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Published in: Trials 1/2022

Open Access 01-12-2022 | Insomnia | Study protocol

Acupuncture combined with traditional Chinese medicine e-aid cognitive behavioral therapy for insomnia (TCM-eCBT-I) for chronic insomnia: study protocol for a randomized controlled trial

Authors: Cheng-yong Liu, Ya-nan Zhao, Xiao-qiu Wang, Shan Qin, Qing-yun Wan, Shi-yu Zheng, Wen-zhong Wu

Published in: Trials | Issue 1/2022

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Abstract

Introduction

The incidence of insomnia is getting higher and higher. Long-term insomnia seriously affects people’s health. Drug use is usually accompanied with adverse events. Both acupuncture and cognitive behavioral therapy for insomnia (CBT-I) have been proven to be safe and effective non-pharmacological treatments for insomnia. As the insomniacs’ bad sleep behavior and wrong cognition have not been effectively corrected, acupuncture has a quick effect, high patient compliance but unstable long-term efficacy, while CBT-I is complex, time-consuming, and expensive; additionally, patient compliance is low, and the number of trained therapists is limited, making it difficult to carry out. Therefore, this study aims to use the insomnia TCM system to construct a convenient and feasible traditional Chinese medicine e-aid cognitive behavioral therapy for insomnia (TCM-eCBT-I) for Chinese people, and combine the advantages of acupuncture and TCM-eCBT-I for maintaining long-term efficacy, and three treatments will be evaluated to provide clinicians with a more effective clinical protocol

Methods and analysis

This study is a single-center, open-label, randomized controlled trial. Ninety subjects will be recruited and randomly assigned to three groups: the acupuncture group, the TCM-eCBT-I group, and the acupuncture combined with TCM-eCBT-I group, in a ratio of 1:1:1. We will evaluate the Pittsburgh Sleep Quality Index (PSQI) and Dysfunctional Beliefs and Attitudes About Sleep Scale (DBAS), Insomnia Severity Index (ISI), sleep diary, Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), and Fatigue Scale-14 Scale (FS-14) scales. All adverse reactions will be assessed through the ADVERSE event table. All outcomes will be evaluated online at 0 weeks, 4 weeks, 8 weeks, 16 weeks, and 28weeks.

Ethics and dissemination

This study has been approved by the Institutional Review Board of the Affiliated Hospital of Nanjing University of Chinese Medicine (2020 NL-018-02). Informed consent will be obtained from all the subjects. The results will be shared with sleep researchers, public, and relevant academic institutions through high-impact peer-reviewed publications.

