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Insomnia is a complex sleep disorder that poses a major challenge to modern medicine and public health. Global epidemiological data show that around 27%–30% of adults experience insomnia to varying degrees, with 6%–10% meeting the diagnostic criteria for chronic insomnia (, ). Insomnia is marked by difficulty falling asleep, poor sleep maintenance, and early awakenings, often accompanied by impaired daytime functioning such as reduced attention, memory decline, and emotional instability, which significantly impair quality of life and productivity (). Epidemiological studies reveal substantial variation in insomnia prevalence by age and gender.Among adults aged 65 and older, prevalence rises to 30%–48%, and women are approximately 1.4 times more likely than men to experience insomnia.These disparities are likely due to age-related physiological changes, hormonal fluctuations, and psychosocial influences.Pathophysiological studies have implicated multiple systems in insomnia, including dysregulation of the hypothalamic–pituitary–adrenal (HPA) axis, autonomic nervous system dysfunction, and altered brain connectivity ().

Insomnia is associated with substantial health consequences. Clinical evidence indicates that individuals with chronic insomnia are 2–3 times more likely to develop depression and 1.5–2 times more likely to experience anxiety disorders. Moreover, insomnia is a significant risk factor for cardiovascular disease and cognitive impairment (–).Socioeconomically, the direct medical costs and indirect productivity losses due to insomnia are considerable.According to the American Academy of Sleep Medicine, insomnia results in annual economic losses amounting to hundreds of billions of dollars in the United States alone (). Current mainstream treatments for insomnia include pharmacological and psychological-behavioral approaches. Benzodiazepine receptor agonists and related drugs offer short-term efficacy but carry risks of dependence, tolerance, and adverse effects with long-term use (). CBT-I, the gold-standard non-pharmacological treatment, faces limitations such as limited availability of trained therapists and extended treatment durations.These gaps have fueled growing interest in complementary and alternative therapies like Tai Chi (, ).

Tai Chi, a traditional Chinese martial art with a history of more than a century, has recently spread worldwide as a form of physical exercise. It combines slow, flowing movements with controlled deep breathing and focused mental attention to form an integrated system for mind-body regulation (). Over centuries, various styles of Tai Chi have evolved, and its health benefits are increasingly recognized in modern medicine (). As a treatment for insomnia, Tai Chi offers distinct advantages: it is low-impact and suitable for all ages; it promotes mind-body integration to balance physical and psychological states; and its adaptable practice settings enhance accessibility (). A growing body of clinical evidence supports Tai Chi’s efficacy for insomnia. Randomized controlled trials (RCTs) have shown that structured Tai Chi practice improves sleep efficiency, reduces sleep latency, and yields sustained benefits (, ). Mechanistically, Tai Chi may improve sleep by enhancing parasympathetic activity, regulating cortisol levels, and improving brain functional connectivity ().

Bibliometric analysis, a key scientometric tool, enables identification of publication trends, emerging themes, interdisciplinary links, and international collaborations, offering a systematic perspective on research field development (). This study employed bibliometric methods to systematically analyze publications related to “Tai Chi” and “insomnia” indexed in the Web of Science Core Collection (WoSCC) and Scopus databases from January 1, 2006, to July 14, 2025. Using bibliometric and visualization techniques, we objectively mapped the field’s research output characteristics, collaborative network structures, and the evolution of research hotspots. The selection of these two databases was based on their recognized status as the world’s most authoritative citation resources. Both provide high-quality, well-structured metadata essential for network construction and trend prediction, which are critical for ensuring the reliability and validity of bibliometric analyses. In addition, only English-language publications were included to maintain methodological feasibility. Searches of major Chinese databases, including CNKI and Wanfang, revealed that studies on Tai Chi interventions for insomnia are exceedingly limited, falling far below the threshold required for robust bibliometric analyses such as co-citation mapping or keyword clustering. Conducting such analyses on sparse datasets would likely produce unstable or even misleading results. Therefore, to preserve methodological rigor and ensure the reliability of our findings, Chinese-language literature was excluded. By systematically summarizing research progress in this field, this study not only advances scholarly understanding but also provides scientific evidence to guide clinical practice and inform health policy development.

