Acupuncture Continuing Education

Acupuncture Helps War Veterans Sleep Better

insomnia back shu

Emory University and Atlanta VA Medical Center researchers find acupuncture effective for the alleviation of sleep disorders for veterans with PTSD and brain injuries. The research team concludes that acupuncture produces significant improvements in both subjective and objective sleep parameters for veterans with mild traumatic brain injuries (mTBI), including veterans with PTSD (post-traumatic stress disorder). The team notes that “acupuncture provides meaningful relief for a particularly recalcitrant problem affecting large segments of the veteran population.” [1]

The randomized-controlled investigation featured a comparison of true acupuncture with sham acupuncture, including effective binding lasting the entirety of the clinical trial. True acupuncture produced a 2.7% improvement in sleep efficiency, measured by actigraphy. [2] True acupuncture was effective for both mTBI patients with or without PTSD. Sham acupuncture did not improve patients’ conditions; in fact, patients receiving sham acupuncture worsened by 5.3%.

True acupuncture produced significant clinical results as measured by Pittsburgh Sleep Quality Index (PSQI) scores and actigraphy. All patients received a total of ten acupuncture treatments. The clinical trial was administered at the Atlanta VAMC (US Department of Veterans Affairs Medical Center, Georgia). The study included a total of 60 veterans with a mean age of 40. The researchers conclude that acupuncture improves overall sleep for mTBI veterans with persistent sleep disturbances. [3]

Acupuncture has been shown to improve the condition of patients with other sleep disturbance etiologies. Researchers find back-shu (beishu) acupoints plus Shenmen (HT7) effective for the alleviation of menopausal insomnia. [4] Researchers from the Asian Sports Village Community Health Service Center (Beijing) and the Beijing Tibetan Hospital of China Tibetology Research Center (Beijing) conclude that acupuncture is more effective for the alleviation of menopausal insomnia than alprazolam (a benzodiazepine anti-anxiety drug).

PSQI scores and hormonal changes were measured, including levels of estradiol, follicle stimulating hormone, and luteinizing hormone. Patients in the acupuncture group received acupuncture once per day for five consecutive days followed by a two day break prior to the next round of care. The following acupuncture points were needled:

  • Feishu (BL13)
  • Xinshu (BL15)
  • Ganshu (BL18)
  • Pishu (BL20)
  • Shenshu (BL23)
  • Geshu (BL17)
  • Shenmen (HT7)

Three weeks of care comprised one course and three courses of care were administered. During the same period, the drug treatment group received oral alprazolam (0.4 mg–0.8 mg) prior to sleep. The results were evaluated 30 days after completion of all treatments. The total cohort size was 128 menopausal patients with a diagnosis of insomnia.

The total effective rate for the acupuncture group was 98.3% and the drug group had a 95.2% total effective rate. PSQI scores were better in the acupuncture group and hormone levels improved in both groups; however, the acupuncture group had significantly better hormone level improvements. Based on the data, acupuncture is more effective than alprazolam for the treatment of menopausal insomnia. [5] Two acupuncture continuing education courses at HealthCMi are relevant to the research presented above. The first course is on the topic of sleep improvement, click the following link to gain course access:

Acupuncture For Insomnia >

The second online course is on the topic of Traditional Chinese Medicine and menopause, click the following link to gain course access:

Menopause >

 

More Findings
Another important finding concerning acupuncture for the treatment of insomnia was produced by a research team comprised of University of Pennsylvania (Philadelphia), Memorial Sloan Kettering Cancer Center (New York), and Memorial University (Newfoundland and Labrador) researchers. This study was specifically designed to measure the effects of electroacupuncture on female breast cancer survivors with hot flashes and insomnia. The research team concludes that acupuncture significantly improves sleep duration and sleep latency (the length of time transitioning from wakefulness to sleep). [6] Moreover, the researchers discovered hot flashes and insomnia are bidirectional. Improvements in sleep produce reductions in hot flashes and vice versa.

The study included a drug control group. Acupuncture significantly outperformed gabapentin and venlafaxine. Acupuncture was significantly more effective than the drugs in improving sleep duration, latency, and efficiency, and was also more effective for reducing sleep disturbances and daytime dysfunction. Additionally, acupuncture did not produce the adverse effects that were caused by the drugs (dizziness, fatigue, ataxia, dry mouth, constipation, headaches). The clinical trial was supported, in part, by a grant from the US National Institutes of Health.

Patients received acupuncture 2 times per week for the first 2 weeks. Next, weekly acupuncture treatments were administered for an additional 6 weeks for a total of 10 acupuncture treatments over 8 weeks. Acupuncture point prescriptions were selected on an individual basis per differential diagnostics. Manual acupuncture techniques were applied to obtain deqi. Electroacupuncture (EA) was applied between 2 acupoints with a 2 Hz frequency setting. The specific points were not detailed in the report. Needles were retained for 30 minutes for each acupuncture treatment.

The researchers conclude that “EA produces comparable, if not better, improvements in sleep quality than GP [gabapentin], a currently recommended pharmacological intervention.” They add, “women receiving EA reported were able to fall asleep faster and spent more time in bed sleeping as opposed to lying awake in bed trying to sleep. Our results suggest that EA results in improved sleep in women with hot flashes and might be a viable treatment option in women who do not wish to take medication.” [7]

Insomnia affects approximately 30% of the adult population. [8] Given the results of the aforementioned research, acupuncture is a reasonable treatment option for the treatment of sleep disorders. Prospective patients are advised to consult with licensed acupuncturists to learn more.

 

References
[1] Huang, W., Johnson, T., Kutner, N., Halpin, S., Weiss, P., Griffiths, P. and Bliwise, D., 2018. Acupuncture for treatment of persistent disturbed sleep: A randomized clinical trial in veterans with mild traumatic brain injury and post-traumatic stress disorder. Annals of Physical and Rehabilitation Medicine, 61, p.e89.
[2] Ibid.
[3] Ibid.
[4] Li, O., and F. Wang. "Acupuncture at back-shu points of five zang, Geshu (BL 17) and Shenmen (HT 7) for the treatment of menopausal insomnia." Zhongguo zhen jiu= Chinese acupuncture & moxibustion 38, no. 5 (2018): 4693.
[5] Ibid.
[6] Garland, Sheila N., Sharon X. Xie, Qing Li, Christina Seluzicki, Coby Basal, and Jun J. Mao. "Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial." Menopause 24, no. 5 (2017): 517-523.
[7] Ibid.
[8] Roth, Thomas. "Insomnia: definition, prevalence, etiology, and consequences." Journal of clinical sleep medicine: JCSM: official publication of the American Academy of Sleep Medicine 3, no. 5 Suppl (2007): S7.

 

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