[Effects of hand acupuncture therapy on sleep quality in sleep disrupted adults: verification by polysomnography and cerebral blood flow test]. Effectiveness of acupressure for residents of long-term care facilities with insomnia: a randomized controlled trial. [Effects of auricular acupuncture on insomnia in Korean elderly]. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Acupressure and Transcutaneous Electrical Acupoint Stimulation in improving fatigue, sleep quality and depression in hemodialysis patients. Acupressure and quality of sleep in patients with end-stage renal disease--a randomized controlled trial. Intradermal acupuncture on shen-men and nei-kuan acupoints in patients with insomnia after stroke. Treatment of phlegm- and heat-induced insomnia by acupuncture in 120 cases. Effectiveness of auricular therapy on sleep promotion in the elderly. Efficacy of wrists overnight compression (HT 7 point) on insomniacs: possible role of melatonin? Electroacupuncture for primary insomnia: a randomized controlled trial. Intradermal acupuncture on shen-men and nei-kuan acupoints improves insomnia in stroke patients by reducing the sympathetic nervous activity: a randomized clinical trial. [Observation on therapeutic effect of rolling needle therapy on insomnia].
The purpose of this study was to identify the effects of hand acupuncture therapy on sleep quality by means of a sleep questionnaire, polysomnography and a cerebral blood flow test in 30-59 year old adults.
                The study was a sham controlled design. Twenty-two adults were assigned to the pellet stimulating group (11) or sham group (11). The pellet stimulating group received hand acupuncture therapy using New Seoam Press Pellets number 1 for 4 weeks. On the other hand, the sham group used the same Adhesive tape in terms of shape, size and quality as New Seoam Press Pellets number 1 for 4 weeks. A Transcranial Doppler Ultrasonography and Carotid Duplex Ultrasonography examination were used for evaluating cerebral blood flow. Data was analyzed using the SPSS 12.0 version program with chi(2)-test, Fisher's exact test and Mann Whitney U-test.
                In the pellet stimulating group, subjective sleep quality significantly improved more than that of the sham group. Among the sleep indices of the polysomnography, total sleep time and sleep latency of the sham group significantly improved. The cerebral blood flow test didn't show any differences.
                These results suggest that hand acupuncture therapy is effective for subjective sleep improvement only, not polysomnographical sleep indices and cerebral blood flow. Acupressure on the Shenmen point (indexed as HT7) can improve insomnia, but there has been no longitudinal study to evaluate its efficacy for residents of long-term care facilities. No evidence from the existing literature indicates how long its efficacy can be maintained after stopping acupressure.
                The aim of this study was to evaluate the effectiveness of acupressure on the Shenmen point for residents of long-term care facilities with insomnia.
                Fifty residents with insomnia in long-term care facilities were enrolled in a randomized controlled trial, with 25 participants allocated to the experimental group and 25 participants to the control group. For a 5-week period, the experimental group received standard acupressure on the HT7 points of both wrists, whereas the control group received only light touch on the same places. Insomnia was measured with the Athens Insomnia Scale-Taiwan form (AIS-T). Participants' self-reported scores were done at baseline, during the 5-week period, and after intervention. This study was analyzed on an intention-to-treat procedure.
                The experimental group has significantly better scores on the AIS-T compared to the control group, not only during the intervention period, but also extending after intervention, as shown by generalized estimating equations (p<0.05).
                Offering acupressure on a regular basis has the potential to improve insomnia in residents of long-term care facilities. Acupressure on the HT7 point may improve insomnia for up to 2 weeks after the intervention.
                Copyright 2009 Elsevier Ltd. All rights reserved. This study was to examine the effects of auricular acupuncture on insomnia in Korean elderly.
                The study design was a triangulation study. Subjects were 40 elderly who were 65 years and over in Seoul, and 10 subjects for a qualitive study who were saturated with interviews and observation. The first auricular acupuncture was applied for three days, and this was applied to subjects on a 5 times series. The quantative data was analyzed by SPSS PC+ and the qualitive data was analyzed by driving of core meaning and abstract concepts using a semi-structural interview and observation.