Bibliometric analysis followed established methodologies (). Annual publication trends were analyzed using Origin 2018. Further analyses were conducted using R (version 4.5.1) with the Bibliometrix software (version 4.0; http://www.bibliometrix.org ) (), VOSviewer (version 1.6.20) (), and CiteSpace (version 6.1.4) (). In the WoSCC database, the co-authorship network analysis was conducted with a minimum threshold of ≥ 2 publications for countries, ≥ 3 publications for institutions, and ≥ 2 publications for authors. For co-citation analysis, the minimum citation count for source references was ≥ 30.For keyword co-occurrence, the minimum frequency was ≥ 6. In the Scopus database, the co-authorship network analysis used thresholds of ≥ 2 publications for countries, ≥ 2 publications for institutions, and ≥ 3 publications for authors. For co-citation analysis, the threshold was ≥35 citations. For keyword co-occurrence, the threshold was ≥24, excluding general terms such as “Tai Chi” and “insomnia” along with their synonyms. Journal impact factors (IF) were retrieved from the 2024 Journal Citation Reports (JCR).

In the WoSCC database, after removing duplicates, 281 unique records were obtained. From 2006 to 2020, the number of publications on Tai Chi and insomnia exhibited a steady upward trend, followed by a slight decline during 2021–2022 and a resurgence in 2024 (). In the Scopus database, 489 unique records were retrieved, with publication numbers consistently increasing from 2006 to 2024 (). These parallel trends reflect a growing global interest in the relationship between Tai Chi and insomnia. A country-level analysis revealed that in the WoSCC database, China (n = 94) was the leading contributor, followed by the United States (n = 92), Australia (n = 11), Brazil (n = 8), and Italy (n = 8). Notably, 25.5% of publications from China and 15.2% from the United States involved international collaboration (; ). In the Scopus database, China (n = 157) and the United States (n = 155) also led in publication volume, followed by Australia (n = 18), Canada (n = 18), and Spain (n = 8). International collaboration accounted for 27.4% of Chinese and 12.9% of American publications (; ).

Importantly, both China and the United States not only led in publication volume but also maintained extensive global collaboration networks, as illustrated in . The high research output from these two countries reflects a convergence of cultural, scientific, and societal factors. As the birthplace of Tai Chi, China possesses a strong foundation in traditional medical theory and clinical practice. Governmental support for the modernization of traditional Chinese medicine has further reinforced China’s leading role in this domain. Chinese researchers have predominantly focused on theoretical frameworks and clinical efficacy, particularly emphasizing Tai Chi as a cost-effective solution for the rising incidence of sleep disorders. By contrast, the United States, leveraging its expertise in neuroscience and sleep medicine, has integrated Tai Chi into the broader framework of complementary and alternative medicine (CAM), emphasizing mechanistic studies and rigorous clinical trials to meet growing demands for non-pharmacological treatments. The complementary strengths of both countries—China contributing traditional knowledge and clinical data, and the U.S. offering advanced research methodologies—have synergistically advanced the field. Future collaboration focused on protocol standardization and mechanistic exploration will be essential for expanding global influence.

In addition, the collaboration maps from both databases indicate that the University of California, Los Angeles (UCLA) and The University of Hong Kong serve as the primary collaborative hubs in the West and East, respectively (; ). These institutions represent the core forces of Western evidence-based medicine and Eastern traditional medicine. Their research philosophies and methodologies are highly complementary and have been continuously supported by funded research projects, thereby fostering sustained, high-level international and cross-cultural collaboration. Among individual researchers, Michael R. Irwin (University of California, Los Angeles) has long focused on Tai Chi for insomnia and its underlying mechanisms, consistently producing a substantial body of high-quality publications and establishing an extensive international collaboration network. As a result, he stands out as both the most prolific author and the most widely connected collaborator in this field (; ), making him a key influencer in the development of Tai Chi–insomnia research.

