ArticlePDF Available

Efficacy of HT 7 point acupressure stimulation in the treatment of insomnia in cancer patients and in patients suffering from disorders other than cancer

Authors:

Abstract

The induction of sleep would depend on interaction between gabaergic system and the pineal gland through its main hormone melatonin. Until few years ago benzodiazepines were the only drugs effective in the treatment of insomnia. Recently, however, both melatonin and acupressure have appear to be active in sleep disorders. The aim of study was to evaluate the efficacy of HT 7 point acupressure in insomnia. The study enrolled 25 patients affected by sleep disorders, 14 of whom had a neoplastic disease. They were treated by HT 7 stimulation for al least two consecutive weeks using a medical device named H7 Insomnia Control. An improvement in the quality of sleep was achieved in 15/25 (60%) patients, with a more evident efficacy in cancer patients (11/14 [79%]). This study confirms previous clinical data showing the efficacy of acupressure in the treatment of sleep disorders, particularly in cancer-related insomnia.
M
I
N
ERVA
MEDICA
VOLUME 99 .2008
PUBBLICAZIONE PERIODICA BIMESTRALE - POSTE ITALIANE SPED. IN A. P. 45% ART. 2 COMMA 20/B LEGGE 662/96 AUT. 584/DC/DCI/CN - ISSN 0026-4806 TAXE PERÇUE
EDIZIONI .MINERVA .MEDICA
EFFICACY OF HT 7 POINT ACUPRESSURE STIMULATION
IN THE TREATMENT OF INSOMNIA IN CANCER PATIENTS
AND IN PATIENTS SUFFERING
FROM DISTURBANCES OTHER THAN CANCER
R. CERRONE, L. GIANI, B. GALBIATI, G. MESSINA, M. CASIRAGHI,
E. PROSERPIO, M. MEREGALLI, P. TRABATTONI, P. LISSONI, G. GARDANI
Reprinted from
Efficacy of HT 7 point acupressure stimulation
in the treatment of insomnia in cancer patients
and in patients suffering
from disturbances other than cancer
R. CERRONE, L. GIANI, B. GALBIATI, G. MESSINA, M. CASIRAGHI,
E. PROSERPIO, M. MEREGALLI, P. TRABATTONI, P. LISSONI, G. GARDANI
Department of Radiotherapy and Oncology
San Gerardo Hospital, Monza, Milan, Italy
Aim. The induction of sleep would depend on
interaction between gabaergic system and the
pineal gland through its main hormone mela-
tonin. Until few years ago benzodiazepines
were the only drugs effective in the treatment
of insomnia. Recently, however, both melato-
nin and acupressure have appear to be active
in sleep disorders. The aim of study was to eva-
luate the efficacy of HT7 point acupressure in
insomniac.
Methods. The study enrolled 25 patients affec-
ted by sleep disorders, 14 of whom had a neo-
plastic disease. They were treated by HT7 sti-
mulation for al least two consecutive weeks
using a medical device named H7 Insomnia
Control®®.
Results. An improvement in the quality of sleep
was achieved in 15/25 (60%) patients, with a
more evident efficacy in cancer patients (11/14
[79%]).
Conclusion. This study confirms previous cli-
nical data showing the efficacy of acupressure
in the treatment of sleep disorders, particu-
larly in cancer-related insomnia.
Key words: Acupressure - Insomnia - Sleep disor-
ders - Neoplasms - Melatonin.
Insomnia is one of the most frequent psy-
chobiological disturbances in the modern
world.1The biochemical mechanisms respon-
sible for insomnia have to be better investi-
gated and defined, since the physiopatholo-
gy of sleep still remains at least in part
unknown. However, according to the knowl-
edgement available up to now, it is known
that the induction of sleep is mainly mediat-
ed by the activation of the gabaergic system.2
In fact, the drugs commonly used in the treat-
ment of insomnia exert their action by stim-
ulating benzodiazepine receptors, which are
connected to the gabaergic ones.3Therefore,
sleep disorders could depend at least in part
on an anomalous function of the gabaergic
system.2, 3 Moreover, recent investigations
have demonstrated the fundamental role of
the pineal hormone melatonin (MLT) in the
induction of sleep 4and in the treatment of
insomnia.5MLT would also act by modulat-
ing the gabaergic system, however in a dif-
ferent way with respect to that followed by
benzodiazepine drugs, as suggested by the
fact that MLT-induced sleep is characterized
by a re-establishment of REM phase of sleep,
with a following amplification of the capac-
ity of dreaming,5whereas the action of ben-
zodiazepines is constantly associated with a
suppression of dream. Finally, further recent
researches have demonstrated the possibili-
Received on September 8, 2008.