Trial registration

Chinese Clinical Trial Registry ChiCTR2000032960. Registered on 17 May 2020
Literature
20.
go back to reference Chinese Sleep Research Society. Guidelines for diagnosis and treatment of insomnia in China. Natl Med J China. 2017;97:1844–56. Chinese Sleep Research Society. Guidelines for diagnosis and treatment of insomnia in China. Natl Med J China. 2017;97:1844–56.
21.
go back to reference Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD, for the Clinical Guidelines Committee of the American College of Physicians. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–33. https://doi.org/10.7326/M15-2175.CrossRefPubMed Qaseem A, Kansagara D, Forciea MA, Cooke M, Denberg TD, for the Clinical Guidelines Committee of the American College of Physicians. Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2016;165(2):125–33. https://​doi.​org/​10.​7326/​M15-2175.CrossRefPubMed
25.
go back to reference Yang Y, Luo X, Paudel D, Zhang J, Li SX, Zhang B. Effects of e-aid cognitive behavioural therapy for insomnia (eCBTI) to prevent the transition from episodic insomnia to persistent insomnia: study protocol for a randomised controlled trial. BMJ open. 2019;9(11). https://doi.org/10.1136/bmjopen-2019-033457. Yang Y, Luo X, Paudel D, Zhang J, Li SX, Zhang B. Effects of e-aid cognitive behavioural therapy for insomnia (eCBTI) to prevent the transition from episodic insomnia to persistent insomnia: study protocol for a randomised controlled trial. BMJ open. 2019;9(11). https://​doi.​org/​10.​1136/​bmjopen-2019-033457.
29.
go back to reference Yang Y, Luo X, Paudel D, Zhang J, Li SX, Zhang B. Effects of e-aid cognitive behavioural therapy for insomnia (eCBTI) to prevent the transition from episodic insomnia to persistent insomnia: study protocol for a randomised controlled trial. BMJ open. 2019;9(11). https://doi.org/10.1136/bmjopen-2019-033457. Yang Y, Luo X, Paudel D, Zhang J, Li SX, Zhang B. Effects of e-aid cognitive behavioural therapy for insomnia (eCBTI) to prevent the transition from episodic insomnia to persistent insomnia: study protocol for a randomised controlled trial. BMJ open. 2019;9(11). https://​doi.​org/​10.​1136/​bmjopen-2019-033457.
32.
go back to reference Ho F-Y, Yeung W-F, Chung K-F. Self-help cognitive-behavioral therapy for insomnia (CBT-I): a systematic review of randomized controlled trials. Denmark: 15th Nordic Conference, Copenhagen; 2015. Ho F-Y, Yeung W-F, Chung K-F. Self-help cognitive-behavioral therapy for insomnia (CBT-I): a systematic review of randomized controlled trials. Denmark: 15th Nordic Conference, Copenhagen; 2015.
35.
go back to reference Espie CA, Luik AI, Cape J, et al. Digital cognitive behavioural therapy for insomnia versus sleep hygiene education: the impact of improved sleep on functional health, quality of life and psychological well-being. Study protocol for a randomised controlled trial. Trials. 2016;17(1):1–9.CrossRef Espie CA, Luik AI, Cape J, et al. Digital cognitive behavioural therapy for insomnia versus sleep hygiene education: the impact of improved sleep on functional health, quality of life and psychological well-being. Study protocol for a randomised controlled trial. Trials. 2016;17(1):1–9.CrossRef
39.
go back to reference Lin F-C, He N-N, Huang D-H. Primary exploration on music therapy based on five elements in Inner Canon of Huangdi. China J Tradit Chin Med Pharm. 2015;30(11):4162. Lin F-C, He N-N, Huang D-H. Primary exploration on music therapy based on five elements in Inner Canon of Huangdi. China J Tradit Chin Med Pharm. 2015;30(11):4162.
40.
go back to reference Pan L, Fan D, Hu H. Therapeutic effect of five notes of ancient China’s pentatonic scale based on acoustic resonance. J Beijing Univ Tradit Chin Med. 2016;39(9):731–3. Pan L, Fan D, Hu H. Therapeutic effect of five notes of ancient China’s pentatonic scale based on acoustic resonance. J Beijing Univ Tradit Chin Med. 2016;39(9):731–3.
41.
go back to reference Xu J-Z, Tang X-Y, Guo Y-B, et al. Effects of somatic music low-frequency sound wave on microcirculation of twelve well points of 30 healthy people. China J Tradit Chin Med Pharm. 2015;30(2):544–8. Xu J-Z, Tang X-Y, Guo Y-B, et al. Effects of somatic music low-frequency sound wave on microcirculation of twelve well points of 30 healthy people. China J Tradit Chin Med Pharm. 2015;30(2):544–8.