To identify the most influential journals in terms of publication output and citation impact in the field of Tai Chi and insomnia, the Bibliometrix package in R was used. Graphical visualizations were generated with the ggplot2 package, while VOSviewer facilitated co-citation analysis. In the WoSCC database, our search retrieved a total of 281 publications distributed across 178 academic journals (see ). As shown in and , Frontiers in Psychiatry (n = 9, IF = 3.2) emerged as the leading publication outlet, followed by Sleep Medicine Reviews (n = 7, IF = 9.7), Medicine (n = 6, IF = 1.4), BMJ Open (n = 5, IF = 2.3), and Complementary Therapies in Medicine (n = 5, IF = 3.5). and list the most frequently cited journals, with Sleep (n = 603, IF = 4.9) ranking first, followed by Sleep Medicine Reviews (n = 280, IF = 9.7), Journal of the American Geriatrics Society (n = 249, IF = 4.5), Journal of Clinical Oncology (n = 243, IF = 41.9), and Sleep Medicine (n = 243, IF = 3.4). In the Scopus database, a total of 489 publications were identified, spanning 283 academic journals (see ). As summarized in , Sleep Medicine Reviews (n = 10, IF = 9.7) was the most prominent publishing journal, followed by Complementary Therapies in Medicine (n = 9, IF = 3.5), Integrative Cancer Therapies (n = 9, IF = 2.8), Medicine (n = 9, IF = 1.4), and BMJ Open (n = 8, IF = 2.3).

Notably, the co-citation analyses from both WoSCC and Scopus () identified Sleep as the central hub of shared references. Collectively, these findings underscore the pivotal roles of Frontiers in Psychiatry, Sleep Medicine Reviews, and Sleep in advancing research on Tai Chi and insomnia.

Keyword clustering provides a concise overview of core themes and research directions within a field. In this study, 1,211 keywords were identified from the WoSCC database using VOSviewer. presents the top 20 most frequently occurring keywords (frequency > 23), revealing major areas of focus. Among them, Quality of Life (n = 100) was the most frequent, followed by Exercise (n = 94), Older Adults (n = 85), Randomized Controlled Trial (n = 66), and Depression (n = 58). Cluster analysis identified four distinct keyword clusters, visualized in (1): The red cluster (36 keywords) includes exercise, older adults, health, physical activity, meta-analysis, and intervention, centering on Tai Chi’s role in promoting physical health—particularly cardiovascular benefits—in older adults, aiming to reduce age-related health risks and enhance overall wellness (2). The green cluster (21 keywords) encompasses depression, anxiety, quality, efficacy, symptoms, and mental health, highlighting research on Tai Chi’s efficacy in alleviating psychological disorders, with a focus on its function as a mind-body therapeutic approach (3). The blue cluster (19 keywords) includes cognitive-behavioral therapy, stress reduction, meditation, mindfulness, disturbance, and inflammation, representing mindfulness-based interventions that address emotional regulation, stress, and inflammatory pathways associated with sleep quality improvement (4). The yellow cluster (18 keywords) comprises quality of life, randomized controlled trial, qigong, yoga, fatigue, and breast cancer, emphasizing evidence-based evaluations of Tai Chi and related therapies in improving quality of life, alleviating fatigue, and supporting cancer rehabilitation—especially in addressing insomnia linked to pain and functional impairment. All keywords are detailed in .