Accepted for publication on October 13, 2008.
Corresponding author: P. Lissoni, Dipartimento di
Radioterapia e Oncologia, Ospedale San Gerardo, 20052
Monza (MI), Italy. E-mail: p.lissoni@hsgerardo.org
Vol. 99, 2008 MINERVA MEDICA
1
MINERVA MED 2008;99
CERRONE EFFICACY OF HT 7 POINT ACUPRESSURE ON INSOMNIA
ty to act on the psychoneuroendocrine system
not only through a biochemical approach,
but also by a bioenergetic strategy, such as
acupuncture and acupressure on specific
body points.6, 7 In particular, it has been
demonstrated that HT7 point (Shenmen in
Chinese) acupressure may be effective in the
treatment of insomnia due to different rea-
sons.8Moreover, it has been shown that HT7
point acupressure may stimulate the release
of MLT from the pineal gland,9by suggesting
that the efficacy of HT7 stimulation in the
treatment of insomnia may be due at least
in part to the stimulation of MLT release,
whose efficacy as sleep inducer has been
well documented.4, 5 On this basis, we have
evaluated the efficacy of HT7 point acupres-
sure in the treatment of insomnia in a group
of oncologic and non-oncologic patients.
Materials and methods
The study enrolled 25 consecutive patients
suffering from insomnia due to different rea-
sons (males/females ratio: 8/17; median age
62 years, range 48-75). Fourteen patients were
affected by cancer (breast cancer: 6; colorectal
cancer: 5; non-small cell lung cancer: 3),
while the remaining 11 patients were suffer-
ing from medical illnesses other than cancer
(anxiety: 7; idiopathic insomnia: 3; depres-
sion: 1). Eligibility criteria were, as follows:
sleep disorders lasting from at least three
months, lack of response to the common
benzodiazepine drugs, no chronic pain, and
no concomitant administration of drugs
inhibiting the induction of sleep. HT7 point
was located on the outer side of the wrist, on
the radial site of the flexor carpi ulnaris ten-
don, between the ulna and the pisiform
bones. The acupressure devices (H7 Insomnia
Control®, Consulteam s.a.s., Como, Italy)
were applied on both wrists at 10.00 p.m.
each night for at least two weeks, corre-
sponding to the time needed to obtain a sig-
nificant improvement of sleep quality.8
Statistical analysis
The results were statistically analyzed by
the χ2test.
Results
Irrespectively of the reason responsible for
sleep disorders, an improvement in the qual-
ity of sleep was achieved within the first 10
days of treatment in 15/25 (60%) patients. The
median period to obtain an improvement of
sleep quality was 6 days (range 2-10).
Moreover, the percentage of improvement in
sleep quality obtained from HT7 point acu-
pressure was higher in oncologic patients than
in those with diseases other than cancer, even
though the difference was not statistically sig-
nificant (11/14 [79%] vs 4/11 [36%]). In contrast,
the efficacy was apparently low in patients
suffering from anxiety and depression. The
diseases of the 10 patients, who had no ben-
efit from acupressure, were, as follows: can-
cer: 3; anxiety: 5; idiopathicinsomnia: 1;
depression: 1. The percentages of the effica-
cy of HT7 point acupressure in relation to the
type of disease are shown in Table I.
Discussion and conclusions
According to previous preliminary results
reported by other authors,9this study con-
firms the efficacy of HT7 point stimulation
in the treatment of insomnia in a relatively
high percent of patients. Obviously, the low
number of patients does not allow us to
establish which may be the human illness
more responsive to HT7 stimulation. Howe-
2
MINERVA MEDICA Vol. 99, 2008
TABLE I.—Percent of efficacy of HT7 point acupressu-
re in the treatment of insomnia in relation to the type
of disease.
Disease Efficacy
N. (%)
Neoplastic disease 11/14 (79%)
— Breast cancer 4/6 (67%)
— Colorectal cancer 4/5 (80%)
— Lung cancer 3/3 (100%)
Anxiety 2/7 (29%)
Idiopathic insomnia 2/3 (67%)
Depression 0/1 (
Overall patients 15/25 (60%)
EFFICACY OF HT 7 POINT ACUPRESSURE ON INSOMNIA CERRONE
ve mediante un dispositivo medico denominato H7
Insomnia Control®.
Risultati. Un miglioramento nella qualità del son-
no è stato ottenuto da 15/25 (60%) pazienti, con una
più evidente efficacia nei pazienti oncologici (11/14
[79%).
