Brisk Walking Training Compared with Cognitive Behavioral Therapy for the Treatment of Chronic Primary Insomnia in People Aged 60 Years or Above: a Randomized, Partially Blinded, Non-inferiority Trial

Inclusion criteria

• Aged ≥60 years;
• Ethnic Chinese; able to read, write and speak Cantonese
• Having a Hong Kong ID;
• Willing to wear an accelerometer on the wrist for a week to assess sleep parameters at T0, T1, and T2.
• Score ≥10 in the Insomnia Severity Index (ISI) (presence of insomnia)
• Experiencing any one of the following symptoms for ≥3 days per week

• Difficulty initiating sleep; OR
• Difficulty maintaining sleep; OR
• Early-morning awakening with inability to return to sleep

Exclusion criteria

• Score ≥1 in the Chinese version of the Physical Activity Readiness Questionnaire (PAR-Q);
• Currently regularly practicing a moderate-intensity PA program such as brisk walking or Tai Chi (≥3 times a week, ≥30 minutes/session);
• Currently receiving or scheduled to receive CBT-I during the study period;
• Score ≤16 in the validated telephone version of the Cantonese Mini-Mental State Examination (T-CMMSE).
• Working nightshifts and unable/unwilling to discontinue such work pattern;
• Having a diagnosis of a major depressive disorder, anxiety disorders or other severe mental disorder (bipolar disorders, psychosis). Those with mild depression or anxiety disorders will not be excluded;
• Use of antidepressant or antipsychotic medication or under treatment of other serious diseases (e.g., cancer chemotherapy) known to affect sleep;
• Presence of any serious chronic diseases which affect sleep (e.g., cancer, autoimmune diseases).
• Having a serious somatic condition preventing the participation of brisk walking training/CBT-I.