Electroacupuncture helps fight insomnia in patients with depression

For patients with depression who struggle to fall asleep, electroacupuncture can help with getting a better night’s sleep, with sustained effects, as shown in a study.

After 24 sessions of electroacupuncture performed over 8 weeks, the Pittsburgh Sleep Quality Index (PSQI) significantly decreased by −6.2 (95 percent confidence interval CI, −6.9 to −5.6) from baseline, according to the investigators, adding that this improvement in sleep quality persisted during the 24-week observational follow-up. [JAMA Netw Open 2022;5:e2220563]

Patients who received electroacupuncture also achieved significant reductions in the severity of insomnia (Insomnia Severity Index, −7.6, 95 percent CI, −8.5 to −6.7), depressive mood (17-item Hamilton Depression Rating Scale, −10.7, 95 percent CI, −11.8 to −9.7), and anxiety symptoms (Self-rating Anxiety Scale, −2.9, 95 percent CI, −4.1 to −1.7). Furthermore, the total sleep time recorded in the actigraphy increased by 29.1 minutes (95 percent CI, 21.5–36.7; p<0.001 for all).

“There were no severe adverse events reported during the trial, indicating that electroacupuncture may be a safe treatment for patients with comorbid depression and insomnia,” the investigators said.

The study included 270 patients (mean age 50.3 years, 71.9 percent female) who were randomized to undergo electroacupuncture plus standard care, sham acupuncture (SA) plus standard care, or standard care only (control). Acupuncture treatment sessions were conducted three times a week, for a total of 24 sessions over 8 weeks. This was followed by a 24-week observational follow-up.

A total of 247 (91.5 percent) patients completed all outcome measurements at week 32, and 23 (8.5 percent) dropped out of the trial.

Between-group comparisons showed that the reduction in PSQI score after the 8-week intervention period was significantly lower in the electroacupuncture group vs the SA group (difference, −3.6, 95 percent CI, −4.4 to −2.8; p<0.001) and the control group (difference, −5.1, 95 percent CI, −6.0 to −4.2; p<0.001).

This PSQI improvement was sustained at week 32, but there were no between-group differences found in the frequency of sleep awakenings at any of the time points.

“In the present trial, the effects of the electroacupuncture treatment on objective sleep maintenance and architecture were clearly observed by the actigraphy. Use of electroacupuncture yielded significant improvements in sleep efficiency and total sleep time and a decreasing trend in the number of sleep awakenings… [as well as] helped patients to improve their mental health status,” according to the investigators [Dialogues Clin Neurosci 2006;8:217-226]

“Previous work has shown that it can be more challenging to treat insomnia among patients with a longer duration of depression. [In the study cohort], the mean duration of depression in the electroacupuncture group was longer than that in the other two groups at baseline, but a significant improvement in sleep quality was still observed in the electroacupuncture group,” they added.

Used to treat depressive disorders and sleep disturbances in China for thousands of years, acupuncture has been shown to help calm nerves, relax patients, and alleviate their depressive symptoms. [Front Neurosci 2019;13:314]

“To our knowledge, there have been no similar large-scale multicentre randomized clinical trials studying the effects of electroacupuncture on treating comorbid depression and insomnia. This strictly designed rigorously conducted trial provides important clinical evidence about the role and value of electroacupuncture as an alternative therapy for treating insomnia and depressive moods,” the investigators said.