title: Auricular acupressure helps improve sleep quality for severe insomnia in maintenance hemodialysis patients: a pilot study.
abstract: BACKGROUND
  Insomnia is common in patients undergoing maintenance hemodialysis (MHD). Long-term use of sedative-hypnotic agents is often correlated with increasing adverse effects. Auricular acupressure therapy (AAT) applied to specific auricular acupoints for managing insomnia has achieved favorable outcomes in a hemodialysis unit. This pilot study was performed to demonstrate the potential of AAT for insomnia in MHD patients and to prepare for a future randomized controlled trial.
  
  
  METHODS
  Eligible patients were enrolled into this descriptive pilot study and received AAT designed to manage insomnia for 4 weeks. Questionnaires that used the Pittsburgh sleep quality index (PSQI) were completed at baseline, after a 4-week intervention, and 1 month after completion of treatment. Sleep quality and other clinical characteristics, including sleeping pills taken, were statistically compared between different time points.
  
  
  RESULTS
  A total of 22 patients were selected as eligible participants and completed the treatment and questionnaires. The mean global PSQI score was significantly decreased after AAT intervention (p<0.05). Participants reported improved sleep quality (p<0.01), shorter sleep latency (p<0.05), less sleep disturbance (p<0.01), and less daytime dysfunction (p=0.01). They also exhibited less dependency on sleep medications, indicated by the reduction in weekly estazolam consumption from 6.98±4.44 pills to 4.23±2.66 pills (p<0.01). However, these improvements were not preserved 1 month after treatment.
  
  
  CONCLUSIONS
  In this single-center pilot study, complementary AAT for MHD patients with severe insomnia was feasible and well tolerated and showed encouraging results for sleep quality.
authors.affiliation: 1 Nephrology Center, Guangdong Provincial Hospital of Chinese Medicine , Guangzhou, China .
authors.forename: Yuchi
authors.initials: Y
authors.lastname: Wu
authors.forename: Chuan
authors.initials: C
authors.lastname: Zou
authors.forename: Xusheng
authors.initials: X
authors.lastname: Liu
authors.forename: Xiuqing
authors.initials: X
authors.lastname: Wu
authors.forename: Qizhan
authors.initials: Q
authors.lastname: Lin
mesh_terms: D019050:Acupressure / Q000379:methods*; D015669:Acupuncture Points; D020831:Acupuncture, Ear / Q000379:methods*; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D006435:Renal Dialysis; D007319:Sleep Initiation and Maintenance Disorders / Q000628:therapy*