Acupuncture Improves Certain Aspects of Sleep in Hematopoietic Stem Cell Transplantation Patients: a Randomized Controlled Trial
Abstract Background High-dose chemotherapy followed by hematopoietic stem cell transplantation (HSCT) is associated with a high symptom burden including decrease in sleep quality. We conducted a randomized sham-controlled trial (#NCT01811862) to study the effect of acupuncture on sleep quality during HSCT. Methods Adult multiple myeloma patients undergoing inpatient and outpatient autologous HSCT were randomized to receive either true or sham acupuncture once daily for 5 days starting the day after chemotherapy. Sleep onset, total sleep time, sleep efficiency percentage, and sleep-onset latency time were assessed using an Actigraphy Sleep Monitor. A multi-variate regression analysis was conducted to compare the average area-under-the-curve of five acupuncture intervention days for each sleep outcome between groups, adjusted by baseline score and inpatient or outpatient chemotherapy stratum. Results Over 32 months, 63 patients were enrolled. Participants undergoing true acupuncture experienced a significant improvement in sleep efficiency when compared to sham (-6.70, 95% CI -13.15, -0.25, p=0.042). Subgroup analysis showed that the improvement is more prominent in the inpatient setting (-9.62, 95% CI -18.76, -0.47, p=0.040). True acupuncture produced noticeable yet non-significant improvement in sleep-onset latency times. Between-group differences in other sleep related variables were not statistically significant. Conclusion Our data suggest that true acupuncture may improve certain aspects of sleep, including sleep efficiency and possibly sleep-onset latency, in multiple myeloma patients undergoing HSCT. By studying patient reported outcomes in future larger scale studies, acupuncture’s role in improving sleep quality during HSCT treatment can be further elucidated.