Conclusioni. Questo studio conferma precedenti
dati clinici che dimostrano l’efficacia dell’acupres-
sione nel trattamento dei disturbi del sonno, in par-
ticolare nell’insonnia connessa al cancro.
Parole chiave: Acupressione - Insonnia - Disturbi del
sonno - Neoplasie - Melatonina.
References
1. Lack LC, Wright HR. Chronobiology of sleep in humans.
Cell Mol Life Sci 2007;64:1205-15.
2. Lloyd KG, Thurer F, Pilc A. Upregulation of gamma-
aminobutyric acid (GABA) B binding system in rat
frontal cortex. J Pharmacol Exp Ther 1985;235:191-9.
3. Nitz D, Siegel JM. GABA release in the dorsal raphe
nucleus: role in the control of REM sleep. Am J Physiol
1997;273:R451-5.
4. Golombek DA, Pevet P, Cardinali DP. Melatonin effects
on behavior. Neurosci Biobehavior Rev 1996;20;403-12.
5. Wyatt JK, Dijk DJ, Ritz-deCecco A, Ronda JM, Czeisler
CA. Sleep facilitating effect of exogenous melatonin
in healthy young men and woman is circadian-phase
dependent. Sleep 2006;29:609-18.
6. Diddble SL, Chapman J, Mach KA, Shih AS. Acupressure
for nausea: results of a pilot study. Oncol Nurs Forum
2000;27:41-7.
7. Werntoft E, Dykes AK. Effect of acupressure on nausea
and vomiting during pregnancy. J Reprod Med
2001;46:835-9.
8. Sok SR, Erlen JA, Kim KB. Effects of acupuncture ther-
apy on insomnia. J Adv Nurs 2003;44:375-84.
9. Warren Spence D, Kayumov L, Chen A, Jain U, Katzman
MA, Shen J et al. Acupuncture increases nocturnal
melatonin secretion and reduces insomnia and anxiety:
a preliminary report. J Neuropsychiatry Clin Neurosci
2004;16:19-28.
10. Maestroni GJM. The immunoneuroendocrine role of
melatonin. J Pineal Res 1193;14:1-10.
11. Gardani G, Cerrone R, Biella G, Galbiati E, Proserpio
E, Casiraghi M et al. A progress study of 100 cancer
patients treated by acupressure for chemiotherapy-
induced vomiting after failure with the pharmacolog-
ical approach. Minerva Med 2007;98:1-4.
Vol. 99, 2008 MINERVA MEDICA
3
ver, according to the results of this study, it
seems that cancer-related sleep disorders may
be particularly responsive to the acupressure
approach. This finding could also have some
importance not only in terms of control of
insomnia in cancer patients, since MLT,
whose secretion would be stimulated by HT7
acupressure,9has been proven to play an
anticancer activity.10 Therefore, HT7 stimu-
lation could improve the pineal function in
cancer patients and contribute to the control
of the neoplastic growth. Then, this prelim-
inary clinical investigation would justify fur-
ther researches to improve the quality of life
of cancer patients and perhaps the clinical
course of the neoplastic disease by a bioen-
ergetic approach, such as acupressure
method. In fact, previous clinical investiga-
tions had already demonstrated the efficacy
of acupressure in the control of chemother-
apy-induced nausea and vomiting.11
Riassunto
Efficacia della stimolazione con acupressione del
punto HT7 nel trattamento dell’insonnia in pazien-
ti oncologici o affetti da patologie non neoplastiche
Obiettivo. L’induzione del sonno sembra dipen-
dere dall’interazione tra il sistema gabaergico e la
ghiandola pineale attraverso il suo ormone melatonina
(MLT). Fino a pochi anni fa le benzodiazepine erano
i soli farmaci efficaci nel trattamento dell’insonnia.
Recentemente, invece, sia la melatonina sia l’acu-
pressione sembrano essere attive sui disturbi del son-
no. Scopo dello studio è valutare l’efficacia dell’acu-
pressione del punto HT7 nell’insonnia.
Metodi. Lo studio ha incluso 25 pazienti affetti da
disturbi del sonno, di cui 14 con malattia neoplasti-
ca. I pazienti sono stati trattati con la stimolazione
del punto HT7 per almeno due settimane consecuti-
... Alternatively, acupressure applied at specific meridians or acupoints has been employed in Traditional Chinese Medicine to improve sleep quality by restoring the yin and yang harmony and balancing life energy (qi) [30]. Several studies have demonstrated its safety and efficacy in various patient populations, including the elderly [31][32][33][34], postmenopausal women [35], and cancer patients [36]. Acupressure is a noninvasive therapy, which is likely to be associated with a low risk of side effect profile, when compared to therapies such as hypnotics. ...
