Immediate Effect of Acupuncture on the Sleep Pattern of Patients with Obstructive Sleep Apnoea

Abstract

Background Most patients with obstructive sleep apnoea (OSA) do not tolerate treatment with nasal continuous positive airway pressure, the 'gold standard' treatment for this condition. It was shown in a pilot study that acupuncture was more effective than placebo treatment (sham acupuncture) in producing signifi cant changes in the respiratory events assessed by polysomnography (PSG). Objectives To investigate the immediate effect of manual acupuncture (MA) and electroacupuncture (EA) on the sleep pattern of patients presenting with moderate OSA. Methods 40 patients with an Apnoea-Hypopnoea Index (AHI) of 15-30/h were randomly allocated to MA treatment (n=10), EA 10 Hz treatment (n=10), EA 2 Hz treatment (n=10) and a no-treatment control group (n=10). The patients received MA or EA (2 or 10 Hz) just before the PSG study at 20:00. Results The AHI (p=0.005; p=0.005), the Apnoea Index (p=0.038; p=0.009) and the respiratory events (p=0.039; p=0.014) decreased signifi cantly in the MA and EA 10 Hz groups, respectively (AHI (21.9, 11.2), Apnoea Index (5.15, 0.7), respiratory events (120.5, 61.0) in the MA group before and after. AHI (20.6, 9.9), Apnoea Index (8.2, 0.3), respiratory events (117.0, 56.0) in the EA 10 Hz group before and after). The micro-arousals decreased only in the MA group (146.0 vs 88.5, p=0.0002). There were no signifi cant changes in the EA 2 Hz group or in the control group. Conclusion A single session of either MA or EA 10 Hz had an acute effect in reducing the AHI as well as the number of nocturnal respiratory events of patients presenting with moderate OSA.

Effects of acupuncture on obstructive sleep apnea severity, blood pressure control and quality of life in patients with hypertension: A randomized controlled trial

“…In our study, no changes, either in AHI or SatO 2 , were observed. Some points may have contributed to the divergent findings between our investigation and other studies (Freire et al, , ; Lv et al, ). First, the number of patients receiving treatment in our study was significantly higher than in the studies by Freire et al (, [10 in acupuncture and 10 in sham]), which, in turn, could reflect more reliable data.…”

“…Some points may have contributed to the divergent findings between our investigation and other studies (Freire et al, , ; Lv et al, ). First, the number of patients receiving treatment in our study was significantly higher than in the studies by Freire et al (, [10 in acupuncture and 10 in sham]), which, in turn, could reflect more reliable data. Second, only two of the six studies included in the meta‐analysis by Lv et al () adopted the same methodology as our study (i.e., acupuncture versus control and/or sham), thus limiting the conclusions of their findings.…”

“…Some points may have contributed to the divergent findings between our investigation and other studies (Freire et al, 2007(Freire et al, , 2010Lv et al, 2016). First, the number of patients receiving treatment in our study was significantly higher than in the studies by Freire et al (2007Freire et al ( , 2010 Previous studies have reported controversial effects of acupuncture on systolic and diastolic BP (Flachskampf et al, 2007;Kim et al, 2012). A previous clinical trial observed differences between acupuncture and sham of 6.4 mm Hg and 3.7 mm Hg in 24-hr systolic and diastolic BP, respectively, after 6 weeks (Flachskampf et al, 2007).…”

“…Previous studies have reported that acupuncture alone can promote improvements in AHI (Freire et al, ) and mean oxygen saturation (Lv et al, ), regardless of effective reduction in BP (Wang, Xiong, & Liu, ; Zhao et al, ). For example, Freire, Sugai, Togeiro, Mello, and Tufik () observed a mean reduction of 9.3 ± 5.0 in the AHI after an acupuncture session, and reduction of 10.7 ± 7.3 in the AHI with an increase of 2.6 ± 2.0% in oxygen saturation (SatO 2 ) after 12 weeks. Moreover, a recent meta‐analysis including six randomized controlled trials reported differences of 10.3 in AHI and 2.0 in SatO 2 between acupuncture and sham treatments.…”

Manual and Electrical Needle Stimulation in Acupuncture Research: Pitfalls and Challenges of Heterogeneity

“…[53][54][55][56][57][58][59][60][61][62][63][64][65][66][67][68][69] Next, trials that used EA adjunctively to MA (designated as MA versus MA + EA) were differentiated from trials that directly compared the two procedures (MA versus EA). If all procedures in the EA group before electrostimulation were the same as procedures in the MA group (e.g., de qi was initially elicited in each group), the trial was considered MA versus MA + EA; if the pre-electrostimulation procedure in the EA group was different (e.g., if de qi was elicited only in the MA group), the trial was considered MA versus EA.…”