Auricular acupuncture versus cognitive behavioural therapy in the discontinuation of hypnotic drug usage, and treatment effects on anxiety, depression and insomnia symptoms − a randomised controlled study

• Published in: European journal of integrative medicine Vol. 16; pp. 15 - 21
• Main Authors: Bergdahl, Lena, Broman, Jan-Erik, Berman, Anne H., Haglund, Kristina, von Knorring, Lars, Markström, Agneta
• Format: Journal Article
• Language: English
• Published: Elsevier GmbH 01.12.2017
• Subjects: Anxiety; Auricular acupuncture; Cognitive behavioural therapy; Depression; Hypnotic consumption; Insomnia; Medicin och hälsovetenskap; AA; TAU; Depression; Cognitive behavioural therapy; HAD-A, HAD-D; SD; SE; NADA; Insomnia; Cohen’s d; Auricular acupuncture; Hypnotic consumption; Anxiety; CBT-i; ISI
• ISSN: 1876-3820; 1876-3839
• DOI: 10.1016/j.eujim.2017.10.002

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. 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. 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. 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.