Utilization, user evaluation, and associated factors of Traditional Chinese Medicine techniques for insomnia symptoms among Chinese community-dwelling older adults: a cross-sectional study

TL;DR

This study explores how older adults in China use Traditional Chinese Medicine for insomnia, finding that over half use at least one technique, but satisfaction is mixed.

Contribution

The study provides new real-world evidence on TCM use for insomnia in community-dwelling older adults and identifies factors associated with its utilization.

Findings

Over half of participants used at least one TCM technique for insomnia.

Satisfaction with TCM techniques was high, but only a minority rated them as 'very satisfied' or 'highly effective'.

Factors like pre-retirement occupation and TCM awareness were linked to TCM use.

Abstract

Insomnia symptoms are common among older adults, and Traditional Chinese Medicine (TCM) techniques have shown benefits in relieving these symptoms. However, real-world evidence on their use, evaluation, and associated factors in community settings remains limited. This study aimed to describe TCM use and user evaluation for insomnia symptoms among community-dwelling older adults and to explore associated factors.

An exploratory cross-sectional survey was conducted from November 2024 to April 2025 in 15 communities in Changsha, China. Older adults (≥60 years) with clinically significant insomnia symptoms (Insomnia Severity Index ≥8) were recruited. Data were collected on TCM use, perceived satisfaction and effectiveness, and predisposing, enabling, and need-related factors based on the Andersen Behavioral Model. Logistic regression was used to identify associated factors.

Among 311 participants, 51.1% reported using at least one TCM technique, most commonly tuina (71.1%) and moxibustion (69.8%). Satisfaction was generally high, though only 20.1–28.3% were “very satisfied” and 22.6% perceived the interventions as “highly effective.” Four factors were significantly associated with TCM use: pre-retirement occupation and awareness of TCM techniques (predisposing), having relatives or friends engaged in TCM-related industries (enabling), and insomnia severity (need).

This study provides preliminary evidence on the real-world use of TCM techniques for insomnia symptoms among community- dwelling older adults. More than half of participants reported using at least one TCM technique, yet only a minority rated the TCM services as “very satisfied” or “highly effective.” Pre-retirement occupation, awareness of TCM techniques, having relatives or friends working in TCM-related industries, and insomnia severity were associated with TCM technique use. These findings may inform the design of culturally sensitive interventions to manage insomnia symptoms among community-dwelling older adults in similar contexts. Future research should further examine implementation quality and ways to improve both utilization and user satisfaction.