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Sleep patterns in a randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for insomnia
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.ORCID iD: 0000-0003-0745-7882
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Medical Sciences, Respiratory Medicine and Allergology.ORCID iD: 0000-0001-9849-363X
Karolinska Institutet, Institutionen för klinisk neurovetenskap, Centrum för psykiatriforskning.ORCID iD: 0000-0002-7709-0230
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
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2017 (English)In: Complementary Therapies in Clinical Practice, ISSN 1744-3881, E-ISSN 1873-6947, Vol. 28, 220-226 p.Article in journal (Refereed) Published
Abstract [en]

The aim of the study was to objectively examine how sleep patterns were affected in a short- and long-term perspective after auricular acupuncture (AA) and cognitive behavioral therapy for insomnia (CBT-i). Sixty participants with insomnia disorders (men/women 9/51; mean age of 60.5 years, (SD 9.4)), were randomized to group treatment with AA or CBT-i. Actigraphy recordings were made at baseline, post-treatment and 6-month follow-up. The CBT-i group reduced their time in bed, their actual sleeping time, their sleep latency and their actual time awake. The AA group slept longer, increased their time in bed and decreased their sleep latency post-treatment. The between-groups results differed in wake-up time, rising, time in bed, actual sleep time and actual wake time. The differences were not maintained six months later. In accordance with previous findings the results support the notion that the objective sleep time does not necessarily affect the subjective perception of insomnia.

Place, publisher, year, edition, pages
2017. Vol. 28, 220-226 p.
Keyword [en]
Actigraphy, Auricular acupuncture, Cognitive-behavioral therapy, Insomnia disorder, Non-pharmacological, Treatment
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:uu:diva-320044DOI: 10.1016/j.ctcp.2017.06.006ISI: 000407722900030PubMedID: 28779933OAI: oai:DiVA.org:uu-320044DiVA: diva2:1088513
Funder
Ekhaga Foundation, 2011 59
Available from: 2017-04-12 Created: 2017-04-12 Last updated: 2017-11-21Bibliographically approved
In thesis
1. Auricular acupuncture for insomnia
Open this publication in new window or tab >>Auricular acupuncture for insomnia
2017 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Cognitive behavioural therapy for insomnia (CBT-i) is the most effective treatment for insomnia. Studies show that auricular acupuncture (AA) may alleviate insomnia symptoms.

The overall aim of the thesis was to compare treatment effects of auricular acupuncture (AA) with cognitive behavioural therapy for insomnia (CBT-i) on symptoms of insomnia, anxiety, depression, hypnotic drugs consumption and quality of life from short- and long-term perspectives.

Paper I had a qualitative approach with a descriptive design. 16 participants received group-treatment with AA during their protracted withdrawal phase and were interviewed about their experiences. They participants experienced a reduction in protracted withdrawal symptoms, improved subjective sleep quality, a strong sensation of peacefulness and increased wellbeing.

Paper II, III and IV present results from a randomised controlled trial in where the effects of group-treatment with AA and CBT-i were compared in short- and long-term using subjective (questionnaires and sleep diary) and objective (actigraphy) measurements.

The results showed that CBT-i was superior to AA in reducing insomnia symptoms in both the short and long run. Both groups experienced significant long-term reduction of depressive symptoms. Further, both groups managed to maintain a decreased intake of hypnotic drugs at the end of the treatment when compared to baseline measurement. Short-term reduction of symptoms of anxiety and depression improved only in the AA group. The results from the objective actigraph recordings showed that the AA group slept more and the CBT-i group less after the treatment and that sleep patterns in both groups reverted to pre-treatment levels after 6 months.

Conclusively: AA, as administered in this study, was not as good as CBT-i in treating insomnia symptoms, and should not be used as a stand-alone treatment for insomnia. Our results also demonstrate that prolonged sleep time does not necessarily yield better sleep, and that the perception of insomnia symptoms is not inevitably affected by sleep duration. AA was as effective as CBT-i in ending hypnotic drugs consumption. Moreover, AA was more successful than CBT-i in reducing symptoms of anxiety and depression in the short run. Further studies investigating AA for anxiety and depression are motivated.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2017. 61 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1330
Keyword
auricular acupuncture, cognitive behavioural therapy, insomnia disorder, non-pharmacological, sleep disorder, treatment
National Category
Psychiatry
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-320045 (URN)978-91-554-9905-1 (ISBN)
Public defence
2017-06-05, Auditorium Minus, Museum Gustavianum, Akademigatan 3, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Funder
Ekhaga Foundation, 2011 59
Available from: 2017-05-15 Created: 2017-04-12 Last updated: 2017-05-16

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The full text will be freely available from 2018-08-01 14:20
Available from 2018-08-01 14:20

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Bergdahl, LenaBroman, Jan-Erikvon Knorring, LarsMarkström, Agneta

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