The SIESTA Trial: A Randomized Study Investigating the Efficacy, Safety, and Tolerability of Acupressure versus Sham Therapy for Improving Sleep Quality in Patients with End-Stage Kidney Disease on Hemodialysis.
Objectives. To compare the effectiveness of real acupressure versus sham acupressure therapy in improving sleep quality in patients receiving hemodialysis (HD) or hemodiafiltration (HDF).Methods. A multicenter, single-blind, randomized controlled trial was conducted in two Australian dialysis units located in Princess Alexandra Hospital and Logan Hospital, respectively. Forty-two subjects with self-reported poor sleep quality were randomly assigned to real (n= 21) or sham (n= 21) acupressure therapy delivered thrice weekly for four consecutive weeks during routine dialysis sessions. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) score measured at week four adjusted for baseline PSQI measurements. Secondary outcomes were quality of life (QOL) (SF-8), adverse events, and patient acceptability (treatment acceptability questionnaire, TAQ).Results. The two groups were comparable on global PSQI scores (difference 0.19, 95% confidence interval [CI] -1.32 to 1.70) and on the subscale scores. Similar results were observed for QOL both in the mental (difference -3.88, 95% CI -8.63 to 0.87) and the physical scores (difference 2.45, 95% CI -1.69 to 6.58). There were no treatment-related adverse events and acupressure was perceived favorably by participants.Conclusion. Acupressure is a safe, well-tolerated, and highly acceptable therapy in adult hemodialysis patients in a Western healthcare setting with uncertain implications for therapeutic efficacy.
Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia; Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.
Kunyu
0000-0002-5041-1233
K
Shen
Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia.
Yeoungjee
Y
Cho
Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia.
Elaine M
EM
Pascoe
Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia.
Carmel M
CM
Hawley
Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia.
Veronica
V
Oliver
Department of Nephrology, Logan Hospital, Logan, QLD, Australia.
Kathryn M
0000-0001-6932-0203
KM
Hughes
Department of Nephrology, Logan Hospital, Logan, QLD, Australia; School of Medicine, Griffith University, Brisbane, QLD, Australia.
Richard
0000-0001-6535-5601
R
Baer
Department of Nephrology, Logan Hospital, Logan, QLD, Australia; School of Medicine, Griffith University, Brisbane, QLD, Australia.
Jeremy
J
Frazier
Department of Nephrology, Logan Hospital, Logan, QLD, Australia.
Elizabeth
E
Jarvis
Department of Nephrology, Logan Hospital, Logan, QLD, Australia; School of Medicine, Griffith University, Brisbane, QLD, Australia; School of Medicine, The University of Queensland, Brisbane, QLD, Australia.
Ken-Soon
KS
Tan
Department of Nephrology, Guangdong Provincial Hospital of Chinese Medicine, Guangzhou, China; Second School of Clinical Medicine, Guangzhou University of Chinese Medicine, Guangzhou, China.
Xusheng
X
Liu
Centre for Kidney Disease Research, School of Medicine, The University of Queensland, Translational Research Institute, Woolloongabba, Brisbane, QLD, Australia.
Glenda
G
Gobe
Department of Nephrology, Princess Alexandra Hospital, Brisbane, QLD, Australia; Australasian Kidney Trials Network, The University of Queensland, Brisbane, QLD, Australia; Centre for Kidney Disease Research, School of Medicine, The University of Queensland, Translational Research Institute, Woolloongabba, Brisbane, QLD, Australia.
David W
0000-0001-5491-3460
DW
Johnson