The effectiveness of acupuncture in improving sleep quality in patients with Parkinson’s disease

In a recently published study, JAMA Network OpenResearchers investigated whether acupuncture, which has previously been used as an add-on therapy alongside other medications to treat Parkinson’s disease, improves sleep quality in people with Parkinson’s disease.

Lack of sleep is known to accelerate the progression of the disease, making this research important for patient care.

study: Acupuncture and sleep quality in patients with Parkinson’s diseaseImage credit: YAKOBCHUK VIACHESLAV/Shutterstock.com

background

Parkinson’s disease is a neurological disorder with complex pathophysiology characterized by muscle rigidity, slowed or bradykinesia, resting tremor, and postural instability.

As the disease progresses, non-motor symptoms also emerge and become dominant, leading to increased disability and reduced quality of life.

One of the main non-motor symptoms is impaired sleep quality, which occurs not only as the disease progresses but also as one of the side effects of the medications used to treat Parkinson’s disease.

Research has also found that poor sleep in people with Parkinson’s disease is associated with a faster progression of walking decline and dyskinesias, as well as cognitive and mood-related symptoms.

About the Research

In this study, researchers conducted a randomized, double-blind clinical trial to determine whether acupuncture is a safe and effective way to improve sleep quality in people with Parkinson’s disease.

The study compared the effects of real acupuncture with sham acupuncture. It assessed improvements in parameters such as anxiety, motor and non-motor symptoms, sleep quality, and health-related quality of life.

Options for managing sleep disorders in patients with Parkinson’s disease are limited, but available methods focus on optimizing dopamine therapy, especially when non-motor symptoms contribute to sleep problems.

Additionally, antipsychotics and antidepressants such as benzodiazepines can be effective, but these medications often cause side effects such as daytime lability, sedation, and drowsiness.

Acupuncture is a long-standing traditional Chinese treatment in which thin needles are inserted into trigger points or acupuncture points and has been used as an adjunct therapy in conjunction with Parkinson’s medications.

Patients included in the study had to have been diagnosed with idiopathic Parkinson’s disease, were between 30 and 80 years old, reported moderate to severe problems with sleep quality, were regular users of Parkinson’s disease medication in the past month, and were able to tolerate acupuncture treatment.

Before conducting the baseline assessment, participants were randomly assigned to either a real acupuncture group or a sham acupuncture group. In addition, an assisted acupuncture device was used to avoid some of the shortcomings of existing sham acupuncture devices.

This assistive device simulates the sense of obstruction felt when inserting a needle and allows you to adjust the direction and angle of the needle.

All participants received sleep hygiene instruction and received either real or sham acupuncture at the same acupuncture points, three times a week for four weeks.

The primary outcome examined in this study was change in Parkinson’s Disease Sleep Scale (PDSS) scores at 4- and 8-week follow-up.

This 15-item score scale assessed eight aspects of nighttime sleep in patients with Parkinson’s disease, including overall sleep quality, nighttime restlessness, insomnia, nocturia, nocturnal psychosis, sleep refreshing, daytime dozing, and nocturnal motor symptoms.

result

Studies have found that acupuncture significantly improves sleep quality in people with Parkinson’s disease, benefiting their quality of life.

Participants in the actual acupuncture group experienced a 29.65 point increase in PDSS scores at the end of the four-week treatment, and this improvement was sustained at the eight-week follow-up.

Patients in the sham acupuncture group also experienced a 10.47-point increase in PDSS scores at the end of the treatment period, but the beneficial effects of sham acupuncture on sleep quality did not persist at the 8-week follow-up.

The researchers concluded that although sham acupuncture has a placebo effect in improving sleep quality in people with Parkinson’s disease in the short term, these clinical benefits are not as long-lasting as real acupuncture.

The PDSS scores of patients in the actual acupuncture group showed improvement in all areas of the scale, including motor symptoms, non-motor symptoms, and health-related quality of life. No serious side effects were reported.

Some patients experienced severe trembling, likely due to anxiety associated with the procedure, but found that the trembling subsided soon after the needle was inserted.

Conclusion

Overall, the findings suggest that acupuncture can have a significant effect on improving nighttime sleep quality and overall quality of life for people with Parkinson’s disease.

The procedure was safe and effective, and it led to long-term improvements in sleep quality.