Association of Acupuncture and Auricular Acupressure With the Improvement of Sleep Disturbances in Cancer Survivors: A Systematic Review and Meta-Analysis

Abstract

BackgroundStudies on the efficacy of acupuncture and auricular acupressure on sleep disturbances in cancer patients have been growing, but there is no specific and comprehensive systematic review and meta-analysis. This review aims to evaluate the efficacy and safety of acupuncture and auricular acupressure on sleep disturbances in cancer survivors based on existing randomized clinical trials (RCTs).MethodsFour English-language and four Chinese-language biomedical databases were searched for RCTs published from database inception to July 30, 2021. RCTs comparing acupuncture and auricular acupressure with sham control, drug therapy, behavior therapy, or usual care for managing cancer were included. The quality of RCTs was appraised with the Cochrane Collaboration risk of bias (ROB) tool. Mean differences (MDs) and 95% confidence intervals (CIs) were calculated for the effect sizes.ResultsThirteen RCTs with 961 patients were included. The risk of performance bias or reporting bias for most of the included trials was high or unclear. Evidence was not found for short-term effects on sleep scales compared to sham control (MD, 1.98; 95% CI, 0.33–3.64; p = 0.02; I2 = 36%), wait list control (MD, 0.40; 95% CI, −0.87–1.68; p = 0.54; I2 = 49%), drug therapy (MD, 1.18; 95% CI, −3.09–5.46; p = 0.59; I2 = 98%). For long-term effect, two sham-controlled RCTs showed no significance of acupuncture on insomnia scale scores (MD, 1.71; 95% CI, −2.38–5.81; p = 0.41; I2 = 89%). Subgroup analyses suggested no evidence that auricular acupressure (MD, 3.14; 95% CI=1.52, 4.76; p = 0.0001; I2 = 0%) or acupuncture (MD, 0.54; 95% CI=−1.27, 2.34; p = 0.56; I2 = 0%) was associated with the reduction in insomnia scale scores.ConclusionsThis systematic review and meta-analysis found no evidence about acupuncture or auricular acupressure in the improvement of sleep disturbances in cancer survivors in terms of short- or long-term effect. Adverse events were minor. The finding was inconsistent with previous research and suggested that more well-designed and large-scale randomized controlled trials are needed to identify the efficacy of acupuncture and auricular acupressure for sleep disturbances in cancer survivors.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, CRD42020171612.

The feasibility and effectiveness of auricular acupressure on managing sleep quality, mood status, and quality of life in parents of children with cancer

“…The effect of auricular acupressure on sleep has been inconsistent. Some researchers have found that auricular acupressure is an effective and safe intervention for improving sleep quality among patients with cancer [14,30], while others found no evidence that auricular acupressure was associated with a reduction in sleep problems [25]. Although we noted a trend for reduction in the total number of parents who reported poorer sleep in AAG, we did not reach statistical signi cance One reason for these negative ndings could be the small sample size in this pilot study.…”

“…The strength of this pilot study was providing a non-invasive and practical intervention to improve sleep quality, and QOL for those parents in clinical practice. Compared to the tested interventions of exercise [9] and relaxation techniques [20], which are time consuming or need guidance from health care providers during the intervention, auricular acupressure treatment is a safe procedure [25] that is easy for participants to do by themselves at home once the seeded tapes are placed.…”

Effectiveness of Tea Made from <i>Cissampelos sympodialis</i> Leaves in the Treatment of Anxiety and Depression: A Controlled Clinical Trial

“…Participants were instructed to stimulate each ear point at least 3 times per day. The auriculotherapy protocol used followed the method suggested by TCM, using areas already researched for anxiety and depression: 'Shen Men' 29,33,34 , 'Kidney' [35][36][37] , 'Sympathetic' 34,38,39 , ' Anxiety' 35,39,40 and 'Heart' 35,41,42 . Each week, the ear seeds were removed from the ear in question and placed on the corresponding contralateral ear.…”

Efficacy of auricular acupressure on lung function among chronic obstructive pulmonary disease: A meta‐analysis of randomised controlled trials

“…Recently, several systematic reviews have shown that AA, as an intervention, has beneficial efficacy on maintenance haemodialysis patients (Pei et al., 2021; Yang et al., 2022), leukaemia patients (Jing et al., 2018), cancer survivors (Wan et al., 2022) and adolescents (Gao, Chen, et al., 2020). Meanwhile, AA has been increasingly used in COPD patients, such as deteriorating lung function and sleep quality, but the efficacy has not yet been unified.…”