... Unfortunately, the analysis was conducted on a per-protocol basis; the dropout rate was moderate (14%), and the statistical methods employed did not adjust for baseline differences in PSQI global scores [44,45]. Other previous studies have reported beneficial effects of acupressure on insomnia in patients without chronic kidney disease, including the elderly [31,33], postmenopausal women [35], and cancer patients [36]. The apparent disparity in findings compared with the present study may relate to the limitations of the previous studies, including suboptimal methodologic quality, for example, lacking of placebo control [35,36], selective outcome reporting [31], and inclusion of predominantly Asian patient populations [31,33,35,36]. ...
... Other previous studies have reported beneficial effects of acupressure on insomnia in patients without chronic kidney disease, including the elderly [31,33], postmenopausal women [35], and cancer patients [36]. The apparent disparity in findings compared with the present study may relate to the limitations of the previous studies, including suboptimal methodologic quality, for example, lacking of placebo control [35,36], selective outcome reporting [31], and inclusion of predominantly Asian patient populations [31,33,35,36]. ...
Article
Full-text available
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 (í µí±› = 21) or sham (í µí±› = 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.
... [17][18][19][20][22][23][24] Similar results were also obtained in all studies in which the effectiveness of acupressure on sleep quality in other patient groups was evaluated. [33][34][35][36][37][38][39][40][41][42][43][44][45][46] This may be due to the positive effect of acupressure on sleep quality as well as on other symptoms. Tsay 19 found that the sleep quality of HD patients applied with acupressure increased and also their fatigue and depression levels decreased. ...
... In the study, it was determined that the sleep quality of 83.3% of the patients in the experimental group improved after the application of acupressure. Cerrone et al 44 showed that there was an improvement in the sleep quality of 60% of the patients after acupressure was applied to the HT7 point with an acupressure wristband. According to a study carried out by Abedian et al, 35 it was reported that there was an improvement in the overall sleep quality of 41% of the patients and in the subjective sleep quality of 53.2% of them after the acupressure intervention. ...
Article
This study was carried out to evaluate the effect of acupressure applied to hemodialysis patients on the level of daytime sleepiness and sleep quality. The data were collected using the Descriptive Information Form, Pittsburgh Sleep Quality Index, and Epworth Sleepiness Scale. In the study, a total of 12 sessions of acupressure were applied to the Shenmen (HT7), Sanyingjao (Sp6), and Yungquan (KI1) points in the experimental group for 4 weeks. No intervention was applied to the control group. After the acupressure, it was determined that the sleep quality of the experimental group was better than that of the control group and that daytime sleepiness was less compared with the control group. After the acupressure, it was determined that the sleep latency of the experimental group was statistically significantly less and their total sleep duration was higher compared with the control group (P < .05). Although there was a decrease in the sleep quality of the experimental group 1 month after the cessation of the acupressure, it was determined that the sleep quality of the experimental group was better than that of the control group (P < .05). It was concluded that acupressure was an effective nursing intervention in increasing sleep quality and decreasing daytime sleepiness of hemodialysis patients.
... Mitarb. [31] veröffentlichten eine weitere Studie, die die Wirksamkeit des untersuchten Akupunkturpunkts Shenmen (He 7) zeigt. Insgesamt nahmen 25 Patient*innen mit Schlafstörungen teil, von denen 14 Krebs hatten. ...
Article
Acupressure is a non-pharmacological technique that has the potential to relieve various diseases. This mini review deals with facts of scientific acupressure studies and summarizes some of important aspects. Scientific articles from the PubMed, Google Scholar and CNKI databases served as research documents. In addition, the research of acupressure versus pharmacologic interventions in mental diseases has included own material already published in scientific articles. A total of 9 listed papers were identified, 8 of which were considered relevant. The author checked the content for accuracy, and discussed limitations of the non-pharmacologic treatment modality critically. The evidence available that acupressure can be used as an additional non-pharmacological method of intervention in mental illness has been sparse. One could not identify any evidence-based high-level trial comparing acupressure with pharmacologic intervention in mental health care. Although considerable progress has been made in evaluating this ancient traditional method of acupressure, further research like large and well-designed randomized controlled trials will still be needed in the coming years.
... [19] Another study proved the efficacy of acupressure in the treatment of cancer-related insomnia. [20] The results of several studies showed that acupressure and acupuncture techniques can lead to the release of neurotransmitters, such as serotonin, which induce a sense of relaxation. [21] Another study reported that certain peptides are released during acupuncture which have analgesic and sedative effects. ...
