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Acupuncture may ease disturbed sleep in veterans with mild TBI, PTSD

Veterans with mild traumatic brain injury and PTSD receiving real acupuncture showed greater improvement in sleep measures than those receiving a sham needling procedure, according to data from a randomized clinical trial published in Journal of Clinical Psychiatry.

“The [mild TBI] veteran population frequently presents with coexisting and significant PTSD, which is one of the major comorbidities in persistent sleep difficulties, making the condition even harder to treat,” Wei Huang, MD, PhD, of the Atlanta VA medical Center and Emory University School of Medicine, and colleagues wrote. “Acupuncture can be a potentially useful treatment modality capable of addressing the need to treat these patients with a holistic approach and relatively few side effects.”

Researchers compared real vs. sham acupuncture in improving persistent sleep disturbance in 60 veterans with mild TBI and refractory sleep disturbance — most of whom also had PTSD (66.7%) — in a randomized clinical trial.

They randomly allocated participants to receive up to 10, one-hour sessions of real or sham acupuncture, then examined change in baseline-adjusted global Pittsburgh Sleep Quality Index (PSQI) score following intervention. Participants also wore wrist-actigraphy monitors to determine sleep measurements. Researchers also evaluated comorbid PTSD as a covariate.

On average, scores on the global PSQI improved by 4.4 points in the real acupuncture group and 2.4 points in the sham group (F = 4.51; P = .04). Wrist actigraphy data demonstrated that sleep efficiency improved an average of 2.7% in the acupuncture group while efficiency decreased by 5.3% in the sham group (F = 12.25; P = .0016). Furthermore, acupuncture was effective for participants regardless of their PTSD status, according to Huang and colleagues.

In addition, the researchers found that the real acupuncture group, but not the sham group, showed a trend for slight worsening in overall sleep quality at 4-week follow-up; however, the PSQI global score was not significantly different between the two groups at follow-up.

“Although the physiologic changes associated with acupuncture are complex, a unifying theme emerges across much of this literature, ie, the positive effects of acupuncture on autonomic nervous system measures,” they wrote. “Because insomnia is often considered to reflect heightened autonomic arousal, acupuncture’s ability to down-regulate such physiologic functions may play a role in reinstituting improved sleep, this being especially true in a veteran population with [mild] TBI and PTSD overlay.” – by Savannah Demko

Disclosure: Huang reports no relevant financial disclosures. Please see the study for all other authors’ relevant financial disclosures.