Acupuncture and Parkinson Disease: Therapy Improves Sleep Quality, QOL in Adults

Acupuncture improves sleep quality and quality of life (QOL) in patients with Parkinson disease (PD), according to study results published in JAMA Network Open.

Researchers conducted a single-center randomized clinical trial in China between February 2022 and February 2023 to determine whether acupuncture is efficacious in treating patients with PD who have poor sleep quality.

Patients aged 30 to 80 with idiopathic PD and self-reported moderate to severe sleep problems or a Parkinson Disease Sleep Scale (PDSS) score between 0 and 110 were randomly assigned 1:1 to receive real or sham acupuncture therapy 3 times per week for 4 weeks. The PDSS is a 15-item scale that assesses 8 aspects of nocturnal sleep in PD, including the overall quality of a night’s sleep, insomnia, nocturnal restlessness, nocturnal psychosis, nocturia, nocturnal motor symptoms, sleep refreshment, and daytime dozing. PDSS scores range from 0 to 150, such that higher scores indicate better sleep quality. The primary outcome was change in PDSS score, which was measured at 3 specific timepoints: baseline, after 4 weeks of treatment, and at 8 weeks of follow-up.

A linear mixed-effects model was used to evaluate outcome scales.

Of the 83 patients who enrolled in the study and randomly assigned to treatment, 78 (mean age, 64.1; men, 52.6%) completed treatment and the follow-up period, 40 of whom received real acupuncture and 38 of whom received sham acupuncture.

Mean PDSS scores improved significantly from baseline for both the real acupuncture (29.55; 95% CI, 24.65-34.65; P <.001) and sham acupuncture (10.47; 95% CI, 5.35-15.60; P <.001) groups. Patients in the real vs sham acupuncture group exhibited a significantly greater increase in PDSS scores after 4 weeks of treatment (19.75; 95% CI, 11.02-28.49; P <.001) and at 8 weeks of follow-up (20.24; 95% CI, 11.51-29.98; P <.001).

The real acupuncture group exhibited significant decreases in scores on the following 6 outcome measures after 4 weeks of treatment vs baseline:

• Epworth Sleepiness Scale (ESS): -3.78; 95% CI, -4.82 to -2.73;
• Unified Parkinson Disease Rating Scale (UPDRS): -14.53; 95% CI, -17.73 to -11.32;
• Unified Parkinson Disease Rating Scale (UPDRS section III): -6.88; 95% CI, -9.01 to -4.73;
• Non-Motor Symptoms Scale (NMSS): -12.28; 95% CI, -16.00 to -8.55;
• Hamilton Anxiety Rating Scale (HAM-A): -5.28; 95% CI, -6.76 to -3.78; and,
• 39-item Parkinson Disease Questionnaire (PDQ-39): -14.75; 95% CI, -18.62 to -10.88.

Compared with the sham acupuncture group, the real acupuncture group exhibited significant decreases in scores after 4 weeks of treatment on the:

• UPDRS: -11.72; 95% CI, -19.90 to -3.55; P =.005;
• NMSS: -7.75; 95% CI, -14.69 to -0.80; P =.03;
• HAM-A: -4.27; 95% CI, -6.58 to -1.98; P <.001; and,
• PDQ-39: -8.84; 95% CI, -15.08 to -2.60; P =.005.

At 8 weeks of follow-up, the real vs sham acupuncture group had significant decreases in scores on the:

• UPDRS: -13.84; 95% CI, -22.01 to -5.67; P =.001;
• HAM-A: -5.64; 95% CI, -7.95 to -3.33; P <.001; and,
• PDQ-39: -8.80; 95% CI, -15.04 to -2.56; P =.006.

Across both treatment groups, no severe adverse events (AEs) occurred. The most common self-reported acupuncture-related AEs included tremor; bleeding, numbness, or infection; and sharp pain during treatment. No patients withdrew from the study due to an AE.

Study limitations included the unblinding of acupuncturists, short duration of the follow-up period, and reduced generalizability of results to more diverse population pools.

“Considering the interaction between sleep conditions and motor symptoms, as well as the effects of poor sleep on quality of life, acupuncture seems to enhance overall function and quality of life in participants with PD by alleviating sleep disturbances,” the researchers concluded.

Disclosure: Study authors disclosed patents for products mentioned in this article. Please see the original reference for a full list of author disclosures.