Article
Full-text available
Background: Postmenopausal women experience a variety of symptoms, among which sleep disorder is one of the most common problems. Acupressure and Pilates exercise programs are effective nonpharmaceutical treatments which can improve sleep quality. In the present study, we aimed to compare the effects of acupressure and Pilates‑based exercises on the sleep quality of postmenopausal women referred to medical clinics. Materials and Methods: In this single‑blinded randomized controlled clinical trial, we recruited 108 women aged 40–60 years who were randomly assigned into one control and two intervention groups using balanced block randomization method (three groups of 36 each). The patients in the Pilates exercise group participated in an exercise training program of three 1‑hour sessions per week for 6 consecutive weeks. The participants of acupressure group received acupressure intervention three times a week for 6 weeks. The sleep quality of all participants was assessed and recorded using the Pittsburgh Sleep Quality Index (PSQI) once before and once after the intervention. Results: The results showed no statistically significant difference among the three groups on the total scores of sleep quality after the intervention. The intragroup comparison revealed that the changes in the mean total scores were significant in both the intervention groups (P ˂ 0.001) but not in the control group (P = 0.76). Conclusions: Pilates‑based exercises and acupressure can effectively improve women’s sleep quality. Both techniques can be applied as effective alternative and complementary methods for improving sleep quality during the postmenopausal period. Keywords: Acupressure, exercise movement techniques, Iran, post menopause, sleep
... [19] Another study proved the efficacy of acupressure in the treatment of cancer-related insomnia. [20] The results of several studies showed that acupressure and acupuncture techniques can lead to the release of neurotransmitters, such as serotonin, which induce a sense of relaxation. [21] Another study reported that certain peptides are released during acupuncture which have analgesic and sedative effects. ...
Article
Full-text available
Background Postmenopausal women experience a variety of symptoms, among which sleep disorder is one of the most common problems. Acupressure and Pilates exercise programs are effective nonpharmaceutical treatments which can improve sleep quality. In the present study, we aimed to compare the effects of acupressure and Pilates-based exercises on the sleep quality of postmenopausal women referred to medical clinics. Materials and Methods In this single-blinded randomized controlled clinical trial, we recruited 108 women aged 40–60 years who were randomly assigned into one control and two intervention groups using balanced block randomization method (three groups of 36 each). The patients in the Pilates exercise group participated in an exercise training program of three 1-hour sessions per week for 6 consecutive weeks. The participants of acupressure group received acupressure intervention three times a week for 6 weeks. The sleep quality of all participants was assessed and recorded using the Pittsburgh Sleep Quality Index (PSQI) once before and once after the intervention. Results The results showed no statistically significant difference among the three groups on the total scores of sleep quality after the intervention. The intragroup comparison revealed that the changes in the mean total scores were significant in both the intervention groups (P < 0.001) but not in the control group (P = 0.76). Conclusions Pilates-based exercises and acupressure can effectively improve women's sleep quality. Both techniques can be applied as effective alternative and complementary methods for improving sleep quality during the postmenopausal period.
Article
Full-text available
Purpose Current evidence for using self-acupressure to manage the cancer-related symptom cluster of insomnia, depression, and anxiety, while promising, is unknown. This study evaluated the feasibility of self-acupressure to manage this symptom cluster and to explore its potential effectiveness. Methods Participants were assigned randomly to three study groups, namely the true acupressure (TAP), the sham acupressure (SAP), and the enhanced standard care group (ESC). Participants in the TAP and SAP groups received a training session on acupressure and were required to practice self-acupressure at home once per day for 28 days. The duration of participant involvement was 8 weeks. Patients completed a Numerical Rating Scale (NRS) for each symptom, the Insomnia Severity Index, the Hospital Anxiety and Depression Scale, and the Functional Assessment of Cancer Therapy—General at baseline (T1), post-intervention (T2, week 4), and post follow-up (T3, week 8). Results The results indicated that the intervention had clinical significance in improving the targeted symptoms and quality of life. In the TAP group, the symptom cluster severity was significantly lower than in the other groups at T2 (p < 0.05). The insomnia severity and anxiety scores in the TAP and SAP groups were significantly lower than those in ESC at T2 and T3 (p < 0.05). Conclusion The trial was feasible. The promising results of the study suggest that further testing of self-acupressure is warranted to inform its effectiveness on the targeted symptom cluster in patients with cancer. A placebo effect was evident alongside therapeutic effects. Trial registration ClinicalTrials.gov (ID: NCT03823456) on January 30th, 2019
Article
Objective To explore the efficacy of acupressure on the improvement of sleep disorders in patients undergoing hemodialysis. Methods: A systematic review and meta-analysis was performed. Pubmed, Embase, the Cochrane database, and Chinese database were searched and sleep quality variables were extracted from eligible articles. The quality of original articles was assessed by the Modified Jadad Scale. Standard mean difference (SMD) and 95% confidential interval (CI) were pooled. Results: Nine studies were included in the systematic review, and seven randomized controlled trials (RCTs) were eligible for meta-analysis. The pooled results showed significant improvement of quality of sleep using the acupressure massage (SMD = −0.81, 95%CI: −1.26, −0.36, P < 0.0001, I² = 78.6%). No severe adverse event was reported during the acupressure intervention. Conclusions: The results provide further evidence favoring the efficacy and safety of acupressure on the improvement of quality of sleep in hemodialysis patients.
