Tai Chi Rivals Therapy for Lasting Sleep Relief

A research team led by the School of Public Health at the LKS Faculty of Medicine, the University of Hong Kong (HKUMed), has discovered that tai chi, a traditional Chinese mind-body exercise, offers long-term benefits for chronic insomnia comparable to cognitive behavioural therapy for insomnia (CBT-I), the current first-line non-pharmacological treatment for chronic insomnia. The study supports the therapeutic use of tai chi as an accessible, culturally relevant, low-cost alternative for managing chronic insomnia among middle-aged and older adults. The findings were published in The BMJ .

Alternative evidence-based approach for insomnia

Insomnia is a common sleep disorder in older adults and is linked to serious disorder risks, including cardiovascular disease, mental illness, and cognitive decline. CBT-I, also known as talking therapy, is a psychological intervention designed to help individuals recognise and alter harmful thought patterns and behaviours that interfere with sleep. CBT-I is considered to be an effective treatment option for chronic insomnia but its accessibility is limited by high costs and a shortage of trained therapists, restricting its availability in the community.

Tai chi is a Chinese martial art and an ancient form of mind-body exercise. As a low-impact, moderate-intensity exercise, tai chi is popular among older adults for regular practice to promote health. While previous studies hinted at its positive effects on sleep, rigorous scientific evidence comparing tai chi to standard clinical treatment was lacking.

Professor Parco Siu Ming-fai, Professor and Head of Division of Kinesiology of the School of Public Health, HKUMed, emphasised the importance of validating tai chi as an evidence-based option. This study was designed to fill this important knowledge gap on the therapeutic role of tai chi in relieving chronic insomnia.

Tai chi delivers positive sleep outcomes comparable to CBT-I

Between May 2020 and July 2022, HKUMed researchers conducted a rigorous trial in Hong Kong involving 200 Chinese adults aged 50 or above who were suffering from chronic insomnia. The participants were randomly assigned to either the tai chi or the CBT-I group. The tai chi group practiced the widely recognised 24-form Yang style in one-hour, instructor-led workout sessions twice a week for three months. To rigorously assess outcomes, insomnia severity was measured using the Insomnia Severity Index (ISI) at three critical points: before the programme (baseline), at three months (post-intervention) and at 15 months (12-month follow-up). Researchers set a benchmark to assess tai chi's potential as an alternative therapy for insomnia. If tai chi's improvement on the ISI fell within four points of the standard CBT-I treatment, it would be recognised as delivering comparable clinical effectiveness.

The results revealed a fascinating dynamic between short and long-term outcomes. At the three-month checkpoint, CBT-I demonstrated a clear advantage, reducing ISI scores by 11.19 points compared to tai chi's 6.67, resulting in a between-group difference of 4.52, underscoring CBT-I's faster impact. However, the picture shifted dramatically over time. By month 15, tai chi had nearly caught up, achieving a reduction of 9.51 points versus CBT-I's 10.18, narrowing the gap to just 0.68 points and meeting the non-inferiority criteria.

"While CBT-I delivers rapid relief, tai chi offers sustained, long-term improvement without the barriers of cost or therapist availability," said Professor Siu. "For many middle-aged and older adults struggling with chronic insomnia, access to CBT-I often means long waits and high expenses. Our research provides strong evidence that tai chi can serve as a practical alternative — providing a lifestyle-based intervention that improves sleep while promoting overall physical and mental well-being. This is more than just good news for insomnia sufferers. Instead of relying solely on clinical referrals, patients can integrate lifestyle-based interventions into insomnia care, empowering individuals to take control of their health."

Professor Parco Siu Ming-fai said that tai chi offers lifestyle-based interventions for integration into insomnia care, empowering individuals to take control of their health and improve both their sleep and overall well-being.

The HKUMed study supports the therapeutic use of tai chi as an alternative for managing chronic insomnia among middle-aged and older adults.

A research team from the Department of Orthopaedics and Traumatology, School of Clinical Medicine, LKS Faculty of Medicine of the University of Hong Kong (HKUMed), has demonstrated that robotic total hip replacement has a lower reoperation rate than the conventional technique. The study found a 90-day reoperation rate of only 0.6% with robotic procedures as compared to 2.5% with conventional procedures. Robotic procedures thus promise long-term benefits for patients, enabling them to regain mobility and return to normal life.

End-stage hip arthritis causes severe groin pain, joint stiffness and functional deficit, including impairment in walking, sitting and standing. While total hip replacement is a common operation, complications can occur and may lead to reoperation and prolonged recovery times.

Precision in robotic arm assisted total hip replacement

Compared to conventional technique, robotic hip replacement utilises three-dimensional computed tomography scans for precise preoperative planning of both acetabular and femoral components. During surgery, acetabular bone preparation and implant positioning are carried out under robotic arm guidance, allowing for precise control over bone removal and cup placement.

Dr Henry Fu Chun-him, Clinical Associate Professor and Chief of the Division of Joint Replacement Surgery, Department of Orthopaedics and Traumatology, School of Clinical Medicine, HKUMed, said, ‘The robotic arm allows the direction and depth of the acetabular cup placement to be executed in accordance with preoperative planning, achieving angular precision down to 2 degrees and depth accuracy within 2mm.’

Six-year local data confirms safety advantages of robotic hip replacement

The research team reviewed the results of 553 primary total hip replacement surgeries performed in Queen Mary Hospital and the Duchess of Kent Children's Hospital at Sandy Bay Joint Replacement Centre between 1 January 2019 and 31 December 2024. These included 311 robotic total hip replacements and 242 conventional total hip replacements. The rate of reoperation within 30 and 90 days after surgery was lower for the robotic total hip replacement.

Dr Fu added, ‘Early reoperations after total hip replacement are devastating. With robotics, the rate of reoperation at 90 days is only 0.6%.’ In cases requiring reoperation in the robotic group, all procedures were done in a closed manner without the need for surgical reopening. In contrast, the conventional group had a 2.5% reoperation rate due to periprosthetic fractures and wound infections, requiring surgical reopening and resulting in prolonged recovery times.

While robotic procedures were associated with an overall increase in operative time of 14 minutes, the team observed a clear learning-curve effect, with surgical times progressively approaching those of conventional manual procedures.

Growing utilisation of robotic surgery

HKUMed Department of Orthopaedics and Traumatology was the first in Hong Kong to utilise robotic arm technology for joint replacement surgery in public hospitals, beginning in January 2019.

Dr Amy Cheung Yim-ling, Honorary Clinical Assistant Professor and Deputy Division Chief of the Division of Joint Replacement Surgery of the same department, said, ‘The utilisation of robotics for total hip replacement in Queen Mary Hospital and the Duchess of Kent Children' s Hospital at Sandy Bay has risen steadily from 32% in 2019 to 85% in 2025. In the local public sector, robotic procedures now account for 49% of total hip replacement surgeries.’

HKUMed study demonstrates that robotic total hip replacement has a lower reoperation rate than the conventional technique. The research team members include Dr Henry Fu Chun-him (right) and Dr Amy Cheung Yim-ling.

HKUMed study demonstrates that robotic total hip replacement has a lower reoperation rate than the conventional technique. The research team members include Dr Henry Fu Chun-him (right) and Dr Amy Cheung Yim-ling.

Dr Henry Fu Chun-him (right) highlights that increased experience has progressively shortened the surgery time of robotic total hip replacement. Ms Lai (middle), a patient who has recovered after the robotic surgery, shares that the robotic surgery helps her regain mobility and return to normal life.