# 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.

## Key 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.