From the Scopus database, 4,685 keywords were extracted using VOSviewer. lists the top 20 most frequent terms (frequency > 89), with Randomized Controlled Trial (n = 226) as the most common, followed by Female (n = 207), Review (n = 203), Quality of Life (n = 194), and Exercise (n = 186). Cluster analysis revealed three major groups () (1): The red cluster (36 keywords) includes review, yoga, fatigue, alternative medicine, acupuncture, mindfulness, meditation, cognitive behavioral therapy, pain, and mind-body therapies, underscoring the prominence of CAM strategies aimed at alleviating symptoms—such as fatigue, pain, and stress—that exacerbate insomnia (2). The green cluster (31 keywords) includes female, adult, controlled study, aged, middle aged, physical activity, treatment outcome, mental health, questionnaire, and cognition, reflecting clinical studies focused on adult and elderly populations, examining the influence of psychological and cognitive factors, as well as physical activity, on insomnia-related mental health outcomes (3). The blue cluster (30 keywords) includes randomized controlled trial, quality of life, exercise, depression, systematic review, meta-analysis, anxiety, kinesiotherapy, breast cancer, and resistance training, emphasizing evidence-based assessments of exercise therapies—such as Tai Chi—in improving sleep, mood, and life quality, particularly for patients with chronic diseases like cancer. All keyword data are provided in .

To further explore emerging frontiers and research foci in Tai Chi and insomnia, we used CiteSpace to identify the top five keywords with the strongest citation bursts in the WoSCC database (). Notably, the three most prominent burst keywords were quality (strength = 3.78), mental health (strength = 3.57), and tai chi exercise (strength = 3.35), indicating that research attention has expanded from sleep improvement alone to broader health outcomes. The keyword quality underscores the importance of both sleep quality and overall quality of life, highlighting the shift toward patient-centered, comprehensive outcomes. Mental health reflects the close association between insomnia and psychological conditions such as anxiety and depression; with its combined exercise and meditative components, Tai Chi can regulate emotions and improve sleep. Tai chi exercise captures the global trend toward standardizing Tai Chi as a structured exercise intervention. In addition, the three most recent frontier burst keywords—risk, mental health, and quality—further reveal a growing focus on insomnia risk factors, psychological health interventions, and quality-of-life enhancement. These findings suggest that Tai Chi is increasingly viewed as a safe, holistic, non-pharmacological treatment, with research shifting from efficacy validation toward risk management and health promotion.

Similarly, CiteSpace identified the top 25 keyword bursts related to Tai Chi and insomnia in the Scopus database (). The three strongest citation bursts were priority journal (strength = 18.88), clinical trial (strength = 10.41), and cognitive therapy (strength = 8.83). The most recent frontier bursts included network meta-analysis, walking, and preferred reporting items for systematic reviews and meta-analyses (PRISMA). These patterns indicate that research on Tai Chi and insomnia is progressively moving toward standardization, clinical application, and methodological rigor. Investigators are focusing not only on treatment outcomes but also on strengthening scientific approaches through clinical trials, network meta-analyses, and adherence to PRISMA guidelines, thereby providing a stronger evidence base for the clinical application of Tai Chi in insomnia management.

To forecast future research trends, we constructed a dynamic thematic evolution map using the bibliometrix package in the R environment. Data from the WoSCC database are presented in and . The thematic progression of Tai Chi–insomnia research in WoSCC shows a continuous transition from basic studies to clinical trials and, more recently, to integrative expansion. During the early stage (2006–2014), research focused on the physiological and psychological mechanisms of sleep disorders and the validation of assessment tools, as reflected by keywords such as validity, reliability, questionnaire, and sleep disturbances. Terms like mood, melatonin, and blood pressure indicate early efforts to explain Tai Chi’s effects through emotional regulation and physiological markers. In the middle stage (2015–2019), the emergence of terms such as randomized controlled trial, trial, stress reduction, balance, and adults signaled a shift toward clinical validation centered on randomized trials. Target populations expanded from healthy adults to individuals with sleep disorders or psychological stress, with growing attention to quality-of-life outcomes. In the most recent stage (2020–2025), research diversified further. Core terms such as tai chi, exercise, insomnia, and sleep quality established Tai Chi as a principal intervention, while the appearance of qigong, yoga, mental health, cancer-related fatigue, and network meta-analysis reflects integration with other mind-body therapies, applications to elderly and cancer populations, and the adoption of advanced evidence-synthesis methods to strengthen the evidence base.