Article
Introduction: Poor sleep quality is prevalent in candidates for percutaneous coronary interventions (PCIs). The present study was conducted to compare aromatherapy with acupressure in terms of their effectiveness in sleep quality in patients undergoing PCIs. Materials and methods: The present study was conducted on 85 patients undergoing PCIs and randomly assigned, using block randomization, to five groups, namely (1)aromatherapy, (2)placebo aromatherapy, (3)acupressure, (4)placebo acupressure (acupressure applied to a point not traditionally associated with improving sleep) and (5)control. The intervention groups received aromatherapy or acupressure or placebo from 10pm to 8am the following day. The control group received only routine care. Sleep quality was measured in the patients using a visual analog scale (VAS) that was completed by them before and after the intervention. Results: The mean pretest score of sleep quality was 2.91 ± 0.53 in the aromatherapy group, 2.84 ± 0.47 in the placebo aromatherapy group, 2.98 ± 0.59 in the acupressure group, 2.75 ± 0.41 in the placebo acupressure group and 2.88 ± 0.41 in the controls. ANOVA suggested no significant differences among these groups in the pretest (P = 0.746). The mean posttest score of sleep quality was 3.72 ± 1.84 in the aromatherapy group, 3.70 ± 1.83 in the placebo aromatherapy group, 7.35 ± 0.99 in the acupressure group, 2.67 ± 0.41in the placebo acupressure group and 2.72 ± 0.34 in the controls, suggesting significant differences among the five groups based on the ANOVA results showed significant differences among the five groups (P < 0.001). The mean posttest score of sleep quality was higher than the pretest score by 4.37 in the acupressure group compared to in the other groups (P < 0.001). Conclusion: The present findings provided scientific evidence for the benefits of using different methods, including acupressure, for sleep quality in patients undergoing PCIs. Iranian registry of clinical trials number: IRCT201707248665N6.
Article
Full-text available
The action of different classes of clinically effective antidepressants and electroshock on gamma-aminobutyric acid (GABA) B recognition sites in the frontal cortex was compared to that of other psychotropic agents. After either prolonged (6-18 days) s.c. infusion via osmotic minipumps or repeated i.p. injections of different antidepressants, or a series of electroshocks, treatment was halted and 72 hr later the animals were sacrificed, the brain was dissected and frozen. All major antidepressants (desipramine, amitryptyline or maprotiline), several newer compounds with reported antidepressant activity (viloxazine, zimelidine, fluoxetine, citalopram, progabide, fengabine, sodium valproate, mianserin, trazodone or nomifensine) as well as pargyline and repeated electroshocks, up-regulated GABA B binding in the rat frontal cortex but not hippocampus. This appeared to be a maximum binding effect, but in some instance the kinetics were more complex. Reserpine, diphenylhydantoin and phenobarbital down-regulated GABA B binding in the frontal cortex, whereas this was unaltered by haloperidol, chlorpromazine or diazepam administration. Desipramine up-regulated GABA B binding in a dose- and time-dependent manner (minimum effective dose, 1.25 mg/kg/day s.c. for 18 days; onset of action, 6 days at 5 mg/kg/day s.c.). Together with the rather sparse data in the literature on GABA in depression and antidepressant drug action, these findings support a common GABAergic mechanism of action of antidepressant drugs and electroshock, mediated via GABA B synapses.
