title: Auricular Acupuncture and Cognitive Behavioural Therapy for Insomnia: A Randomised Controlled Study.
abstract: Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i). However CBT-i may not suit everyone. Auricular acupuncture (AA) is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4), with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression scale (HAD), were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder. The trial is registered with ClinicalTrials.gov NCT01765959.
authors.affiliation: Psychiatry, Department of Neuroscience, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: Bergdahl
authors.affiliation: Psychiatry, Department of Neuroscience, Uppsala University, 751 85 Uppsala, Sweden; Lung, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: J-E
authors.initials: JE
authors.lastname: Broman
authors.affiliation: Department of Clinical Neuroscience, Center for Psychiatry Research, Karolinska Institutet, Norra Stationsgatan 69, 113 64 Stockholm, Sweden.
authors.forename: A H
authors.initials: AH
authors.lastname: Berman
authors.affiliation: Psychiatry, Department of Neuroscience, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: K
authors.initials: K
authors.lastname: Haglund
authors.affiliation: Psychiatry, Department of Neuroscience, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: L
authors.initials: L
authors.lastname: von Knorring
authors.affiliation: Lung, Allergy and Sleep Research, Department of Medical Sciences, Uppsala University, 751 85 Uppsala, Sweden.
authors.forename: A
authors.initials: A
authors.lastname: Markström