title: Acupressure, reflexology, and auricular acupressure for insomnia: a systematic review of randomized controlled trials.
abstract: Previous randomized controlled trials (RCTs) have shown that acupuncture may be efficacious for insomnia. Instead of needling, acupressure, reflexology, and auricular acupressure are procedures involving physical pressure on acupoints or reflex areas. These variants of acupuncture are gaining popularity, perhaps due to their non-invasive nature. A systematic review has therefore been conducted to examine their efficacy and safety for insomnia. Two independent researchers searched five English and 10 Chinese databases from inception to May 2010. Forty RCTs were identified for analysis. Only 10 studies used sham controls, four used double-blind design, nine studies scored three or more by the Jadad scale, and all had at least one domain with high risk of bias. Meta-analyses of the moderate-quality RCTs found that acupressure as monotherapy fared marginally better than sham control. Studies that compared auricular acupressure and sham control showed equivocal results. It was also found that acupressure, reflexology, or auricular acupressure as monotherapy or combined with routine care was significantly more efficacious than routine care or no treatment. Owing to the methodological limitations of the studies and equivocal results, the current evidence does not allow a clear conclusion on the benefits of acupressure, reflexology, and auricular acupressure for insomnia.
authors: Department of Psychiatry, University of Hong Kong, Hong Kong Special Administrative Region.
authors: Wing-Fai
authors: WF
authors: Yeung
authors: Ka-Fai
authors: KF
authors: Chung
authors: Maggie Man-Ki
authors: MM
authors: Poon
authors: Fiona Yan-Yee
authors: FY
authors: Ho
authors: Shi-Ping
authors: SP
authors: Zhang
authors: Zhang-Jin
authors: ZJ
authors: Zhang
authors: Eric Tat-Chi
authors: ET
authors: Ziea
authors: Vivian Taam
authors: VT
authors: Wong
mesh_terms: D019050:Acupressure / Q000379:methods*; D020831:Acupuncture, Ear / Q000379:methods*; D006801:Humans; D008405:Massage / Q000379:methods*; D016032:Randomized Controlled Trials as Topic; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*