Auricular Acupuncture for Sleep and Pain: A Feasibility Study

Background: Sleep disturbance (SD), specifically insomnia, is linked to impaired cognitive and immune functions, decreased quality of life, and increased accidents. Insomnia is well established in the general population and primary care patients as comorbidity for psychological problems (eg, post traumatic stress disorder, anxiety, and depression) and medical problems (eg, irritable bowel syndrome, cancer, acute and chronic pain). Hypnotic drugs for sleep and narcotics for pain have undesirable side effects. Numerous studies have revealed that acupuncture is an effective complementary and alternative medicine (CAM) for sleep or pain; however, very few studies have tested the use of auricular acupuncture (AA), a safe, portable, and an easy-to-administer modality, using a standard protocol in patients for improvement in both sleep and chronic pain as administered by nurse practitioners (NPs). Thus, a CAM treatment modality for SD and chronic pain that can easily be implemented and with minimal side effects is needed for military beneficiaries. Primary aims are to 1. test the feasibility and acceptability of AA as administered by NPs; and 2. evaluate the change in pre- and post-treatment sleep and pain variables; and secondary aims are to 1. evaluate the reliability of the Defense and Veterans Pain Rating Scale; and 2. determine the agreement between sleep diary and actigraphy on sleep parameters to successfully guide future studies. Method: A convenience sample of up to 64 military beneficiaries who meet the inclusion/exclusion criteria, initial screening, and signed consent will be randomized to either usual care + AA (treatment group) or to usual care only (control group) over an eight-day period. Outcome Variables: Recruitment and retention numbers; sleep (insomnia severity index and sleep parameters) and pain (intensity and functionality) variables; and reliability and agreement of outcome measures. Plan for Analysis: descriptive, mixed model analysis using repeated measures, and the Bland-Altman method.

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