Acupuncture for Sleep Disturbances in Post-Deployment Military Service Members: A Randomized Controlled Trial.

This RCT and mixed-methods study examined the difference between two groups receiving the following interventions: (1) brief manual standardized stress acupuncture (MSSA) combined with an abbreviated Cognitive Behavioral Therapy (ACBT) versus (2) ACBT alone. Three study aims: Aim (1): Insomnia Severity Index (ISI) and Pittsburg Sleep Quality Index (PSQI) scores were analyzed using descriptive summaries, linear regression, and reliable change index (RCI). Aim (2): Journal entries were analyzed using content analysis. Aim (3): Acupuncture Expectancy Scale (AES) scores were analyzed using paired t-test and RCI. Aim (1): Both groups demonstrated similar improvements in the ISI scores (p = .480). Aim (2): The ACBT/MSSA group reported greater benefits in sleep and in other life areas including mental, physical, and social functioning. Aim (3): The AES showed that 21.6% had a clinically meaningful increase in expectations in the effect of acupuncture for stress (p = .965). The study was registered in ClinicalTrials.gov (NCT04031365) at https://clinicaltrials.gov/ct2/show/NCT04031365 on July 24, 2019.

Perceived benefits of brief acupuncture for sleep disturbances in postdeployment military service members.

STUDY OBJECTIVES: The purpose of this study was to describe the perceived benefits of manual standardized stress acupuncture (MSSA) for sleep disturbances in service members with deployment exposure. METHODS: This qualitative study was embedded in a 2-arm randomized controlled trial using mixed-methods research that evaluated the effect of weekly MSSA for 4 weeks as an adjunct treatment with abbreviated cognitive-behavioral therapy for insomnia (CBTi) for sleep disturbances in service members. Participants were randomized to either the experimental group (CBTi and MSSA) or the control group (CBTi only). The CBTi consisted of 1 group psychotherapy session for 60 minutes, follow-up telephone therapy for 30 minutes, and an additional four 30-minute follow-up sessions via telephone. Participants provided written journal entries by answering 5 open-ended questions about their treatment experiences at week 5 during the posttreatment assessment. Journal log entries were transcribed verbatim using the Dedoose software. A content analysis method was used to code emerging themes. RESULTS: Three overarching categories were found from the qualitative data: personal challenges in implementing the CBTi sleep strategies, no perception of improvement from treatment, and perceived benefits of treatment. The CBTi/MSSA group reported greater benefits in sleep and in other life areas including mental, physical, and social functioning using content analysis. CONCLUSIONS: Findings of this study showed greater improvements in participants' sleep, mood, physical health, and occupational and social functioning after receiving the combination of CBTi and MSSA. Future research that investigates the long-term effects of CBTi and MSSA may be beneficial among postdeployment service members. CLINICAL TRIAL REGISTRATION: Registry: ClinicalTrials.gov; Name: Jane J. Abanes; URL: https://clinicaltrials.gov/ct2/show/NCT04031365; Identifier: NCT04031365. CITATION: Abanes J, Ridner SH, Rhoten B. Perceived benefits of brief acupuncture for sleep disturbances in postdeployment military service members. J Clin Sleep Med. 2021;17(8):1533-1543.

Feasibility and Acceptability of a Brief Acupuncture Intervention for Service Members with Perceived Stress.

INTRODUCTION: Given the role of perceived stress in disability and suicidality in the military, intervening early before service members become at risk for severe injuries, hospitalizations, and chronic disability could improve health outcomes. The purpose of this study was to explore the feasibility and acceptability of a standardized stress acupuncture (SSA) approach on perceived stress in U.S. military personnel. This study had the following aims: examine feasibility of recruitment for SSA and implementation of study procedures in preparation for a methodologically rigorous study; examine acceptability of SSA treatment in a sample of military personnel with perceived stress; and examine change in perceived stress and general health before and after SSA. MATERIALS AND METHODS: This was a single-arm, single-site study protocol which assessed the feasibility of SSA in 16 patients with perceived stress. Upon IRB approval and written informed consent, the participants received 4 weekly sessions of SSA which consisted of 6 acupuncture points. RESULTS: This study showed that recruitment and implementation of SSA is feasible in service members. Service members found SSA to be acceptable. Statistically significant increases were found on the energy/fatigue, well-being, and social functioning components of the Short Form Health Survey (SF 36) (reliable change: 50%, 56%, and 25% respectively, Cohen's d = 0.72-0.78, all p < 0.05). A statistically significant decrease in perceived stress based was found on the Perceived Stress Scale (PSS) (reliable change 63%, Cohen's d = 1.03, p = 0.001). CONCLUSION: These results suggest that SSA is a feasible and acceptable treatment for perceived stress in military personnel. Preliminary findings suggest that SSA may be useful in improving energy/fatigue, social functioning, and perceived stress of service members.