Associations of resistance liuzijue qigong with sleep and mood in chronic insomnia: a pilot open-label Non-randomized trial

Chronic insomnia is highly prevalent worldwide. First-line treatments are constrained by adverse effects, dependence, and limited accessibility. Traditional mind-body exercises such as Resistance Liuzijue Qigong are safe and feasible. This prospective pilot study preliminarily explored associations between Qigong practice and changes in sleep, mood, fatigue, and quality of life in patients with chronic insomnia.

In this prospective open-label non-randomized pilot trial, 40 patients with chronic insomnia were assigned to intervention or control groups. The intervention group underwent 3 months of Resistance Liuzijue Qigong training, while the control group received routine health education. Primary outcomes were the Pittsburgh Sleep Quality Index (PSQI) and actigraphy-derived objective sleep parameters; secondary outcomes included the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Fatigue Severity Scale (FSS), 36-Item Short Form Health Survey (SF-36), and nocturnal mean heart and respiratory rates. Normally distributed data were analyzed with paired and independent t-tests; skewed data with paired rank-sum and Mann-Whitney U tests; categorical data with chi-square or Fisher's exact test. Significance was set at α = 0.05.

Comparisons between the 3-month Resistance Liuzijue Qigong intervention group and the routine care control group showed significant within-group reductions in PSQI, SAS, SDS and FSS scores for both groups (all P<0.001). Between-group comparisons revealed numerically lower SAS (t=4.268, P<0.001) and SDS (t=2.371, P=0.024) scores in the intervention group compared to the control group. For objective sleep parameters, the between-group comparison showed a statistically significant difference in sleep efficiency (t=-3.049, P=0.004) and wake after sleep onset (U=284.5, P=0.023). The between-group difference in the change rate of sleep efficiency was also statistically significant (W=284, P=0.023).

This pilot study suggested that Resistance Liuzijue Qigong may be associated with anxiety, depression, objective sleep continuity, and sleep efficiency in chronic insomnia patients. However, given the non-randomized open-label design, these findings are exploratory and require confirmation in large-scale RCTs with allocation concealment.