Data from the Scopus database (, ) reveal a similar but distinct trajectory. In the early stage (2006–2014), research centered on foundational exploration and methodological validation, with high-frequency terms such as controlled clinical trial, diet supplementation, self-efficacy, breathing exercise, and cognitive therapy, reflecting feasibility testing and preliminary mechanistic investigations. During the middle stage (2015–2019), studies increased in scale and rigor, featuring terms such as Tai Chi, major clinical study, treatment outcome, massage, and relaxation training. This phase emphasized randomized trials to confirm Tai Chi’s benefits for sleep and broader health indicators such as balance and blood pressure, consolidating its role as a key complementary intervention. In the most recent stage (2020–2025), research entered a phase of diversification and high-level evidence synthesis. Emerging terms such as systematic review, meta-analysis, sensitivity analysis, GRADE approach, sleep quality, sleep latency, and insomnia severity index highlight the widespread adoption of advanced evidence-based methods and more refined outcome assessments. Intervention strategies have also expanded to include combinations with exercise, resistance training, and other therapies. Overall, the field has progressed from preliminary feasibility testing to multidimensional, high-quality evidence evaluation, underscoring the growing clinical value of Tai Chi in the prevention and management of insomnia.

In summary, comprehensive analyses of citation bursts, keyword frequency, clustering, and thematic evolution revealed the major research hotspots in the Tai Chi and insomnia domain. Our analysis revealed that research in this field primarily converges on three key thematic directions (1): the clinical application of Tai Chi and the verification of its therapeutic efficacy for sleep disorders in specific populations (2); mechanistic and evidence-based investigations exploring how Tai Chi interventions alleviate insomnia; and (3) comparative and integrative studies examining Tai Chi alongside other non-pharmacological therapies for insomnia management.

This study presents a comprehensive bibliometric analysis of publications on Tai Chi interventions for insomnia indexed in the WoSCC and Scopus from 2006 to 2025. By examining publication trends, contributing countries, journal distribution, highly cited articles, and keyword evolution, we mapped the global landscape, identified key regions of activity, and outlined future research directions in this field.

A total of 281 WoSCC and 489 Scopus articles were included, spanning 2006–2025. The analysis revealed a steady increase in publications on Tai Chi and insomnia, reflecting growing scholarly interest in Tai Chi as a strategy for sleep health. This upward trend not only demonstrates sustained research attention but also underscores the potential of Tai Chi as a widely recognized non-pharmacological intervention for insomnia. China and the United States emerged as the leading contributors, with publication outputs far surpassing those of other countries. This dominance reflects distinct cultural, scientific, and policy advantages. As the birthplace of Tai Chi, China benefits from a strong foundation in traditional medicine and extensive clinical practice, supported by government policies promoting the modernization of Traditional Chinese Medicine and the dissemination of wellness culture. Consequently, Chinese scholars have made significant contributions to theoretical development and clinical validation, emphasizing Tai Chi’s holistic, accessible, and cost-effective role in addressing the rising prevalence of sleep disorders.

In contrast, U.S. research has drawn on strengths in neuroscience, sleep medicine, and evidence-based methodologies, positioning Tai Chi within the broader framework of complementary and integrative medicine. U.S. studies often focus on rigorous clinical trials and mechanistic investigations, exploring biological and psychological pathways through which Tai Chi alleviates insomnia, thereby responding to the demand for non-pharmacological therapies. The complementary strengths of the two countries—China providing traditional knowledge and clinical data, and the United States contributing methodological rigor and evaluative frameworks—have collectively advanced global progress in this area. Closer collaboration on intervention standardization, mechanistic exploration, and cross-cultural applications could further enhance international impact.Collaboration maps from both databases highlight UCLA and the University of Hong Kong as central hubs in East–West academic partnerships. Professor Michael R. Irwin from UCLA is the most prolific author in this field and maintains the broadest collaborative network.

