7, and 16; all ps < .05) and proinflammatory gene expression (month 4, p < .001). In CBT-I and TCC, TELiS promoter-based bioinformatics analyses indicated reduced activity of nuclear factor-κB and AP-1.

CONCLUSIONS:

Among older adults with insomnia, CBT-I reduced systemic inflammation, TCC reduced cellular inflammatory responses, and both treatments reduced expression of genes encoding proinflammatory mediators. The findings provide an evidence-based molecular framework to understand the potential salutary effects of insomnia treatment on inflammation, with implications for inflammatory disease risk.

TRIAL REGISTRATION:

ClinicalTrials.gov NCT00280020.

KEYWORDS:

Aging; Cognitive-behavioral therapy; Gene expression; Inflammation; Insomnia; Tai chi

PMID:
25748580
PMCID:
PMC4524803
DOI:
10.1016/j.biopsych.2015.01.010
[Indexed for MEDLINE]
Free PMC Article

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