43.
go back to reference MacPherson H, Altman DG, Hammerschlag R, et al. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): extending the CONSORT statement. J Altern Complement Med. 2010;16(10):ST-1–ST-14.CrossRef MacPherson H, Altman DG, Hammerschlag R, et al. Revised standards for reporting interventions in clinical trials of acupuncture (STRICTA): extending the CONSORT statement. J Altern Complement Med. 2010;16(10):ST-1–ST-14.CrossRef
48.
go back to reference Zhao Y-N, Wu W-Z, Liu C-Y, et al. A theoretical probe into the treatment of insomnia with the acupuncture method of “Tongdu-tiaoshen”. J Clin Acupunct Moxibustion. 2019;5(06):1–4. Zhao Y-N, Wu W-Z, Liu C-Y, et al. A theoretical probe into the treatment of insomnia with the acupuncture method of “Tongdu-tiaoshen”. J Clin Acupunct Moxibustion. 2019;5(06):1–4.
50.
go back to reference Zhang Q-Q, Liu P, Zhao J-L, Liu Y-X. Study on clinical acupoint selection rule of acupuncture and moxibustion treatment of insomnia based on data mining in recent 30 years. World Sci Technol-Modern tradit Chin Med. 2018;20(09):1596–602. Zhang Q-Q, Liu P, Zhao J-L, Liu Y-X. Study on clinical acupoint selection rule of acupuncture and moxibustion treatment of insomnia based on data mining in recent 30 years. World Sci Technol-Modern tradit Chin Med. 2018;20(09):1596–602.
52.
go back to reference Standardization Administration of the People’s Republic of China. GB/ T12346-2006, Nomenclature and Location of Acupuncture Points. 2006;14,16,35,36. Standardization Administration of the People’s Republic of China. GB/ T12346-2006, Nomenclature and Location of Acupuncture Points. 2006;14,16,35,36.
57.
go back to reference Liu X, Tang M, Hu L. Reliability and validity of the Pittsburgh Sleep Quality Index. Chin J Psychiatry. 1996;29:103–7. Liu X, Tang M, Hu L. Reliability and validity of the Pittsburgh Sleep Quality Index. Chin J Psychiatry. 1996;29:103–7.
62.
go back to reference Xu Bo Y. L-J, Li Z-J. Study on the reliability and validity of the Chinese version of the sleep disorder belief and attitude scale. J Capital Med Univ. 2019;40(05):665–70. Xu Bo Y. L-J, Li Z-J. Study on the reliability and validity of the Chinese version of the sleep disorder belief and attitude scale. J Capital Med Univ. 2019;40(05):665–70.
63.
go back to reference Nicholson I. Insomnia: psychological assessment and management. Journal of Mind and Behavior. 1994;15(3):299-302. Nicholson I. Insomnia: psychological assessment and management. Journal of Mind and Behavior. 1994;15(3):299-302.
72.
go back to reference Levine J, Nina R. SAFTEE: a technique for the systematic assessment of side. Psychopharmacol Bull. 1986;22(2-3):343.PubMed Levine J, Nina R. SAFTEE: a technique for the systematic assessment of side. Psychopharmacol Bull. 1986;22(2-3):343.PubMed
75.
77.
go back to reference Bergdahl L, Broman J-E, Berman AH, Haglund K, von Knorring L, Markström A. 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. Eur J Integr Med. 2017;16:15–21. https://doi.org/10.1016/j.eujim.2017.10.002.CrossRef Bergdahl L, Broman J-E, Berman AH, Haglund K, von Knorring L, Markström A. 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. Eur J Integr Med. 2017;16:15–21. https://​doi.​org/​10.​1016/​j.​eujim.​2017.​10.​002.CrossRef
79.
go back to reference Chinese Sleep Research Society. Guidelines for diagnosis and treatment of insomnia in China. Natl Med J China. 2017;97:1844–56. Chinese Sleep Research Society. Guidelines for diagnosis and treatment of insomnia in China. Natl Med J China. 2017;97:1844–56.
Metadata
Title
Acupuncture combined with traditional Chinese medicine e-aid cognitive behavioral therapy for insomnia (TCM-eCBT-I) for chronic insomnia: study protocol for a randomized controlled trial
Authors
Cheng-yong Liu
Ya-nan Zhao
Xiao-qiu Wang
Shan Qin
Qing-yun Wan
Shi-yu Zheng
Wen-zhong Wu
Publication date
01-12-2022
Publisher
BioMed Central
Published in
Trials / Issue 1/2022
Electronic ISSN: 1745-6215
DOI
https://doi.org/10.1186/s13063-022-06012-6

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