Auricular acupressure for chemotherapy-related insomnia in cancer patients: A systematic review and meta-analysis

Cancer patients undergoing chemotherapy are prone to experiencing sleep disturbances. Research has shown that auricular acupressure may be beneficial in relieving these symptoms, but high-quality evidence is lacking. This study was designed to systematically evaluate the efficacy of auricular acupressure for relieving chemotherapy-related insomnia.

This review was reported in accordance with the PRISMA framework. A total of 4 English databases (PubMed, Embase, Web of Science, The Cochrane Library) and 4 Chinese databases (CNKI, Wanfang, VIP, CBM) were searched from inception to October 31, 2024 to identify randomized clinical trials (RCTs) examining the use of auricular acupressure for the treatment of chemotherapy-related insomnia. The methods recommended by the Cochrane collaboration group were applied to evaluate the quality of the methodology. Cochrane Review Manager 5.4 was used for the meta-analysis.

This meta-analysis included 1073 patients from 14 randomized controlled trials. We mainly compared auricular acupressure with routine nursing or sham auricular acupressure. The results showed that auricular acupressure could alleviate chemotherapy-related insomnia(MD(PSQI)=-3.68, 95 %CI [-4.74,-2.62], P < 0.00001), anxiety(SMD=-1.07, 95 %CI [-1.57,-0.57], P < 0.0001), depression (SMD=-1.14, 95 %CI [-1.78-0.50], P = 0.0005<0.05) and fatigue (SMD = -1.14, 95 % CI [-1.78 to 0.50], P = 0.0005) more effectively than sham auricular acupressure and routine nursing.

This meta-analysis found that auricular acupressure can relieve chemotherapy-related insomnia, anxiety, depression and fatigue, and improve the quality of life of patients. However, the current relevant literature has low quality and is highly heterogeneous, which reduces the credibility of the research results. Therefore, more rigorously designed randomized controlled trials are needed to verify these conclusions.