Electroacupuncture More Successfully Ameliorated Symptoms of Insomnia Than Sham Treatment or Usual Care

Cons: Insomnia
A study found that ten sessions of electroacupuncture can improve the sleep quality of patients with insomnia without serious adverse effects.

Individuals with insomnia had improved sleep quality following 10 sessions of electroacupuncture. These findings, from a multicenter, randomized, controlled trial, were published in Nature and Science of Sleep.

Patients (N=150) with clinically defined insomnia were recruited at 4 hospitals in South Korea between 2015 and 2016. Participants were randomly assigned in a 1:1:1 ratio to receive 10 electroacupuncture sessions 2-3 times per week for 4 weeks (n=49), sham-electroacupuncture (n=52), or usual care (n=49). Participants were assessed by the Insomnia Severity Index (ISI), Pittsburgh Sleep Quality Index (PSQI), and asked to keep a sleep diary.

At the conclusion of the study, 14 participants dropped out due to consent withdrawal or protocol violations. All groups were well balanced at baseline for demographic characteristics, except for gender, in which more men were randomized to receive usual care compared with the other groups (P =.0253).

Throughout the study duration, ISI scores differed significantly between treatment and usual care at 2, 4, 8, and 12 weeks (all P <.0001). At the beginning of the study no difference in ISI scores were observed during weeks 2 and 4 between the treatment and sham groups, however, at weeks 8 (P =.0213) and 12 (P =.0446) ISI scores were significantly reduced among the treatment group.

PSQI scores did not differ between the treatment and sham group throughout the study (all P >.05). PSQI scores were significantly lower among the treatment group after week 2 compared with usual care (weeks 4, 8, and 12: P <.0001).

On the basis of the sleep diary, at week 4 patients in the treatment group had higher sleep efficiency compared with the sham (P =.0397) or usual care (P =.0002) groups and improved sleep onset latency (P =.0113) and total sleep time (P =.0010) compared with usual care. No significant differences for total time in bed or waking after sleep onset were observed.

At week 12, treatment success was reported by 62.50% of the electroacupuncture, 44.68% of the sham, and 11.11% of the usual care groups. Treatment success was more likely among the electroacupuncture recipients compared with sham (RR, 1.40; 95% CI, 0.95-2.06) or usual care (RR, 5.63; 95% CI, 2.39-13.23) recipients.

Adverse events were elevated among the usual care group (16.02%; P <.0001) compared with the treatment (6.71%) or sham (4.38%) cohorts. The adverse events included upper respiratory infections (58.49%), dyspepsia (14.15%), and headache (4.72%).

This study may have been biased by the gender imbalance among the usual care group, as gender has been significantly associated with insomnia.

The study authors concluded electroacupuncture may be a safe and effective intervention for individuals with insomnia.

Reference

Lee B, Kim BK, Kim HJ, et al. Efficacy and safety of electroacupuncture for insomnia disorder: A multicenter, randomized, assessor-blinded, controlled trial. Nat Sci Sleep. 2020;12:1145-1159. doi:10.2147/NSS.S281231