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- Bergdahl, Lena, 1980-, et al.
(author)
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Auricular Acupuncture and Cognitive Behavioural Therapy for Insomnia : A Randomised Controlled Study
- 2016
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In: Sleep Disorders. - : Hindawi Publishing Corporation. - 2090-3545 .- 2090-3553. ; 2016
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Journal article (peer-reviewed)abstract
- Objective. The most effective nonpharmacological treatment for insomnia disorder is cognitive behavioural therapy-insomnia (CBT-i). However CBT-i may not suit everyone. Auricular acupuncture (AA) is a complementary treatment. Studies show that it may alleviate insomnia symptoms. The aim of this randomised controlled study was to compare treatment effects of AA with CBT-i and evaluate symptoms of insomnia severity, anxiety, and depression. Method. Fifty-nine participants, mean age 60.5 years (SD 9.4), with insomnia disorder were randomised to group treatment with AA or CBT-i. Self-report questionnaires, the Insomnia Severity Index (ISI), Dysfunctional Beliefs and Attitudes about Sleep scale (DBAS-16), Epworth Sleepiness Scale (ESS), and Hospital Anxiety and Depression scale (HAD), were collected at baseline, after treatment, and at 6-month follow-up. A series of linear mixed models were performed to examine treatment effect over time between and within the groups. Results. Significant between-group improvements were seen in favour of CBT-i in ISI after treatment and at the 6-month follow-up and in DBAS-16 after treatment. Both groups showed significant within-group postintervention improvements in ISI, and these changes were maintained six months later. The CBT-i group also showed a significant reduction in DBAS-16 after treatment and six months later. Conclusions. Compared to CBT-i, AA, as offered in this study, cannot be considered an effective stand-alone treatment for insomnia disorder.
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- Bergdahl, Lena, 1980-
(author)
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Auricular acupuncture for insomnia
- 2017
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Doctoral thesis (other academic/artistic)abstract
- Cognitive behavioural therapy for insomnia (CBT-i) is the most effective treatment for insomnia. Studies show that auricular acupuncture (AA) may alleviate insomnia symptoms.The overall aim of the thesis was to compare treatment effects of auricular acupuncture (AA) with cognitive behavioural therapy for insomnia (CBT-i) on symptoms of insomnia, anxiety, depression, hypnotic drugs consumption and quality of life from short- and long-term perspectives.Paper I had a qualitative approach with a descriptive design. 16 participants received group-treatment with AA during their protracted withdrawal phase and were interviewed about their experiences. They participants experienced a reduction in protracted withdrawal symptoms, improved subjective sleep quality, a strong sensation of peacefulness and increased wellbeing.Paper II, III and IV present results from a randomised controlled trial in where the effects of group-treatment with AA and CBT-i were compared in short- and long-term using subjective (questionnaires and sleep diary) and objective (actigraphy) measurements.The results showed that CBT-i was superior to AA in reducing insomnia symptoms in both the short and long run. Both groups experienced significant long-term reduction of depressive symptoms. Further, both groups managed to maintain a decreased intake of hypnotic drugs at the end of the treatment when compared to baseline measurement. Short-term reduction of symptoms of anxiety and depression improved only in the AA group. The results from the objective actigraph recordings showed that the AA group slept more and the CBT-i group less after the treatment and that sleep patterns in both groups reverted to pre-treatment levels after 6 months.Conclusively: AA, as administered in this study, was not as good as CBT-i in treating insomnia symptoms, and should not be used as a stand-alone treatment for insomnia. Our results also demonstrate that prolonged sleep time does not necessarily yield better sleep, and that the perception of insomnia symptoms is not inevitably affected by sleep duration. AA was as effective as CBT-i in ending hypnotic drugs consumption. Moreover, AA was more successful than CBT-i in reducing symptoms of anxiety and depression in the short run. Further studies investigating AA for anxiety and depression are motivated.
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- Bergdahl, Lena, 1980-, et al.
(author)
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Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage and treatment effects of anxiety-, depression and insomnia symptoms
- 2017
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In: European Journal of Integrative Medicine. - : Elsevier BV. - 1876-3820 .- 1876-3839. ; 16, s. 15-21
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Journal article (peer-reviewed)abstract
- Introduction: The interest in non-pharmacological interventions for insomnia disorder has increased. The aim was to assess the immediate treatment effects of auricular acupuncture (AA) and cognitive behavioural therapy for insomnia (CBT-i) regarding discontinuation of hypnotic usage and symptoms of anxiety, depression and insomnia.Method: Prospective randomised controlled study. Fifty-seven participants (mean age 61 years (SD 8.6)) with insomnia disorder and long-term use of non-benzodiazepine hypnotics received group-treatment with AA or CBT-i. Pre- and post-treatment measures included symptoms of anxiety, depression and insomnia via self-report questionnaires: Hospital Anxiety and Depression scale (HAD-A, HAD-D) and Insomnia Severity Index (ISI). Other sleep parameters and hypnotic consumption were measured with a sleep diary. Linear mixed models were performed to examine treatment effect over time within and between the groups.Results: Seventy-one percent of the AA participants and 84% of the CBT-i participants managed to discontinue their hypnotic drug consumption post-treatment. Symptoms of anxiety and depression decreased within the AA group (HAD-A (p < 0.05), HAD-D (p < 0.05)) and insomnia symptoms decreased within the CBT-i group (ISI (p < 0.001)). The only between-group difference occurred in ISI (p < 0.001), in favour of CBT-i. According to the within-group sleep diary results, the CBT-i group went to bed later (p < 0.001), fell asleep quicker (p < 0.05), increased their sleep efficiency (p < 0.001) and self-rated sleep quality (p < 0.05) post-treatment.Conclusions: Both groups ended/maintained low hypnotic drug consumption post-treatment. Short-term reductions occurred in the AA group in anxiety and depression symptoms and in the CBT-i group regarding insomnia symptoms.
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- Bergdahl, Lena, 1980-, et al.
(author)
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Sleep patterns in a randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for insomnia
- 2017
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In: Complementary Therapies in Clinical Practice. - : Elsevier BV. - 1744-3881 .- 1873-6947. ; 28, s. 220-226
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Journal article (peer-reviewed)abstract
- The aim of the study was to objectively examine how sleep patterns were affected in a short- and long-term perspective after auricular acupuncture (AA) and cognitive behavioral therapy for insomnia (CBT-i). Sixty participants with insomnia disorders (men/women 9/51; mean age of 60.5 years, (SD 9.4)), were randomized to group treatment with AA or CBT-i. Actigraphy recordings were made at baseline, post-treatment and 6-month follow-up. The CBT-i group reduced their time in bed, their actual sleeping time, their sleep latency and their actual time awake. The AA group slept longer, increased their time in bed and decreased their sleep latency post-treatment. The between-groups results differed in wake-up time, rising, time in bed, actual sleep time and actual wake time. The differences were not maintained six months later. In accordance with previous findings the results support the notion that the objective sleep time does not necessarily affect the subjective perception of insomnia.
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