Acupressure, reflexology, and auricular acupressure for insomnia: A systematic review of randomized controlled trials

Abstract

Previous randomized controlled trials (RCTs) have shown that acupuncture may be efficacious for insomnia. Instead of needling, acupressure, reflexology, and auricular acupressure are procedures involving physical pressure on acupoints or reflex areas. These variants of acupuncture are gaining popularity, perhaps due to their non-invasive nature. A systematic review has therefore been conducted to examine their efficacy and safety for insomnia. Two independent researchers searched five English and 10 Chinese databases from inception to May 2010. Forty RCTs were identified for analysis. Only 10 studies used sham controls, four used double-blind design, nine studies scored three or more by the Jadad scale, and all had at least one domain with high risk of bias. Meta-analyses of the moderate-quality RCTs found that acupressure as monotherapy fared marginally better than sham control. Studies that compared auricular acupressure and sham control showed equivocal results. It was also found that acupressure, reflexology, or auricular acupressure as monotherapy or combined with routine care was significantly more efficacious than routine care or no treatment. Owing to the methodological limitations of the studies and equivocal results, the current evidence does not allow a clear conclusion on the benefits of acupressure, reflexology, and auricular acupressure for insomnia.

Effect of self-acupressure for symptom management: A systematic review

“…[1][2][3] According to the meridian theory, acupressure increases the flow of energy (qi) in the body; therefore, it is effective for managing symptoms of disease. 4 Acupuncture, which is considered a representative treatment of alternative and complementary medicine, uses fine needles inserted in specific points on the body.…”

A feasibility study of auricular therapy and self-administered acupressure for insomnia following cancer treatment

“…The findings from published systematic reviews suggest that acupuncture, and variants of acupuncture (acupressure; auricular acupuncture; auricular therapy), may be effective treatment options for sleep disturbance [7][8][9][10][11][12][13]. However, evidence of the effectiveness of acupuncture and related interventions within cancer are more limited [14].…”

“…However many previous studies of acupuncture and related interventions have contained numerous methodological weaknesses [7][8][9][10][11][12][13][14][15][16], and there is no conclusive evidence to suggest which modality of acupuncture may be more effective for sleep disturbance. This feasibility study aimed to address this gap in the evidence base and provide preliminary data on the effectiveness of two variants of acupuncture (auricular therapy (attaching semen vaccariae seeds to ear acupoints) and selfadministered acupressure) in the relief of insomnia in a sample of patients with cancer in a methodologically rigorous feasibility study.…”

Influence of Study Design on Outcomes Following Reflexology Massage: An Integrative and Critical Review of Interventional Studies

“…Systematic reviews of randomized controlled trials (RCTs) do not support efficacy of reflexology for clinically relevant outcomes, [1][2][3][4][5] but the value of RCT criteria to CAM research has been questioned on the basis that the holistic approach typical of CAM therapies is contrary to the reductionist approach of RCT designs. 6 Research designs appropriate for the study of CAM therefore present an unresolved issue depending on professional viewpoint, yet the extent of influence an interventional design might have on reflexology outcomes is unknown.…”

“…[7][8][9][10] The importance of the therapeutic relationship also complicates the identification of an adequate placebo and makes blinding of the practitioner and/or participant difficult, perhaps even impossible, within a research design. 6,11 Systematic reviews of RCTs involving reflexology [1][2][3][4][5] identify such design issues as hindrances to data interpretation.…”