Effect of acupuncture versus usual care on sleep quality in cancer survivors with chronic pain: Secondary analysis of a randomized clinical trial

Abstract

Background Chronic pain negatively affects sleep; it is unclear whether pain relief from acupuncture contributes to sleep quality improvements in cancer survivors. This study aimed to evaluate the effect of acupuncture versus usual care on sleep quality among cancer survivors with comorbid sleep disturbance and chronic musculoskeletal pain. Methods Sleep outcome data from the Personalized Electroacupuncture Versus Auricular Acupuncture Comparative Effectiveness (PEACE) randomized clinical trial were analyzed. Electroacupuncture or auricular acupuncture was compared with usual care for sleep quality improvement over 10 weeks of treatment among cancer survivors with clinically significant sleep disturbance and chronic musculoskeletal pain at baseline. Sleep quality was measured with the Pittsburgh Sleep Quality Index (PSQI) global score. Results Among 268 participants (mean [standard deviation (SD)] age, 61.4 [12.6] years; 191 women [71.3%]; mean [SD] baseline PSQI global score, 10.3 [3.3] points), electroacupuncture and auricular acupuncture resulted in greater reductions in the PSQI global score from baseline to 10 weeks in comparison with usual care: 1.42 points (95% confidence interval [CI], 0.45–2.38; p = .004) and 1.59 points (95% CI, 0.62–2.55; p = .001), respectively. The improvement in sleep quality for the acupuncture groups was sustained for 24 weeks from randomization. Furthermore, a greater proportion of patients in the electroacupuncture and auricular acupuncture groups had clinically meaningful improvement in sleep quality compared to the usual care group (41.0% and 42.9% vs. 21.4%; p = .044). Conclusions Among cancer survivors with comorbid sleep disturbance and chronic pain, electroacupuncture and auricular acupuncture produced a clinically relevant and persistent improvement in sleep quality. These findings suggest that acupuncture may be an evidence‐based nonpharmacologic intervention to improve sleep health for cancer survivors with pain. Plain Language Summary This study analyzed the sleep quality data from a published randomized clinical trial that evaluated the effect of electroacupuncture or auricular acupuncture versus usual care on pain relief among people who survived cancer. This analysis included a prespecified subgroup of 268 participants with co‐occurring sleep disturbance and chronic musculoskeletal pain at baseline and found that patients who used acupuncture for pain relief demonstrated greater improvements in sleep quality compared with patients who received usual care. Sleep quality improvement by acupuncture was sustained after the treatment ended.

Personalized Medicine in Cancer Pain Management

“…They discovered that electroacupuncture and auricular acupuncture caused a clinically meaningful and long-lasting enhancement of sleep quality in cancer survivors with concomitant sleep disruption and chronic pain. Acupuncture, according to their findings, may be an evidence-based nonpharmacologic strategy for improving sleep health in cancer survivors who are in pain [ 83 ]. The preliminary findings from a remarkable trial by Reddy et al indicated that cancer patients might effectively transition from opioids to levorphanol utilizing an opioid rotation ratio (ORR) of 8.5.…”

Mechanism and application of acupuncture and electro‐acupuncture associated with cancer therapy

“…Furthermore, some studies have shown that AC can rapidly reduce pain in cancer survivors with pain and insomnia, which can contribute to the reduction of insomnia. 85,191 However, these studies generally suffer from the disadvantage of small sample sizes.…”

“…However, other studies have demonstrated that AC can provide clinically significant and long‐lasting benefits for cancer survivors 83,84 and patients 81,85 with CRI. Furthermore, some studies have shown that AC can rapidly reduce pain in cancer survivors with pain and insomnia, which can contribute to the reduction of insomnia 85,191 . However, these studies generally suffer from the disadvantage of small sample sizes.…”

Current and future trends of acupuncture as an adjuvant therapy in cancer: A bibliometric and visual analysis

“…[8][9][10][11] There is a growing body of evidence showing that the use of acupuncture has positive implications for improving cancer-related symptoms and enhancing the quality of life of cancer patients. [12,13] Although this state of affairs is gradually gaining attention among scholars, there has not been a systematic review to organize and summarize the research in this area in detail. Therefore, this study summarizes and combs the research in this field through bibliometric analysis methods to explore the current research hotspots and future research trends.…”