Acupuncture for post-stroke insomnia

Xiang, Jie; Li, Honglian; Xiong, Jun; Hua, Fanghui; Huang, Shouqiang; Jiang, Yunfeng; Zhou, Xiaohong; Liao, Kai; Xu, Lingling

doi:10.1097/md.0000000000021381

Cited by 6 publications

(5 citation statements)

References 26 publications

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“…These findings should make clinicians aware of the potential harm that can result from insomnia. Several researchers have reported that acupuncture can effectively reduce PSI, but this information has been presented in the form of protocols that lacked research results (Xiang et al, 2020).Interestingly, past retrospective studies also have found that acupuncture exhibited advantages in treating diseases that developed as sequelae to stroke (Cao et al, 2016;Liao et al, 2020).Although the research topics were not precisely the same, our conclusions were consistent with these studies in that acupuncture was advantageous in treating stroke-related diseases. This was a retrospective clinical study whose primary purpose was to explore the protective factors of PSI, because most previous studies focused on analyzing the risk factors related to stroke.…”

Section: Discussionsupporting

confidence: 83%

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study

Qiu

Han

Yao

et al. 2021

Front. Aging Neurosci.

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Background: Post-stroke insomnia (PSI) affects the quality of life for stroke patients, reduces the likelihood of successful rehabilitation, and produces additional complications following stroke. Previous reports have provided some information regarding PSI risk factors, but little is known concerning protective factors for PSI. This study analyzed the relationship between acupuncture and insomnia in stroke patients and explored the use of acupuncture as a preventive treatment.Methods: Patients diagnosed with stroke from 2010 to 2019 were identified in the case database of the First Affiliated Hospital of Guangzhou University of Chinese These patients followed until 2020, and numerous factors were examined, including gender, age, stroke type, stroke location, and baseline comorbidities. A 1:1 propensity score was used to match an equal number of patients receiving acupuncture with stroke patients who did not receive acupuncture (N = 1,680 for each group). The purpose of the study was to compare the incidence of insomnia in these two stroke cohorts. We used the Cox regression model and Kaplan-Meier method to estimate the risk of insomnia as the outcome event.Results: Compared with the non-acupuncture cohort in general, stroke patients who received acupuncture treatment exhibited a lower risk of insomnia after adjusting for age, gender, stroke type, stroke location, and comorbidities (adjusted hazard ratio HR = 0.27, 95% confidential interval = 0.23 to 0.32). Acupuncture also reduced the risk of PSI for both genders. The respective risks were HR = 0.28 (adjusted) for males and HR = 0.26 (adjusted) for females. Acupuncture also lowered the risk for PSI for different age groups. The risks were HR = 0.22 (adjusted) for individuals 18 to 39 years of age, HR = 0.31 (adjusted) for individuals 40 to 59 years of age, HR = 0.28 (adjusted) for those 60 to 79 years of age, and HR = 0.18 (adjusted) for individuals 80 years of age and older. Concerning the stroke type, regardless of whether the stroke was ischemic, hemorrhagic, or a combination of the two stroke types, patients who received acupuncture exhibited lower risk (adjusted HR = 0.28, 0.17, and 0.49, respectively). Concerning stroke location, except for the cerebral hemispheres (adjusted HR = 1.10, 95% confidential interval = 0.12 to 1.01), the risk of PSI after receiving acupuncture was lower for the frontal lobe (adjusted HR = 0.42), the basal ganglia (adjusted HR = 0.22), the radiation crown (adjusted HR = 0.42), the diencephalon (adjusted HR = 0.20), or multiple partial strokes (adjusted HR = 0.26), the risk of PSI after receiving acupuncture was lower. For all baseline complications, acupuncture reduced the risk of insomnia. The cumulative incidence of insomnia in the acupuncture cohort was significantly lower than the non-acupuncture cohort (log-rank test, P = 0.000).Limitations: First, our research only included patients from a single center. Second, we did not classify the post-stroke insomnia severity. Second, the information was extracted manually. Overall, the sample size was small, and we needed to increase the sample size to strengthen the conclusions.Conclusion: Acupuncture treatment reduced the risk of insomnia in stroke patients. Future research be conducted with increased sample sizes and further elaboration on the specific acupuncture protocols that were used.

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Section: Discussionsupporting

confidence: 83%

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study

Qiu

Han

Yao

et al. 2021

Front. Aging Neurosci.

