Group Auricular Acupuncture for PTSD-Related Insomnia in Veterans: A Randomized Trial

Prisco, M.K.

Jecmen, M.C.

Bloeser, K.J.

McCarron, K.K.

Akhter, J.E.

Duncan, A.D.

Balish, M.S.

Amdur, R.L.

Reinhard, M.

Medical acupuncture

2013

25(6)

407-422

RCT

Sleep Disorders

Sleep Initiation and Maintenance Disorder

Post-Traumatic Stress Disorder

PTSD

RCT

Acu Versus > 1 Control

Auricular Acupuncture

TCM Acupuncture Style

Group Acupuncture Style

Fixed Acupuncture Protocol

Restricted Modalities, Acupuncture Only

Sham Control

Penetrating Sham

Standard Needling Depth

Non Specific Acupoint Control

Wait List Control

Objectives: This study examined how group auricular acupuncture may influence sleep quality, sleep patterns, and hypnotic medication use associated with PTSD-related insomnia in Operation Enduring Freedom and Operation Iraqi Freedom veterans. Design: This study was a randomized controlled trial with sham acupuncture and wait-list controls. Setting: This study took place at the Washington, DC, Department of Veterans Affairs (VA), Medical Center. Subjects: Thirty-five subjects were randomized to participate in the study, but only 25 subjects completed the study. Interventions: Subjects were randomized to one of three groups: (1) true group auricular acupuncture; (2) sham auricular acupuncture; or (3) wait-list control. Outcome Measures: The primary outcome measure was perceived sleep quality (as measured by Insomnia Severity Index (ISI) questionnaires and Morin Sleep Diaries [MSDs]). Secondary outcome measures were total sleep time (TST), sleep efficiency, sleep latency, naps (as measured by MSD and wrist actigraphs [WAs]), hypnotic medication use, veteran satisfaction, and attrition rates. Results: Subjects in the true auricular acupuncture group had a statistically significant improvement ( p = 0.0165) in sleep quality as measured by the ISI at time (t) = 1 month. This group had a trend toward lower MSD TST at t = 2 months ( p = 0.078), lower WA TST at t =1 month (p = 0.0893), and toward higher MSD nap times than the other two groups post treatment ( p = 0.0666). No statistically significant association between group assignment and hypnotic medication use and satisfaction scores were noted. Conclusions: Acupuncturists should consider incorporating sleep hygiene education into their clinical practices and/or collaborate with insomnia health care professionals when working with individuals with insomnia. This study also supports the finding that perceived sleep quality and objective WA measurements are not significantly correlated.

10.1089/acu.2013.0989

Sleep Disorders

>1/WK

35

8 Weeks