Auricular Acupressure Therapy relieves pain and induces sleep in elderly osteoarthritis patients

South Korea: A study published in "EXPLORE" examined the effects of auricular acupressure (AA) on elderly people with osteoarthritis and concluded it to be effective in improving the sleep and reducing pain.

The prevalence rate of osteoarthritis is high among the elderly, constituting about 47.3%. The prevalence of pain is high at 30.2%. Sleep disorders and osteoarthritis pain in the elderly have a common correlation, and osteoarthritis is a risk factor for sleep disorders.

The worsening pain caused by osteoarthritis decreases total sleeping time and reduces sleep efficiency.

Elderly people in nursing homes have severe sleep-wake dysfunction due to environmental factors, lifestyle changes, decreased physical activity, limited social communication, and reduced daylight exposure.

Drug therapy improves sleep but remains non-satisfactory with more side effects and complications. This requires a nonpharmacological intervention which includes exercises, massage, and tai chi. However, these interventions cannot be practically applied by elderly people with osteoarthritis.

AA is a complementary and alternative non-invasive therapy, relatively simple to use, and can be applied quickly with few side effects. The treatment is self-applied with pressure application to auricular points. The scientific evidence for AA has a well-documented role in improving sleep and pain reduction.

Previous sleep has failed to verify the placebo effect, involved a non-treated control group, a small sample size, etc. Other studies focused on long-term intervention for more than eight weeks.

AA is effective, but there is a lack of generalized results. Considering this, a study was conducted by a team of researchers led by Won Jin Lee from the Department of Nursing Science at the Daejeon Health Institute of Technology University to examine AA effect on sleep and pain in such cases with an accurate intervention through scientific evidence by applying randomization, single blinding, and placebo control.

The critical points of the study are:

• The study included 52 elderly aged 65 years or older.

• The subjects had a history of osteoarthritis and lived in any of four nursing homes.

• The treatment and control groups had 26 patients each.

• The treatment duration was eight weeks.

• The mean age in the treatment and control groups was 78.38±4.54 and 79.27±4.50 years, respectively.

• The study period was from June 1, 2020, to October 18, 2020.

• No significant differences were recorded related to the accompanying diseases and drugs taken between the two groups.

• Polysomnography (efficiency of sleep, latency, awakening, stage 2 sleep), actigraphy (sleep efficiency, sleep latency, number of awakenings), melatonin levels, and PPT (Pressure Pain Threshold) were measured.

• The standardized measurement of sleep quality and the pain was used.

• In the Experimental group, sleep quality scores were significantly improved than the placebo control group.

• The polysomnography and the actigraphy were significant.

• There was a significant increase in melatonin levels after therapy termination.

• The visual analog scale of pain showed significant reduction.

• There was a significant increase in PPT in the intervention group.

• There was a significant decrease in the PSQI scores of the intervention group, and no difference was recorded in the placebo control group.

• The PSQI scores were reduced to –1.30 points after four weeks and –2.26 points after eight weeks of the intervention, showing significant results.

Hyojung Park from the College of Nursing, Ewha Woman's University, wrote, "The hypothesis of our study was AA could improve sleep quality, and its application would reduce the subjective and objective pain intensity."

The final words of conclusion by the team were "AA, when applied to exact reflexology pressure points, can improve sleep and reduce pain in osteoarthritis elderly living in nursing homes."

Further studies are warranted using objective measurement tools such as PSG.

This work was supported by the National Research Foundation of Korea with the financial resources of the government they mentioned.

Further reading:

Won Jin Lee, Hyojung Park. Effects of auricular acupressure on sleep and pain in elderly people who have osteoarthritis and live in nursing homes: A randomized, single-blind, placebo-controlled trial,

EXPLORE, 2022.