The Beneficial Role of Auricular Point Pressure in Insomnia and Anxiety in Isolated COVID-19 Patients

Abstract

Background. Coronavirus disease 2019 (COVID-19) causes psychological distress and can have a negative impact on the general mental health and rehabilitation in affected patients under currently implemented isolation guidelines. Auricular point pressure (APP) as well-established technique in traditional Chinese medicine may help to relieve sleep disturbance and anxiety in COVID-19 patients. Methods. During the early phase of the epidemic/pandemic, patients were enrolled in this study (02/2020 until 03/2020 n = 84). They were strictly isolated on specific wards at the Hubei Provincial Hospital of Integrated Chinese and Western Medicine in Hubei. The retrospective cohort study design included two groups. Group A patients were treated with an auricular point pressure (APP) in addition to standard intensive care medicine while Group B participants (No-APP) received routine nursing measures alone. Treatment outcome was measured using the St. Mary’s Hospital Sleep Questionnaire (SMH) Score and the 7-Item Generalized Anxiety Disorder Scale (GAD-7). Both scores were measured in each patient at baseline and on the discharge day. Results. The SMH score and sleep status changed in APP patients at the end of the treatment period when compared with No-APP patients ( P < 0.01 ). APP-treated patients demonstrated lower GAD-7 scores than No-APP controls ( P < 0.01 ). Further, no significant differences in safety or adverse events between the APP and No-APP groups were observed. Conclusion. The results from our snapshot study during the early phase of the SARS-CoV-2 epidemic/pandemic suggest that auricular point pressure could be a simple and effective tool to relieve insomnia and situational anxiety in hospitalized patients suffering from COVID-19 and kept under disconcerting conditions of isolation.

Living through the psychological consequences of COVID-19 pandemic: a systematic review of effective mitigating interventions

“…Of the 29 studies, one was conducted globally (3.5%)27 and the rest were categorised according to WHO geographical area. Three studies (10.3%) were conducted in the Eastern Mediterranean region,28–30 10 (34.5%) in the European region,31–40 4 (13.8%) in the Americas41–44 and 11 (37.9%) in the Western Pacific 26 45–52. Applying the World Bank’s income group categories, 13 (44.8%) studies were in high-income group,31–33 35–41 43–45 12 (41.4%) in upper middle-income group26 34 42 46–52 and 3 (10.3%) in lower middle-income group28–30; there were no studies from the low-income group.…”

“…On population, out of the total 29 studies, 8 (27.6%) targeted patients with COVID-19,28–30 45 48 49 51 52 6 (20.7%) among healthcare workers31 34 35 44 46 47 and more than half (51.7%) were general population 26 27 32 33 36–43 50. Out of the 29 studies, 14 (48.3%) were RCTs 27–29 33 34 38–42 44…”

“…The interventions reported by the studies can be classified into three types: 19 online-based interventions (65.5%),26 27 29–31 33 35 36 38 40–45 47 48 6 on-site-based interventions (20.7%)28 34 39 49–51 and 4 combined online and on-site interventions (13.8%) 32 37 46 52…”

“…On outcome measurement, out of the total 29 studies, only 1 (3.5%) assessed suicide ideation,45 while 14 (48.3%) measured depression outcome,32 35 38–41 43–47 50–52 24 (82.8%) measured anxiety,26 28 29 32 34–36 38–52 9 (31.0%) measured psychological stress,30 35–40 43 50 9 (31.0%) measured sleep quality27 33 35 43 45 47–49 52 and 6 (20.7%) measured other outcomes such as loneliness and self-compassion 26 31 36 41 44 Table 2. shows the characteristics of the studies.…”

“…Of 24 anxiety interventions from 18 publications, 21 (87.5%) significantly lowered anxiety in intervention groups; 11 were RCT26 28 29 34 39 41–43 48 50 and 10 quasiexperimental studies 26 32 36 44–47 49 51 52. Among the 11 RCT studies, five interventions (45.5%) were mindfulness and meditation based 26 39 42 43 50.…”