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      Efficacy of Electroacupuncture on Treating Depression-Related Insomnia: A Randomized Controlled Trial

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          Abstract

          Objective

          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.

          Trial Registration

          Chinese Clinical Trial Registry (ChiCTR); URL: http://www.chictr.org.cn/showproj.aspx?proj=12327 ; Trial ID: ChiCTR-IIR-16008058.

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          Most cited references31

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          Management of Depression in Older Adults: A Review.

          Depression in older adults is a common psychiatric disorder affecting their health-related quality of life. Major depression occurs in 2% of adults aged 55 years or older, and its prevalence rises with increasing age. In addition, 10% to 15% of older adults have clinically significant depressive symptoms, even in the absence of major depression.
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            Sleep and Depression

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              Introducing a placebo needle into acupuncture research.

              A problem acupuncture research has to face is the concept of a control group. If, in control groups, non-acupoint needling is done, physiological acupuncture effects are implied. Therefore the effects shown in this group are often close to those shown in the acupuncture group. In other trials, control groups have received obviously different treatments, such as transcutaneous electrical nervous stimulation or TENS-laser treatment; it is not clear if the effects of acupuncture are due only to the psychological effects of the treatment. We developed a placebo acupuncture needle, with which it should be possible to simulate an acupuncture procedure without penetrating the skin. In a cross-over experiment with 60 volunteers we tested whether needling with the placebo needle feels any different from real acupuncture. Of 60 volunteers, 54 felt a penetration with acupuncture (mean visual analogue scale [VAS] 13.4; SD 10.58) and 47 felt it with placebo (VAS 8.86; SD 10.55), 34 felt a dull pain sensation (DEQI) with acupuncture and 13 with placebo. None of the volunteers suspected that the needle may not have penetrated the skin. The placebo needle is sufficiently credible to be used in investigations of the effects of acupuncture.
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                Author and article information

                Journal
                Nat Sci Sleep
                Nat Sci Sleep
                NSS
                nss
                Nature and Science of Sleep
                Dove
                1179-1608
                21 July 2020
                2020
                : 12
                : 497-508
                Affiliations
                [1 ]Department of Acupuncture and Moxibustion, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine , Shanghai, 200071, People’s Republic of China
                [2 ]School of Basic Medicine, Guangzhou University of Chinese Medicine , Guangzhou, 510006, People’s Republic of China
                [3 ]Shanghai Research Institute of Acupuncture and Meridian, Shanghai University of Traditional Chinese Medicine , Shanghai, 200003, People’s Republic of China
                [4 ]School of Chinese Medicine, The University of Hong Kong , Hong Kong
                [5 ]Virginia University of Integrative Medicine , Fairfax, VA 22031, USA
                Author notes
                Correspondence: Shifen Xu; Lixing Lao Email xu_teacher2006@126.com; llao@vuim.edu
                [*]

                These authors contributed equally to this work

                Author information
                http://orcid.org/0000-0002-0173-5936
                Article
                253320
                10.2147/NSS.S253320
                7382580
                32765146
                0a92c443-8b15-45ae-bc00-5c438867c2e7
                © 2020 Yin et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                History
                : 22 March 2020
                : 06 July 2020
                Page count
                Figures: 2, Tables: 4, References: 41, Pages: 12
                Categories
                Original Research

                insomnia,depression,electroacupuncture,randomized controlled trial

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