Article
Full-text available
To compare differences in nausea experience and intensity in women undergoing chemotherapy for breast cancer between those receiving usual care plus acupressure training and treatment and those receiving only usual care. Single-cycle, randomized clinical trial. Outpatient oncology clinic in a major teaching medical center and a private outpatient oncology practice. Seventeen women participated in the study. The typical participant was 49.5 years old (SD = 6.0), Caucasian (59%), not married/partnered (76%), on disability (53%), born a U.S. citizen (76%), and heterosexual (88%); lived alone (59%); had at least graduated from high school (100%); and had an annual personal income of $50,000 or greater (65%). The intervention included finger acupressure bilaterally at P6 and ST36, acupressure points located on the forearm and by the knee. Baseline and poststudy questionnaires plus a daily log were used to collect data. Nausea experience measured by the Rhodes inventory of Nausea, Vomiting, and Retching and nausea intensity. Significant differences existed between the two groups in regard to nausea experience (p < 0.01) and nausea intensity (p < 0.04) during the first 10 days of the chemotherapy cycle, with the acupressure group reporting less intensity and experience of nausea. Finger acupressure may decrease nausea among women undergoing chemotherapy for breast cancer. This study must be replicated prior to advising patients about the efficacy of acupressure for the treatment of nausea.
Article
Full-text available
To compare the antiemetic effect of acupressure at the Neiguan point (P6) in a group of healthy women with normal pregnancy and nausea and vomiting during pregnancy (NVP) with a similar group receiving acupressure at a placebo point and another, similar group not receiving any treatment. A randomized, placebo-controlled, pilot study involving 60 women. It is possible to reduce NVP significantly with acupressure at P6 as compared to acupressure at a placebo point or no treatment at all in healthy women with normal pregnancies. Relief from nausea appeared one day after starting treatment in both the P6 and placebo groups but lasted for only six days in the placebo group. The P6 group, however, experienced significantly less nausea after 14 days as compared to the other two groups. This study involved 60 healthy women with normal pregnancy and suffering from NVP. According to the results, in healthy women with normal pregnancy it is possible to reduce NVP significantly at P6 as compared to acupressure at a placebo point and to no treatment.
Article
Full-text available
To investigate the effects of a physiologic and a pharmacologic dose of exogenous melatonin on sleep latency and sleep efficiency in sleep episodes initiated across a full range of circadian phases. Double-blind placebo-controlled parallel-group design in a 27-day forced desynchrony paradigm with a 20-hour scheduled sleep-wake cycle. Private suite of a general clinical research center, in the absence of time-of-day information. Subjects: Thirty-six healthy, 18- to 30-year-old, men (n = 21) and women (n = 15). Oral melatonin (0.3 mg or 5.0 mg) or identical-appearing placebo was administered 30 minutes prior to each 6.67-hour sleep episode during forced desynchrony. Both doses of melatonin improved polysomnographically determined sleep efficiency from 77% in the placebo group to 83% for sleep episodes occurring during circadian phases when endogenous melatonin was absent. However, this remained below the average sleep efficiency of 88% observed during sleep episodes scheduled during the circadian night, when endogenous melatonin was present. Melatonin did not significantly affect sleep initiation or core body temperature. Melatonin appeared to maintain efficacy across the study and did not significantly affect percentages of slow-wave sleep or rapid eye movement sleep. Exogenous melatonin administration possesses circadian-phase-dependent hypnotic properties, allowing for improved consolidation of sleep that occurs out of phase with endogenous melatonin secretion during the circadian night. The results support the hypothesis that both exogenous and endogenous melatonin attenuate the wake-promoting drive from the circadian system.
Article
Full-text available
Periodic circadian (24-h) cycles play an important role in daily hormonal and behavioural rhythms. Usually our sleep/wake cycle, temperature and melatonin rhythms are internally synchronized with a stable phase relationship. When there is a desynchrony between the sleep/wake cycle and circadian rhythm, sleep disorders such as advanced and delayed sleep phase syndrome can arise as well as transient chronobiologic disturbances, for example from jet lag and shift work. Appropriately timed bright light is effective in re-timing the circadian rhythm and sleep pattern to a more desired time, ameliorating these disturbances. Other less potent retiming effects may also be obtained from the judicious use of melatonin and exercise.
Article
Full-text available
The response to acupuncture of 18 anxious adult subjects who complained of insomnia was assessed in an open prepost clinical trial study. Five weeks of acupuncture treatment was associated with a significant (p = 0.002) nocturnal increase in endogenous melatonin secretion (as measured in urine) and significant improvements in polysomnographic measures of sleep onset latency (p = 0.003), arousal index (p = 0.001), total sleep time (p = 0.001), and sleep efficiency (p = 0.002). Significant reductions in state (p = 0.049) and trait (p = 0.004) anxiety scores were also found. These objective findings are consistent with clinical reports of acupuncture's relaxant effects. Acupuncture treatment may be of value for some categories of anxious patients with insomnia.