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“…The benzodiazepine Estazolam, which was selected in this study, can block the impulse conduction from the limbic system to the brainstem reticular structure, reduce the conduction excitation in the cerebral cortex, and thereby have sedative and anticonvulsant effects. However, benzodiazepines are known to induce drug dependence and cause various adverse reactions [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Application of Wireless Dynamic Sleep Monitor in Acupuncture Treatment of Insomnia after Ischemic Stroke: A Retrospective Study

Song

Wang

Schubert

2021

Evidence-Based Complementary and Alternative Medicine

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Purpose. Retrospective analysis of the clinical effect of acupuncture on insomnia after ischemic stroke by using a wireless sleep monitor as an innovative evaluation method. Methods. From March 1, 2018, to September 30, 2019, 105 cases of insomnia after ischemic stroke were extracted from the inpatient medical record system of Shenzhen Longhua District Central Hospital. According to differences in the treatment plan, the cases were divided into an acupuncture group (57 cases) and a drug group (48 cases). The acupuncture group was given acupuncture treatment on the basis of usual care, while the drug group was given estazolam oral treatment on the basis of usual care. Under the ICF framework, the related items of sleep function and emotion function were selected for evaluation. As outcome parameters, the alterations of the Pittsburgh sleep quality index (PSQI), the self-rating anxiety scale (SAS), and the self-rating depression scale (SDS) were used before the treatment, after treatment, and in a follow-up; meanwhile, the ActiSleep-BT wireless sleep monitor was used to measure total sleep time (TST), sleep efficiency (SE), and sleep arousal (SA) of the two groups before and after treatment and at follow-up. Results. Within-group comparison showed significant differences in the acupuncture group before treatment and after treatment on the ActiSleep-BT wireless dynamic sleep monitor data as well as in PSQI and ICF. Comparing the acupuncture group with the control group also showed significant differences in the ActiSleep-BT wireless dynamic sleep monitor data, PSQI, and ICF. Conclusion. By evaluation using ActiSleep-BT wireless sleep monitor, acupuncture treated insomnia after ischemic stroke; the effect is better than usual care.

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“…The alternatives are in varied forms, such as acupuncture, massage, auricular acupoint, catgut embedment in acupoint, the music of 5 phases, Tai Chi, also the decoction including Si Ni San, Tianma Gouteng Yin, Da Ding Feng Zhu, Gui Pi Decoction, Chaihu Longgu Muli Decoction (CLMD), self-designed Ningxin Anshen Formula and so on. [10][11][12][13][14] Especially, Herbal medicine shows a significant efficacy in relieving insomnia. [15] Other treatments like cognitive-behavioral therapy, bright light therapy are also mentioned.…”

Section: Description Of the Conditionmentioning

confidence: 99%

Chaihu Longgu Muli Decoction for post-stroke insomnia: A protocol for systematic review and meta-analysis

et al. 2023

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Background: Poststroke insomnia (PSI) is a frequent complication of stroke usually as a comorbidity of poststroke depression and mainly occurs within the first 6 months after stroke. [ 1 ] Addressing PSI to improve stroke prognosis is of great value. Herbal medicine like Chaihu Longgu Muli Decoction (CLMD), which is commonly considered to be a good treatment for depression and epilepsy, has the therapeutic potential on PSI; however, insufficient systematic reviews were conducted to testify its efficacy. Therefore, the objective of this paper is to provide reliable evidence of the efficacy and safety of CLMD on PSI and a foundation for further investigation. Methods: The literature of clinical randomized controlled trials (RCTs) regarding CLMD for PSI published before June of 2021 will be retrieved in the databases, and 2 investigators will be asked to collect and crosscheck the data independently. For the including studies, the quality evaluation on methodology will be assessed in the light of the Cochrane Handbook for Systematic Review of Interventions V.5.1.0 as well as the quality of evidence will be evaluated by the Grading of Recommendations Assessment, Development, and Evaluation. Besides, the assessment of heterogeneity and reporting bias, the sensitivity analysis and the subgroup analysis will be conducted. Stata 15 will be applied to analyze the above data. Results: The review will conduct a high-quality synthesis on present evidence of CLMD for PSI. Conclusion: The conclusion of the study will indicate whether CLMD is effective and safe for PSI.

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Acupuncture for post-stroke insomnia

Cited by 6 publications

References 26 publications

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study

Application of Wireless Dynamic Sleep Monitor in Acupuncture Treatment of Insomnia after Ischemic Stroke: A Retrospective Study

Chaihu Longgu Muli Decoction for post-stroke insomnia: A protocol for systematic review and meta-analysis

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