Acupuncture outperforms drug therapy for the treatment of insomnia. Hangzhou Hospital of Traditional Chinese Medicine researchers compared the efficaciousness of auricular acupuncture with estazolam drug therapy for the treatment of insomnia in senior citizens. Estazolam achieved an 82.9% total effective rate and auricular acupuncture achieved a 91.4% total effective rate. Acupuncture outperformed drug therapy for the improvement of sleep quality, duration, and daytime functioning. Results were determined by analysis of Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) scores.
Auricular acupuncture involves the application of filiform needles (1.5 mm length) to specific acupoints located on the outer surface of the ear. Estazolam is a benzodiazepine, a psychoactive drug in the same class as chlordiazepoxide (Librium) and diazepam (Valium). The study involved the selection of 70 patients at the acupuncture department of Hangzhou Hospital of Traditional Chinese Medicine. All patients were diagnosed with insomnia between March 2015 and March 2016. They were randomly divided into an acupuncture treatment group and a drug control group, with 35 patients in each group.
Group Selection Process
The statistical breakdown for each randomized group was as follows. The acupuncture treatment group was comprised of 14 males and 21 females. The average age in the acupuncture treatment group was 68 (±6) years. The average course of disease in the treatment group was 5.37 (±2.66) years. The drug control group was comprised of 16 males and 19 females. The average age in the drug control group was 67 (±7) years. The average course of disease in the drug control group was 5.44 (±3.12) years. For both groups, there were no significant differences in terms of their gender, age, and course of disease prior to initiation of the investigation.
Inclusion criteria were as follows. All participants were diagnosed with insomnia according to the Chinese Classification and Diagnostic Criteria for Mental Disorders (3rd edition). In addition, patients participating in the study met the following inclusion criteria:
Exclusion criteria were applied. This assured that patients participating in the study suffered from primary insomnia and were suitable for auricular acupuncture treatment. Patients who had the following conditions did not participate in the study:
Insomnia secondary due to biologically identified illnesses
Severe primary and comorbid cardiovascular, liver, kidney, digestive, or hematopoietic diseases
Skin lesions of the auricle
Alcohol or psychotropic drug dependence
All patients underwent Pittsburgh Sleep Quality Index (PSQI) and Insomnia Severity Index (ISI) assessments before and after treatments. PSQI is a measurement instrument for determining the sleep quality of patients with sleep disorders. PSQI measures seven different aspects of sleep, including subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medications, and daytime dysfunction. Lower scores in PSQI assessment denote a healthier sleep quality. ISI is a measurement instrument for determining insomnia severity, including measurements of difficulty falling asleep, staying asleep, waking up too early, and daytime dysfunction resulting from lack of quality sleep. Lower scores in ISI assessments denote a lower insomnia severity. After completion of treatment, the efficacy rates for each patient were categorized into 1 of 4 tiers:
Recovery: Improvement of sleep duration. Sleep duration reaching at least 6 hours. PSQI rating reduction of at least 75%.
Significantly effective: Improvement of sleep duration. A sleep duration increase of at least 3 hours. PSQI rating reduction of at least 50%.
Effective: Improvement of sleep duration. A sleep duration increase of less than 3 hours. PSQI rating reduction of at least 25%.
Ineffective: No improvement of sleep duration. PSQI rating reduction of less than 25%.
Estazolam achieved an 82.9% total effective rate. While effective, the downside is that the medication is contraindicated during pregnancy and for patients with severe liver or mental disorders. It is also contraindicated for patients with acute angle-closure glaucoma or those taking clozapine or sodium oxybate. Estazolam cannot be taken with alcohol and may cause memory loss, dizziness, fatigue, dry mouth, upset stomach, headaches, or difficulty with movement and coordination. Auricular acupuncture achieved a 91.4% total effective rate. The downside to acupuncture is that it must be applied by a licensed acupuncturist and may cause minor bruising in some cases.
Source - Healthcare Medicine Institute: