Doctors should be trained to offer acupressure to cancer patients with sleep problems, according to the authors of a new study that found this treatment to be more effective than acupuncture and improved supportive treatment.
It is estimated that up to 59% of all cancer patients suffer from sleep disorders – almost three times as many as in the general population.In this new study, researchers conducted a systematic review and network meta-analysis of 24 randomized controlled trials involving 2,002 cancer patients. They compared 6 treatments: manual acupuncture, electroacupuncture, acupressure, sham treatment, improved usual treatment and no treatment.
Unlike acupuncture, acupressure involves applying mechanical pressure to acupuncture points on the body or ears, using fingers, vaccaria seeds, magnetic beads, or other devices.
In contrast, acupuncture is an invasive procedure in which either a needle is inserted into the acupuncture points (manual acupuncture) or an electrostimulator is used to conduct weak electric current into the acupuncture points of the body by attaching pairs of electrodes to the handle of the inserted needles. In this study, enhanced supportive care included training patients to manage symptoms, psychological support, rehabilitation, providing a sleep environment, or using routine drug treatment to control symptoms.
Most acupuncture treatments lasted 4-12 weeks, with the shortest being 30 days and the longest 6 months.In most studies, acupuncture was performed 1-2 times a week.
The data analysis showed that most acupuncture and acupressure treatments were well tolerated and the length of stay, attendance and adherence were satisfactory. However, compared to no treatment, only acupressure showed significant improvement in sleep parameters over manual acupuncture, electroacupuncture, sham treatment, improved supportive treatment, and no treatment. No significant result was observed for the other interventions.
Based on the available evidence, acupressure may be recommended as an optimal treatment for reducing sleep disorders in cancer patients, the study authors said, and they advise that doctors should be trained in acupressure to help patients with sleep problems.
They add that training patients to self-administer acupressure could have additional benefits because it is flexible and cost-effective compared to treatment by a doctor, and patients take on more ownership.In addition, it is less often associated with undesirable effects such as bleeding and residual pain.
Unfortunately, the certainty of evidence for acupressure and manual acupuncture was modest in terms of sleep improvement, while it was low for electroacupuncture. The authors therefore call for more rigorous studies to investigate whether different forms of acupuncture or acupressure have different effects on the sleep of cancer patients.
In particular, studies are needed to investigate acupuncture treatments alone and not in combination with other therapies.
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