According to a recent study, patients with Parkinson's disease (PD) who received real acupuncture (RA) showed a 29.65-point improvement in sleep quality scores compared to those who received sham acupuncture (SA).
Acupuncture, used in China for thousands of years, has shown efficacy in treating insomnia and motor symptoms in conjunction with pharmacologic therapy among patients with PD in previous studies, noted researchers. However, to their knowledge, there have been no large-scale randomized clinical trials on acupuncture for sleep problems in patients with PD. However, smaller studies, including a 2002 pilot study and a 2022 meta-analysis, showed acupuncture's benefits for PD-related insomnia, cognition, quality of life, behavior, and mood.
In a new randomized clinical trial, published in JAMA Network Open, researchers evaluated the efficacy and safety of RA compared to SA in improving sleep quality among patients with PD. This single-center, double-blind study was conducted at The First Affiliated Hospital of Guangzhou University of Chinese Medicine from February 2022 to February 2023. It included 83 patients with idiopathic PD, aged 30 to 80 years (mean age = 64.1 years), who experienced moderate-to-severe sleep problems; 52.6% of participants were men. Participants were randomly assigned in a 1:1 ratio to receive either RA or SA for four weeks, with assessments conducted at baseline, post-treatment, and at an eight-week follow-up.
RA involved inserting sterilized, stainless steel needles into specific acupoints, while SA used specially designed needles that mimicked acupuncture without skin penetration. Both enrollment groups received three sessions per week, each lasting 30 minutes.
The primary outcome was the change in Parkinson Disease Sleep Scale (PDSS) scores at the three assessment time points. Secondary outcomes included motor symptoms (assessed via the Unified Parkinson Disease Rating Scale [UPDRS]), nonmotor symptoms (assessed via the Non-Motor Symptoms Scale [NMSS], the Epworth Sleepiness Scale [ESS], and the Hamilton Anxiety Rating Scale [HAM-A]), and overall quality of life (assessed via the 39-item Parkinson Disease Questionnaire [PDQ-39]).
Of the 83 participants, 78 (94.0%) completed the study. The researchers noted significant improvements in PDSS scores in both the RA and SA groups after four weeks of treatment. The RA group showed a mean increase of 29.6 points (95% confidence interval [CI] = 24.6-34.6; P < .001) from baseline, while the SA group exhibited a mean increase of 10.47 points (95% CI = 5.3-15.6; P < .001). The RA group’s improvement was significantly greater than that of the SA group (difference of 19.7 points; P < .001) and persisted at the eight-week follow-up (difference of 20.2 points; P < .001).
Secondary outcomes revealed statistically significant improvements in UPDRS, HAM-A, and PDQ-39 scores at four weeks post-treatment and at eight weeks follow-up compared to baseline. NMSS scores significantly decreased post-treatment, but not during follow-up, and no significant differences were found in ESS and UPDRS-III scores post-treatment or follow-up.
The RA group showed significant score decreases at four weeks in ESS (−3.78), UPDRS (−14.53), UPDRS-III (−6.88), NMSS (−12.28), HAM-A (−5.28), and PDQ-39 (−14.75). Compared to the SA group, the RA group had significant post-treatment decreases in UPDRS (−11.72; P = .005), NMSS (−7.75; P = .03), HAM-A (−4.27; P < .001), and PDQ-39 (−8.84; P = .005), with no significant differences in ESS and UPDRS-III scores. No severe adverse events were reported for either group.
“We preliminarily conclude that although SA may induce a short-term placebo effect, [RA] provides lasting clinical benefits in improving subjective sleep quality in patients with PD,” stated researchers.
Full list of disclosures can be found in the original study.
