Acupuncture improves certain aspects of sleep in hematopoietic stem cell transplantation patients: a secondary analysis of a randomized controlled trial.
IF 2.4 3区 医学Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE
Sarah El Iskandarani, Lingyun Sun, Susan Qing Li, Gloria Pereira, Sergio Giralt, Gary Deng
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引用次数: 0
Abstract
Background: High-dose chemotherapy followed by hematopoietic stem cell transplantation (HSCT) is associated with a high symptom burden including sleep disturbance. Here we present the results of a secondary analysis of a randomized, sham-controlled trial assessing the effect of acupuncture on sleep quality during HSCT.
Methods: Adult multiple myeloma patients undergoing inpatient and outpatient autologous HSCT were randomized and blinded to receive either true or sham acupuncture (by licensed acupuncturists) once daily for 5 days starting the day after chemotherapy. Sleep onset, total sleep time, sleep efficiency percentage and sleep-onset latency time were assessed using an actigraphy-based sleep monitor. A multivariate regression analysis was conducted to compare the average area-under-the-curve of five acupuncture intervention days for each sleep outcome between groups, adjusted by baseline score and inpatient or outpatient chemotherapy stratum.
Results: Over 32 months, 63 patients were enrolled. Participants undergoing true acupuncture experienced a significant improvement in sleep efficiency when compared to sham (-6.70, 95% CI -13.15, -0.25, p = 0.042). Subgroup analysis showed that the improvement was more prominent in the inpatient setting (-9.62, 95% CI -18.76, -0.47; p = 0.040). True acupuncture tended to improve wake time after sleep onset (WASO; -10.95, p = 0.054). Between-group differences in other sleep related variables were not statistically significant.
Conclusion: Our data suggest that true acupuncture may improve certain aspects of sleep, including sleep efficiency and possibly WASO, in multiple myeloma patients undergoing HSCT. By studying patient reported outcomes in future larger scale studies, acupuncture's role in improving sleep quality during HSCT treatment could be further elucidated.
背景:大剂量化疗后的造血干细胞移植(HSCT)与包括睡眠障碍在内的高症状负担相关。在此，我们介绍了一项随机、假对照试验的二次分析结果，该试验评估了针灸对HSCT期间睡眠质量的影响。方法:接受住院和门诊自体造血干细胞移植的成年多发性骨髓瘤患者随机和盲法接受真针灸或假针灸(由执业针灸师)，每天一次，从化疗后第一天开始，持续5天。睡眠开始时间、总睡眠时间、睡眠效率百分比和睡眠开始潜伏期使用基于活动记录仪的睡眠监测仪进行评估。采用多变量回归分析比较针刺干预5天各睡眠结果的平均曲线下面积，并根据基线评分和住院或门诊化疗分层进行调整。结果:在32个月的时间里，63例患者入组。与假针灸相比，接受真实针灸的参与者在睡眠效率方面有显著改善(-6.70,95% CI -13.15， -0.25, p = 0.042)。亚组分析显示，住院患者的改善更为显著(-9.62,95% CI -18.76， -0.47;p = 0.040)。真正的针灸倾向于改善睡眠后的清醒时间(WASO;-10.95, p = 0.054)。其他睡眠相关变量组间差异无统计学意义。结论:我们的数据表明，真正的针灸可以改善接受HSCT的多发性骨髓瘤患者睡眠的某些方面，包括睡眠效率和可能的WASO。通过在未来更大规模的研究中研究患者报告的结果，针刺在改善HSCT治疗期间睡眠质量方面的作用可以进一步阐明。试验注册号:NCT01811862 (ClinicalTrials.gov)。
期刊介绍：
Acupuncture in Medicine aims to promote the scientific understanding of acupuncture and related treatments by publishing scientific investigations of their effectiveness and modes of action as well as articles on their use in health services and clinical practice. Acupuncture in Medicine uses the Western understanding of neurophysiology and anatomy to interpret the effects of acupuncture.
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