Effectiveness of Acupressure at Different Ear Acupoints on Insomnia: A Secondary Analysis of a Randomized Controlled Trial

Authors

Jingyu Zhang
Giulia Castelli
Aomei Shen
Junxin Li
Jennifer Kawi
Hulin Wu
Paul Christo
Claudia M Campbell
Johannes Thrul
Constance M Johnson
Nada Lukkahatai

Language

English

Publication Date

12-15-2025

Journal

Sleep Medicine: X

DOI

10.1016/j.sleepx.2025.100158

PMID

41170529

PMCID

PMC12569834

PubMedCentral® Posted Date

10-15-2025

PubMedCentral® Full Text Version

Post-print

Abstract

Introduction: Insomnia is highly prevalent among older adults with chronic low back pain (cLBP), contributing to a cycle of heightened pain sensitivity, impaired physical function, and reduced quality of life. Auricular Point Acupressure (APA), a nonpharmacologic intervention for pain, has shown emerging evidence of improving sleep. We compared the effectiveness of targeted APA (T-APA) versus non-targeted APA (NT-APA) on insomnia in older adults with cLBP.

Methods: This secondary analysis used data from a parent RCT, including 99 adults aged 60 or older with cLBP and clinical insomnia (Insomnia Severity Index [ISI]>7). Participants received four weeks of T-APA or NT-APA. Sleep outcomes (ISI, PROMIS-29 sleep disturbance) and pain outcomes (intensity, interference) were assessed at baseline and post-intervention, with pain examined as a mediator of sleep change.

Results: The T-APA (n = 45) and NT-APA (n = 54) groups had similar baseline characteristics. Both groups showed significant reductions in sleep disturbance, pain interference, and pain intensity (p < 0.05). However, only the NT-APA group demonstrated significant improvement in ISI scores (p < 0.001, d = 0.50). No significant mediation effect of pain on sleep outcomes was found.

Conclusions: APA may be an effective nonpharmacologic approach for improving sleep among older adults with cLBP. Unexpectedly, NT-APA showed greater improvements in insomnia compared to T-APA, suggesting mechanisms beyond traditional somatotopic theory. Further research is warranted to confirm these findings and explore the potential of point-specific versus non-specific APA protocols in treating insomnia.

Comments

Trial id: NCT03589703 (registration date: May 22, 2018).

Published Open-Access

yes

Recommended Citation

Zhang, Jingyu; Castelli, Giulia; Shen, Aomei; et al., "Effectiveness of Acupressure at Different Ear Acupoints on Insomnia: A Secondary Analysis of a Randomized Controlled Trial" (2025). Faculty, Staff and Student Publications. 742.
https://digitalcommons.library.tmc.edu/uthshis_docs/742