Background: Pediatric chronic pain not only affects the child but also has a ripple effect on the entire family.While several studies have shown that acupuncture is beneficial for decreasing pain intensity in adults, few studies have examined the effectiveness of acupuncture in children and adolescence as well as the impact of acupuncture on the association between parent stress and child pain.Objective: This study examined whether two acupuncture treatments may help reduce child pain and parent stress as well as examining the bidirectional relationship between parent stress and child pain across the two treatments. Design: The study was a pre/post test design. Participants completed the Pediatric Inventory for Parents and Faces Pain Scale-Revised at baseline and at the conclusion of the second acupuncture treatment (at Time 2). Setting: Participants were recruited from a pain clinic at an academic pediatric hospital. Patients: Parent-child dyads (N = 29; M age = 14.13; standard deviation = 2.43) participated in the study. Results: Child pain and parent stress significantly decreased after two acupuncture treatments. Child pain significantly predicted parent stress frequency, difficulty, and stress frequency, while parent stress difficulty significantly predicted child pain at baseline. At T2, there was a bidirectional relationship between parent stress frequency, difficulty and child pain. Conclusions: These findings suggest that acupuncture is beneficial for reducing child pain and parent stress. The results also emphasize the bidirectional relationship between parent stress frequency and the child's perception of pain.

Purpose: Insomnia is a common problem with significant psychological and general health comorbidities and is often resistant to treatment. Specific aims included: 1. To determine the efficacy of acupuncture on self-report and objective measures of sleep. 2. To determine the impact of acupuncture on daytime manifestations of insomnia. 3. To explore the impact of acupuncture on physiologic measures of hyperarousal. Methods: 47 subjects were randomized to receive verum-vssham acupuncture in a protocol based on TCM principles. Verum treatment involved 15 needles with mild manual stimulation over 30 minutes. Park Sham Needles were used for the sham protocol. Subjects were seen twice weekly for 4 weeks then weekly for 4 weeks. Self-report measures included sleep quality, fatigue, anxiety, and depression. Objective outcomes included polysomnography, wrist-actigraphy, and psychophysiologic testing of HRV. Assessments were obtained at baseline, end-of-intervention, and 3-months post-treatment. Intention-totreat analysis was used. Results: Four subjects dropped out. Significant improvement was seen in both groups over time on self-report measures of insomnia and secondary symptoms, but there was no between group difference. The key objective measure, sleep-efficiency on polysomnography, did not improve in either group. Physiologic measures of hyperarousal, including EEG delta power on polysomnography, and HRV, improved over time, but there were no significant group differences. On secondary analysis there was no correlation between primary sleep measures and physiologic measures of hyperarousal. Nor was there a difference in physiologic measures of hyperarousal between responders and nonresponders to the intervention, independent of group assignment. Conclusion: Based on TCM literature, acupuncture shows promise for insomnia. In this trial, acupuncture was no more effective than placebo. Subjects in both groups showed improvement in self-report measures of insomnia as well as secondary symptoms. The primary weakness of this study was small sample size. While this trial is considered negative, acupuncture for insomnia merits further study.