                1. The experimental group had higher significant sleep scores than that of the control group (t=32.739, p=.001). 2. The experimental group had higher significant self- satisfaction scores on sleep than that of the control group (t=30.049, p=.001). 3. In the qualitive study, insomnia characteristics before application of auricular acupressure therapy were confirmed by physical dysfunction, recall of past, and psychological dysfunction. Insomnia characteristics after application of auricular acupressure therapy were confirmed by recovery of physical dysfunction, improving recall of past, and recovery of psychological dysfunction.
                Auricular acupuncture was effective on insomnia in Korean elderly. Sleep disturbances are very common in elderly people and Traditional Chinese acupressure a noninvasive technique that promotes health and comfort recently has been used in this regard. The purpose of the present study was to evaluate the potential beneficial effects of acupressure on a group of institutionalized elders experiencing sleep disturbances.
                A randomized controlled clinical trial was conducted to test the effectiveness of acupressure on quality of sleep of elderly residing in a Nursing home. The Pittsburgh Sleep Quality index (PSQI) questionnaire was used as a screening tool to select 90 residents with moderate to marked sleep disturbances. The elders were randomly assigned to an acupressure group, a sham acupressure group and a control group by Balanced randomization method.
                There were significant differences between the acupressure group and the control group in subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency and sleep disturbance. But no significant differences were found in sleep indices between the sham acupressure group and the control group. Sleep log data showed a significant decrease in nocturnal awakenings in acupressure group compared to other two groups.
                The findings of this study indicated that acupressure has an effect on improvement of sleep quality and endorsed it as a non-pharmacological and complementary therapy for sleep-disturbed elderly people.
                Crown Copyright 2009. Published by Elsevier Ltd. All rights reserved. The purpose of this study was to test the effectiveness of acupressure and Transcutaneous Electrical Acupoint Stimulation (TEAS) on fatigue, sleep quality and depression in patients who were receiving routine hemodialysis treatment. The study was a randomized controlled trial; qualified patients were randomly assigned to acupressure, TEAS or control groups. Patients in the acupressure and TEAS groups received 15 minutes of treatment 3 times a week for 1 month, whereas patients in the control group only received routine unit care. A total of 106 patients participated in the study. Methods of measurement included the revised Piper Fatigue Scale (PFS), the Pittsburgh Sleep Quality Index and the Beck Depression Inventory. Data were collected at baseline, during the intervention and post-treatment. The results indicated that patients in the acupressure and TEAS groups had significantly lower levels of fatigue, a better sleep quality and less depressed moods compared with patients in the control group based upon the adjusted baseline differences. However, there were no differences between acupressure and TEAS groups in outcome measures. This study provides an alternative method for health care providers in managing dialysis patients with symptoms of fatigue, poor sleep or depression. The purpose of the study is to test the effectiveness of acupressure on sleep quality of end-stage renal disease patients. The study was a randomized controlled trial; qualified patients in the dialysis centers of four major hospitals were randomly assigned into an acupressure group, a sham acupressure group, and a control group. A total of 98 participants were included in the study. The main outcomes measured were the Pittsburgh sleep quality index (PSQI) and the sleep log. Data were collected at pretreatment and following treatment. Primary statistical analysis was by means of Analysis of Covariance, the Kruskal-Wallis Test and repeated measure ANOVA. The results indicated that PSQI scores of the acupressure group have a significantly greater improvement (p < 0.01) than the control group. However, there were no differences between the acupressure group and the sham group or the sham group and the control group (p > 0.05). Subscales of PSQI were further analyzed. Results demonstrated significant differences between the acupressure group and the control group in subjective sleep quality (p = 0.009), sleep duration (p = 0.004), habitual sleep efficiency (p = 0.001), and sleep sufficiency (p = 0.004). Significant differences in the subscale of subjective sleep quality (p = 0.003) between the sham acupressure group and the control group were also observed. Sleep log data showed that the acupressure group significantly decreased awake time and improved quality of sleep over time more than the control group (p < 0.01). The improvement could be seen as soon as the acupoints massage was implemented, and it was maintained through the post intervention.
