Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial

Garland, Sheila N.; Xie, Sharon X.; Li, Qing; Seluzicki, Christina; Basal, Coby; Mao, Jun J.

doi:10.1097/gme.0000000000000779

Cited by 46 publications

(57 citation statements)

References 48 publications

(47 reference statements)

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“…The common acupoints in the treatment of sleep disturbances were presented in Figure 2 . Garland et al ( 79 ) made a randomized controlled trial involving 58 breast cancer survivors experiencing bothersome hot flashes at least two times per day. Participants were randomly assigned to receive 8 weeks of electroacupuncture or daily gabapentin (total dose of 900 mg/d).…”

Section: Measures To Prevent and Improve Postoperative Sleep Disturbamentioning

confidence: 99%

Sleep Disturbances After General Anesthesia: Current Perspectives

2020

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The purpose of this article is to review (1) sleep mechanism under general anesthesia, harmful effects of postoperative sleep disturbances; (2) risk factors associated with postoperative sleep disturbances; (3) measures to prevent and improve postoperative sleep disturbances. General anesthesia changes the postoperative sleep structure especially in elderly patients after major surgery and results in a high incidence rate of sleep disturbances. Sleep disturbances produce harmful effects on postoperative patients and lead to a higher risk of delirium, more cardiovascular events, and poorer recovery. Some researchers do propose non-pharmacological treatments such as attention to environmental and psychological factors, application of electroacupuncture (EA) technology and pharmacological treatments are helpful, but larger high-quality clinical trials with longer following-up are needed to further investigate the efficacy and safety.

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Section: Measures To Prevent and Improve Postoperative Sleep Disturbamentioning

confidence: 99%

Sleep Disturbances After General Anesthesia: Current Perspectives

2020

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“…Some experimental researches suggest that acupuncture may aid mood imbalances 35 and minimize sleep disturbances. 36 Animal studies found that acupuncture can alleviate the depressive-like behaviors in rats by inhibiting the inflammatory mediators in the hippocampus and prefrontal cortex via modulation of NF-κB pathway. 37 Our previous study found that EA could ameliorate behaviors of depressive model rats by restoring hippocampus CA1 synaptic plasticity, which might be mainly mediated by regulating 5-HT receptor levels.…”

Section: Discussionmentioning

confidence: 99%

<p>Efficacy of Electroacupuncture on Treating Depression-Related Insomnia: A Randomized Controlled Trial</p>

Yin

et al. 2020

NSS

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To evaluate the efficacy of electroacupuncture (EA) on treating insomnia in patients with depression. Patients and Methods: In a patient-assessor-blind, randomized and sham controlled trial, 90 depression patients with insomnia were assigned into three different groups, receiving EA in the treatment group, superficial acupuncture at sham points in the control group A, or Streitberger non-insertion sham acupuncture in the control group B. Treatment was applied 3 times weekly for 8 consecutive weeks. The primary outcome was measured using the Pittsburgh Sleep Quality Index (PSQI). Secondary outcomes were sleep parameters including sleep efficiency (SE), total sleep time (TST) and numbers of sleep awakenings (SA) recorded in the actigraphy, as well as applying the Hamilton Rating Scale for Depression (HAMD-17), Self-Rating Depression Scale (SDS) and Hamilton Rating Scale for Anxiety (HAMA). Assessments were performed at the baseline (week 0), week 4, week 8, and week 12. Linear mixed-effects models were used for analyses and all statistical tests were two-sided. Results: Patients in the EA group had more significant improvement in PSQI scores than those in the control groups over time (respectively p<0.001 and p=0.04 for treatment and time interaction). At 8-week posttreatment, the EA group reported a reduction of −6.64 points in PSQI scores compared with −2.23 points in the control group A (95% CI= −5.74 to −2.39) and −2.94 points in the control group B (95% CI= −5.73 to −2.47). Compared with the two control groups, significant between-group differences were seen in SE (both p<0.01) and TST (both p<0.01) at week 8; similar results can be found in HAMD-17, SDS, and HAMA scores as well. However, there were no between-group differences in SA (respectively p=0.24 and p=0.08) after 8-weeks of treatment. Conclusion: Electroacupuncture may improve the sleep quality of patients with depression.

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“…Kupperman index 3 [34,32,35] 157 −0.36 (−1.08 to 0.37)k P = .74 0.01% P = .34 Physical well-being 8 [17,18,27,28,38,31,40,41] 576 0.08 (−0.44 to 0.60) P = .00 86.5% P = .76 Social well-being 3 [17,27,28] 176 0.08 (−0.21 to 0.38) P = .47 0.00% P = .58 Emotional well-being 176 −0.12 (−0.59 to 0.34) P = .11 53.8% P = .61 TNF 2 [26,27] 64 −0.65 (−1.83 to 0.54) P = .03 77.1% P = .28 IL 2 [26,27] estrogen agonist activity may lead to harmful effects. 43 Shah et al 17 evaluated the estrogen level decline caused by decreased cerebral cortex endorphin levels, which causes secondary vasomotor and psychological symptoms, including increased endometrial carcinoma, irritability, hot flashes, vaginal dryness, loss of libido, menstrual disorders, fatigue, and musculoskeletal side effects.…”

Section: Pathology Parametersmentioning

confidence: 99%

Acupuncture for Hormone Therapy–Related Side Effects in Breast Cancer Patients: A GRADE-Assessed Systematic Review and Updated Meta-Analysis

et al. 2020

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Purpose: To determine the efficacy of acupuncture on the management of hormone therapy–related side effects in breast cancer patients. Methods: Randomized controlled trials of acupuncture versus a control or placebo in breast cancer patients that examined reductions in therapy-related side effects were retrieved from PubMed, EMBASE, Web of Science, and the Cochrane Library through April 2020. Data on patient symptoms (hot flashes, fatigue, pain, stiffness, and gastrointestinal symptoms), physical capacity, cytokines, and general psychosomatic well-being were analyzed. We evaluated and analyzed the quality of all included studies with the 5.2 Cochrane Handbook standards using Stata software (version 10.0) and Revman software (version 5.2), respectively. We assessed the risk of bias using the Cochrane Risk of Bias tool and evaluated the quality of evidence using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach. Results: The pooled results suggested that acupuncture led to moderate improvements in hot flashes, fatigue, and stiffness. No significant differences were observed in pain, gastrointestinal symptoms, Kupperman index scores, Overall quality of life, tumor necrosis factor levels, and interleukin levels. Conclusions: Evidence for outcome indicators of symptom management were downgraded by the GRADE system for inconsistency, indirectness, and imprecision in the included RCTs. Nonetheless, acupuncture is a moderately appropriate alternative therapy for hormone therapy–related side effects in breast cancer patients. However, it still lacks large-sample, multicenter, prospective RCTs. Future research should focus on standardizing comparison groups and treatment methods, be at least single-blinded, assess biologic mechanisms, have adequate statistical power, and involve multiple acupuncturists.

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Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial

Cited by 46 publications

References 48 publications

Sleep Disturbances After General Anesthesia: Current Perspectives

Sleep Disturbances After General Anesthesia: Current Perspectives

<p>Efficacy of Electroacupuncture on Treating Depression-Related Insomnia: A Randomized Controlled Trial</p>

Acupuncture for Hormone Therapy–Related Side Effects in Breast Cancer Patients: A GRADE-Assessed Systematic Review and Updated Meta-Analysis

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