With regard to journal distribution, the 281 WoSCC articles were published in 178 journals, while the 489 Scopus articles appeared in 283 journals. This wide dispersion highlights the interdisciplinary nature of Tai Chi and insomnia research, spanning medicine, psychology, sports science, and public health. The lack of concentration in a few core journals indicates that the field is still expanding, with findings disseminated across diverse outlets. Nevertheless, Frontiers in Psychiatry and Sleep Medicine Reviews have played central roles in both the volume of publications and citation impact within this field, serving as key platforms for disseminating related research findings. Meanwhile, Sleep has distinguished itself through its high citation frequency and central position within collaborative networks, highlighting its pivotal influence in academic communication and knowledge exchange. The prominent roles of these three journals collectively underscore their indispensable contribution to advancing research on Tai Chi and insomnia.

Research on Tai Chi for insomnia has evolved through three distinct stages, each marked by representative studies. In the early stage (2006–2014), Irwin et al.’s “Cognitive Behavioral Therapy vs. Tai Chi for Late Life Insomnia and Inflammatory Risk: A Randomized Controlled Comparative Efficacy Trial” reflected the exploratory focus of this period, demonstrating the feasibility of Tai Chi and providing a methodological foundation for subsequent research (). During the middle stage (2015–2019), Du et al.’s “Taichi exercise for self-rated sleep quality in older people: A systematic review and meta-analysis” synthesized multiple RCTs, confirming its efficacy not only in improving sleep but also in enhancing broader health outcomes, thereby consolidating Tai Chi’s position as a core integrative medical intervention (). In the recent stage (2020–2025), Han et al.’s “Effectiveness of Taijiquan in treating insomnia: A systematic review and meta-analysis of randomized controlled studies” incorporated high-quality evidence and provided more nuanced evaluations, highlighting Tai Chi’s therapeutic value in both sleep and comorbid conditions (). Together, these studies chart the transition from preliminary testing, to rigorous validation, and finally to advanced evidence synthesis.

Using multidimensional bibliometric techniques—including literature clustering, keyword frequency analysis, keyword clustering, Keyword Bursts, and Thematic Evolution—this study identified several major research hotspots in the field of Tai Chi interventions for insomnia. These hotspots can be summarized into three core areas:

Tai Chi, a traditional mind-body practice integrating gentle movement, breath regulation, and mindfulness, has increasingly attracted attention for improving sleep disorders across diverse populations. Numerous RCTs and systematic reviews have demonstrated its efficacy and safety in older adults, cancer survivors, patients with chronic pain, and individuals with mood disorders.

Against the backdrop of global aging, insomnia and sleep disorders among the elderly are rising, severely affecting quality of life. Due to its low-impact nature and high adherence, Tai Chi has become a suitable non-pharmacological intervention for older adults. High-quality evidence accumulated over the past two decades strongly supports the significant effects of Tai Chi on improving sleep quality in this population. For example, Siu et al. (2021) reported in an RCT that Tai Chi provided superior long-term benefits for chronic insomnia in older adults compared with conventional exercise (). Du et al. (2015) found through a systematic review that Tai Chi enhanced sleep quality, life satisfaction, and mental health in older adults (). Li et al. (2004) conducted a 24-week RCT demonstrating significant improvements in subjective sleep quality, including reduced sleep latency, increased sleep efficiency, and fewer nocturnal awakenings (). Similarly, Irwin et al. (2008) confirmed that, compared with a health education group, Tai Chi more effectively improved sleep quality and daytime function in older adults with chronic insomnia, with sustained benefits (). Systematic reviews and meta-analyses by Wu et al. (2015) and Du et al. (2015) synthesized multiple studies, highlighting Tai Chi’s positive impact on overall sleep quality, sleep efficiency, and sleep duration in older adults, as well as its favorable safety profile (, ).