                Copyright 2002 Elsevier Science Ltd. This is the first study that focuses on the effects of intradermal acupuncture on insomnia after stroke. We enrolled hospitalized stroke patients with insomnia and assigned them into a real intradermal acupuncture group (RA group) or a sham acupuncture group (SA group) by randomization. The RA group received intradermal acupuncture on shen-men (He-7) and nei-kuan (EH-6) for 2 days, and the SA group received sham acupuncture on the same points. The effectiveness was measured by the Morning Questionnaire (MQ), Insomnia Severity Index (ISI), and Athens Insomnia Scale (AIS). These scales were examined by an independent, blinded neurologist before, and 1 and 2 days after treatment, repeatedly. Thirty subjects (15 in the RA group and 15 in the SA group) were included in the final analysis. The RA group showed more improvement on insomnia than the SA group. Repeated measures analysis detected that there were significant between-subjects effects in the MQ, the ISI and the AIS. In conclusion, we suggest that intradermal acupuncture on shen-men and nei-kuan is a useful treatment for post stroke-onset insomnia. nan Sleep disturbances are a particularly common problem in the elderly. The purpose of this study was to examine the effectiveness of auricular therapy on sleep behaviors in the elderly. One hundred and twenty participants of 60 years old or above and who were suffering from sleep disturbances were invited to participate in this study. Eligible participants were randomly allocated to receive auricular therapy using Junci Medulla (Group A = 30), Semen Vaccariae (Group B = 30) or magnetic pearls (Group C = 60). Groups A and B were the control groups, while Group C was the experimental group. Seven auricular points which are thought to have an effect on promoting sleep were selected. The total treatment course lasted for three weeks. Objective measurement using actigraphic monitoring was performed before the therapy commenced, in the middle period of the therapy, and within one week after the therapy had been completed. After the therapy, there were significant differences among the three groups in terms of the nocturnal sleep time (NST) (F(2,117) = 6.84, p < 0.05) and sleep efficiency (SE) (F(2,117) = 7.69, p < 0.05). Significant improvement in the sleep behaviors was observed in the experimental group using magnetic pearls. In a backward multiple regression, the effect of auricular therapy on SE after allowing for age in female participants is of high statistical significance (F(3,106) = 9.04, p < 0.001). The paper concludes that auricular therapy using magnetic pearls is an effective means of improving the quantity and quality of sleep in the elderly. Insomnia is a major problem which decreases life quality. Many causes are involved with it and anxiety is often associated. The underlying mechanism is not completely understood, even though different factors seem to be associated. Among them melatonin and its circadian rhythm is thought to have an important role. In addition, acupressure and acupuncture are known to ameliorate insomnia and anxiety, when a specific wrist point is stimulated (HT 7 Shenmen). With these bases, the aim of the present study has been to evaluate the efficacy of an acupressure device, ''H7-insomnia control'', positioned on HT 7 points, during the night, in terms of general health and anxiety levels, together with the evaluation of sleep quality and the urinary melatonin metabolite 6-hydroxymelatonin sulphate determination, in a number of insomniacs.
                Forty patients with insomnia were divided into two groups and randomly received either the H7 or placebo treatments, in a double-blind protocol, for 20 nights. Before and after treatments every subject answered a series of questionnaires (General Health Questionnaire 28 items; State-Trait Anxiety Inventory; Pittsburgh Sleep Quality Index) and collected 24 h urines, divided into two samples of 12 h each. Urinary melatonin metabolite was then determined using a RIA method.
                Data obtained indicate that the device H7-insomnia control is efficacious to ameliorate quality of sleep and reduce anxiety levels in insomniacs, at a higher extent than in the placebo group. In addition, the 24 hours urinary melatonin metabolite rhythm, obtained at the end of treatment, was considered as being normal in a higher percentage of H7-treated patients, with respect to the placebo group.
