THE EFFECT OF ACUPRESSURE ON QUALITY OF SLEEP IN HEMODIALYSIS PATIENTS

Sleep disturbance is a common complaint among patients with end-stage renal
disease. The aim of this study is to determine the effect of acupressure on the quality of sleep in
hemodialysis patients.
Materials & Methods: in this randomized double blind clinical trial, 108hemodialysis patientsof three
hemodialysis units of Imam Reza, Shahid Hasheminejad and Emam Zaman hospitals of Mashhad city
were assigned to three groups: acupressure, sham acupressure, and the control group via balanced
randomized method. The subjects in the acupressure group were given a massage of the Shenmen
(HT7) points on the wrists for three minutes on each point for three times a week, for up to four weeks
during dialysis. The same technique was used for subjects in the sham acupressure group; however it
was done 1-1.5 centimeter away from the main points. For control group, they were only given the
usual medical care. Pittsburg Sleep Quality Index (PSQI) Questionnaire and the Sleep Log were used
for gathering the data and for data analysis one way ANOVA, Kruskal-Wallis, paired t-test, Wilcoxon,
and repeated measure ANOVA were used.
Result: the global score of PSQI (p=0.000) and subscale scores of the subjective sleep quality
(p=0.000), sleep latency (p=0.000), sleep duration (p=0.000), sleep sufficiency (p=0.000), sleep
disturbance (p=0.003), and daily performance (p=0.000) were improved in acupressure group patients
after intervention. In paired analysis of the groups (the acupressure group with the sham acupressure
group and the control group in respect), a significant difference was found in the global score and all
the subscale scores, but this difference was not significant in terms of sleep sufficiency and sleep
medication. According to the results of the Sleep Log, an increase in sleep quality and a decrease in
the number of sleepless periods during night were found for the acupressure group.
Conclusion: The study shows that acupressure has a positive effect on the sleep quality of patients
undergoing dialysis, and it can be used as a noninvasive way to treat sleep disturbance in such
patients