Article
A tight, physiological link between the pineal gland and the immune system is emerging from a series of experimental studies. This link might reflect the evolutionary connection between self-recognition and reproduction. Pinealectomy or other experimental methods which inhibit melatonin synthesis and secretion induce a state of immunodepression which is counteracted by melatonin. In general, melatonin seems to have an immunoenhancing effect that is particularly apparent in immunodepressive states. The negative effect of acute stress or immunosuppressive pharmacological treatments on various immune parameters are counteracted by melatonin. It seems important to note that one of the main targets of melatonin is the thymus, i.e., the central organ of the immune system. The clinical use of melatonin as an immunotherapeutic agent seems promising in primary and secondary immunodeficiencies as well as in cancer immunotherapy. The immunoenhancing action of melatonin seems to be mediated by T-helper cell-derived opioid peptides as well as by lymphokines and, perhaps, by pituitary hormones. Melatonin-induced-immuno-opioids (MHO) and lymphokines imply the presence of specific binding sites or melatonin receptors on cells of the immune system. On the other hand, lymphokines such as --interferon and interleukin-2 as well as thymic hormones can modulate the synthesis of melatonin in the pineal gland. The pineal gland might thus be viewed as the crux of a sophisticated immunoneuroendocrine network which functions as an unconscious, diffuse sensory organ.
Article
The cessation of firing of serotonergic dorsal raphe neurons is a key controlling event of rapid eye movement (REM) sleep. We tested the hypothesis that this cessation of activity is due to gamma-aminobutyric acid (GABA) release using the in vivo microdialysis technique. We found that REM sleep is accompanied by a selective increase in GABA release, but not by a change in glutamate or glycine release in the dorsal raphe nucleus. Microinjection of the GABA agonist muscimol into the dorsal raphe increased REM sleep, although microperfusion of the GABA antagonist picrotoxin blocked REM sleep. These results implicate GABA release as a critical element in the production of the REM sleep state and in the control of discharge in serotonergic neurons across the sleep/wake cycle.
Article
Acupuncture therapy, commonly used in clinical practice in oriental cultures, has the potential to produce a positive effect with patients experiencing insomnia. The purposes of this systematic review were: (1) to assess the trends across intervention studies using acupuncture for insomnia from 1975 to 2002, (2) to examine dependent variables, and (3) to evaluate the effects of acupuncture therapy on insomnia in older people. Data were collected from November 2001 to January 2003. A wide range of electronic databases was searched using the keywords 'insomnia', 'acupuncture' and 'experimental design'. Papers were included if they were published in the English language between 1975 and 2002 and described an experimental study using acupuncture therapy to treat insomnia. Eleven reports met these criteria. Most of the studies had been conducted since 1990. The findings showed that the first author was usually a Chinese medical doctor (n = 9) employed in a traditional department of medicine. Most of the papers were published in two journals: International Journal of Clinical Acupuncture and Journal of Traditional Chinese Medicine. Data were limited because of the small number of studies available. Half the studies had small samples (50 subjects or fewer), which were composed mainly of older women who had a variable duration of insomnia from 3 days to 34 years. The main method used to assess outcomes was questionnaire. All the studies reported statistically significant positive results. The results of this review suggest that acupuncture may be an effective intervention for the relief of insomnia. Further research, using a randomized clinical trial design, are necessary to determine the effectiveness of acupuncture. More work is also needed to promote the long-term therapeutic effects of acupuncture and to compare it with other therapies for insomnia.
Article
The recent rediscovery of the natural traditional medical sciences has contributed to improve the treatment of the human diseases and, in particular, it has been shown that the pharmacological approach is not the only possible strategy in the treatment of nausea and vomiting, since bioenergetic approaches, such as acupressure and acupuncture, may also counteract the onset of vomiting due to different causes. Previous preliminary clinical studies had already suggested a possible efficacy of acupressure also in the treatment of chemotherapy-induced vomiting resistant to the classical antiemetic drugs. The aim of this study was to confirm these preliminary data. The study was performed in 100 consecutive metastatic solid tumour patients, who underwent chemotherapy for their advanced neoplastic disease, and who had no benefit from the standard antiemetic agents, including corticosteroids, antidopaminergics and 5-HT 3R-antagonists. Acupressure was made by a stimulation of PC6 acupoint. The emetic symptomatology was reduced by acupressure in 68/100 (68%) patients, without significant differences in relation to tumour histotype. The lowest efficacy was observed in patients treated by anthracycline-containing regimens, without, however, statistically significant differences with respect to the other chemotherapeutic combinations. This study confirms previous preliminary clinical results, which had already suggested the potential efficacy of acupressure in the treatment of vomiting due to cancer chemotherapy. Therefore, acupressure may be successfully included within the therapeutic strategies of cancer chemotherapy-induced vomiting.