                It is plausible to hypothesize that the wrist acupressure device might be considered a valid tool, without adverse effects since it does not contain pharmaceutical products, that is able to naturally ameliorate sleep quality in insomniacs, acting through a not jet completely clarified mechanism, that may involve melatonin. To evaluate the short-term efficacy and safety of electroacupuncture for the treatment of primary insomnia.
                Randomized, single-blind, placebo-controlled, parallel-group.
                A university-based sleep clinic.
                Community sample of 60 Chinese adult volunteers who report having insomnia 3 or more nights per week, whose symptoms meet the DSM-IV criteria for primary insomnia for at least 3 months, and who have an Insomnia Severity Index total score of at least 15. Participants were screened with polysomnography and the Structured Clinical Interview for the DSM-IV prior to randomization.
                Electroacupuncture at Yintang (EX-HN3), Baihui (GV20), bilateral ear Shenmen, Sishencong (EX-HN1), and Anmian (EX) 3 times per week for 3 weeks or placebo acupuncture using Streitberger needles at the same points.
                Self-reported questionnaires, 1-week sleep diaries, and 3-day actigraphy were collected at baseline and 1 week after treatment. The Insomnia Severity Index was used as the primary outcome measure. Both groups showed significant improvement compared with the pretreatment baseline. One-way analysis of covariance adjusted for baseline scores showed that there were significantly greater improvements in sleep efficiency by sleep diary and actigraphy in the electroacupuncture group. However, no significant between-group differences were observed in the Insomnia Severity Index and other outcome measures. The proportions of subjects having less than 30 minutes of wake after sleep onset and a sleep efficiency of at least 85% at the posttreatment visit were significantly higher in the electroacupuncture group. All adverse events were mild in severity.
                We found a slight advantage of electroacupuncture over placebo acupuncture in the short-term treatment of primary insomnia. Because of some limitations of the current study, further studies are necessary to verify the effectiveness of acupuncture for insomnia. This study is a double-blind randomized controlled trial on the effect of intradermal acupuncture on insomnia after stroke. Hospitalized stroke patients with insomnia were enrolled in the study and were randomly assigned to either a real intradermal acupuncture group (RA group) or a sham acupuncture group (SA group). The RA group received intradermal acupuncture on Shen-Men (He-7) and Nei-Kuan (EH-6) for three days, and the SA group received sham acupuncture on the same points. The effect of acupuncture on insomnia was measured using Insomnia Severity Index (ISI) and Athens Insomnia Scale (AIS) at baseline and three days after treatment. To assess the effect of acupuncture on the autonomic nervous function, the subjects' blood pressure and heart rate variability were monitored. Fifty-two subjects (27 in the RA group and 25 in the SA group) were included in the final analysis. The insomnia-related scales ISI and AIS showed greater improvement of insomnia in the RA group than in the SA group. Moreover, there is a greater reduction of the number of non-dippers and a greater decrease of the LF/HF ratio (heart rate variability) in the RA group than in the SA group. These results indicate that sympathetic hyperactivities were stabilized in the RA group. It can thus be concluded that intradermal acupuncture on Shen-Men and Nei-Kuan is a useful therapeutic method for post stroke-onset insomnia as it reduces sympathetic hyperactivities. To assess the effect-increasing action of rolling needle therapy on insomnia.
                Sixty-four cases were randomly divided into a rolling needle treatment group and a control group, 32 cases in each group. The control group were treated with oral administration of clonazepam 4 mg, once each night, for 4 consecutive weeks. The rolling needle therapy group were treated with the same treatment as the control group, plus the rolling needle stimulation of the back. The therapeutic effect was assessed by effective rate of sleep improvement and Pittsburgh sleep quality index (PSQI).
                After treatment there was a significant difference between the two groups in the score of PSQI (P < 0.01).
                The rolling needle therapy can increase the improving action of clonazepam on insomnia, and increase life quality of the patient.
Due to poor methodological quality, high levels of heterogeneity and publication bias, the current evidence is not sufficiently rigorous to support or refute acupuncture for treating insomnia. Larger high-quality clinical trials are required.