Is acupuncture effective in improving sleep quality in adult cancer survivors with comorbid sleep disorders and chronic pain?
In adult cancer survivors with comorbid musculoskeletal pain and sleep disturbance, electroacupuncture and auricular acupuncture were each more effective than usual care in improving sleep. These improvements were sustained for at least 12 weeks after completing the acupuncture sessions.
Plan de l'etude:
Randomized controlled trial (nonblinded)
These authors report a planned secondary analysis of the Personalized Electroacupuncture Versus Auricular Acupuncture Comparative Effectiveness (PEACE) study. For this analysis of sleep quality, the authors included adult survivors of cancer with comorbid chronic musculoskeletal pain and poor sleep (Pittsburgh Sleep Quality Index [PSQI] score 6 or higher; minimum clinically important difference = 3 points). The patients were randomized to receive 1 of 2 forms of acupuncture (n = 110 to electroacupuncture in traditional acupuncture points; n = 110 to auricular or “battlefield” acupuncture) or to usual care (n = 48). A stronger study would have included a sham acupuncture arm. Licensed acupuncturists with at least 5 years of experience performed the procedures in 10 weekly treatments. Each electroacupuncture session lasted 30 minutes. The auricular acupuncture needles were left in place for 3 to 4 days, after which the patients could remove them. The usual care patients continued to receive therapy from their healthcare clinicians but were offered 10 acupuncture sessions after week 12 of the study. At 12 weeks, each group had improvements in the PSQI score, but the acupuncture groups had greater improvements than the usual care group (1.79, 1.96, and 0.37 points, respectively). The acupuncture groups had sustained improvement over 12 additional weeks of follow-up. Additionally, more patients in the acupuncture-treated groups had at least 3-point improvements than did those in the usual care group (41%, 43%, and 21%, respectively; numbers needed to treat [NNTs] = 6 and 6, respectively). Additionally, more patients receiving acupuncture had remission of their sleep disturbance (19%, 16%, and 2%, respectively; NNTs = 7 and 8, respectively). The authors did not provide any information on adverse events.
Henry C. Barry, MD, MS
Michigan State University
East Lansing, MI