麻豆传媒

Acupuncture improved sleep quality among patients with Parkinson's disease, a single-center randomized trial showed.

After 4 weeks of treatment, patients receiving real and sham acupuncture had a significant increase from baseline in the , with increases of 29.65 and 10.47 points, respectively (P<0.001 for both), but only the real acupuncture group had continued benefits at 8 weeks, with an increase of 25.35 points (P<0.001) versus 5.68 points for the sham group (P=0.03), reported Lixing Zhuang, MM, PhD, of the First Affiliated Hospital of Guangzhou University of Chinese Medicine in China, and co-authors.

"We preliminarily conclude that although sham acupuncture may induce a short-term placebo effect, acupuncture provides lasting clinical benefits in improving subjective sleep quality in patients with Parkinson's disease," they wrote in . "In this study, the placebo effect of acupuncture diminished gradually, but its therapeutic benefits remained over a prolonged period."

Sleep disorders are common among patients with Parkinson's disease, occurring with disease progression or as a side effect of treatment. Previous studies have shown that poor sleep is linked to accelerated deterioration in and , and faster progress in .

No other large-scale randomized clinical trials have focused on acupuncture for Parkinson's-related sleep problems, Zhuang and team said, though a established its safety and tolerability in 20 Parkinson's patients, with improved sleep. One with 30 patients showed improvements in PDSS and Non-Motor Symptoms Scale (NMSS) scores with electroacupuncture.

Because the study used one validated questionnaire for its primary outcome, Shirin Shafazand, MD, of the University of Miami, who wasn't involved with the study, told 麻豆传媒 that "the study was not designed to evaluate the impact of acupuncture as an additional therapy on various aspects of sleep quality. For example, does it improve insomnia symptoms or overall impressions of refreshing sleep or pain or stiffness, etc."

Though the differences in sleep quality were statistically significant, "it is also not clear whether these differences in reported sleep quality are clinically meaningful," she added. She recommended replicating such a study elsewhere, with larger numbers and with more sleep parameters.

For this study, participants were recruited from the Parkinson Clinic of the First Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2022 to February 2023. They were eligible if they were between the ages of 20 and 80; had a diagnosis of idiopathic Parkinson's disease; reported moderate or severe sleep problems or had a PDSS score below 110 (scores range from 0-150 and increases as sleep quality improves); had a stage of 1 to 3; and maintained use of Parkinson's medication over 30 days.

All patients received sleep hygiene guidance. The acupuncture group received real acupuncture, and the sham group was administered stainless steel needles that did not enter the subcutaneous tissue, in 30-minute sessions, three times a week for 4 weeks. Both groups used the same 10 acupoint locations on the head, hands, feet, and legs.

Of 83 participants enrolled, 78 completed the intervention and 4-week follow-up. Mean age was 64, and 52.6% were men. Most participants had a Hoehn and Yahr Scale stage of <2.5, and the average baseline PDSS score was 85.3.

Secondary outcomes included measures of excessive daytime sleepiness, anxiety, non-motor symptom severity, motor symptom severity, and quality of life. In the real acupuncture group, scores for motor and non-motor symptoms, sleepiness, anxiety, and health-related quality of life improved significantly after the intervention.

No severe adverse events were recorded in either group. The most common self-reported acupuncture-related adverse events were severe tremor; bleeding, numbness, or infection; or sharp pain during treatment.

Zhuang and colleagues acknowledged several limitations to their study. Acupuncturists were unblinded because of the nature of acupuncture, and follow-up was only 4 weeks, which could have limited the assessment of long-term effects and sustainability of the treatment. Participants were recruited from a specialty Parkinson's clinic in China, which likely restricted the generalizability of the findings.

Comment