Auricular therapy and insomnia in the elderly

Abstract

Sleep disturbances are a particularly common problem in the elderly. According to the principles of traditional Chinese diagnosis, insomnia can be deficient or excessive in nature. Sleep efficiency declines with an increase in time spent in bed and a decrease in the total time spent asleep in people with insomnia. Medication such as hypnotics has been widely adopted by the elderly to overcome their sleeping problems; however the adverse effects of these drugs such as decreased reaction time and withdrawal insomnia will further compound the sleeping problems of the elderly. The purpose of this study is to examine the effectiveness of auricular therapy on sleep behaviours in the elderly. One hundred and twenty participants of 60 or above and have sleep disturbances were invited to participate in this study. Eligible participants were randomly assigned to receive auricular therapy using Junci Medulla (Group A=30), Semen Vaccariae (Group B=30) or magnetic pearls (Group C=60). Group A and Group B were the control groups, while Group C being the experimental group. Seven auricular points which are thought to have an effect on promoting sleep were selected. Junci Medulla/Semen Vaccariae/Magnetic pearls were replaced every three to four days to avoid the possibility of local irritation of auricular points under treatment. The total treatment course lasted for three weeks (21 days). Objective measurement using actigraphic monitoring was performed before the therapy commenced, in the middle period of the therapy, and within one week after the therapy has been completed. After the therapy, there were significant differences among the three groups in terms of the nocturnal sleep time (NST) (F2, 117 = 6.84, p<0.05) and sleep efficiency (SE) (F2, 117 = 7.69, p<0.05). Significant improvement in the sleep behaviours was observed in the experimental group using magnetic pearls. No significant difference in the therapeutic effect on sleep could be found between clients with 'excessive' and 'deficiency' syndrome even when the treatment protocol was standardized. In a backward multiple regression, the effect of auricular therapy on sleep efficiency after allowing for age in female participants is of high statistical significance (F3, 106 = 9.04, p<0.001). It is argued that auricular therapy using magnetic pearls is an effective means towards improving the quantity and quality of sleep in the elderly, and is recommended that nurses should incorporate this in their nursing therapeutics for improvement of clients' sleep.