Evidence map›Paper›PMID 41170529›Full record

ArticleSleep medicine: X2025

Effectiveness of acupressure at different ear acupoints on Insomnia: A secondary analysis of a randomized controlled trial.

Jingyu Zhang, Giulia Castelli, Aomei Shen, Junxin Li, Jennifer Kawi, Hulin Wu, Paul Christo, Claudia M Campbell, Johannes Thrul, Constance M Johnson and 1 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Sleep medicine: X, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03589703 (Management of Chronic Low Back Pain in Older Adults Using Auricular Point Acupressure), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03589703 nacompletednot on this map

Management of Chronic Low Back Pain in Older Adults Using Auricular Point Acupressure

TypeinterventionalSponsorThe University of Texas Health Science Center, HoustonRan2019 to 2023Enrolled272ConditionsChronic Low Back PainArmsTarget ear points related to chronic low back pain (T-APA), Non-Target ear Points not related to chronic low back pain (NT-APA), Enhanced Educational Control Group (CG-2)
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jingyu ZhangSchool of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Giulia CastelliSchool of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Aomei ShenPeking University School of Nursing, Tianjin Medical University Cancer Institute & Hospital, Tianjin, China.
Junxin LiSchool of Nursing, Johns Hopkins University, Baltimore, MD, USA.
Jennifer KawiCizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Hulin WuSchool of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Paul ChristoSchool of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Claudia M CampbellSchool of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Johannes ThrulDepartment of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
Constance M JohnsonCizik School of Nursing, The University of Texas Health Science Center at Houston, Houston, TX, USA.
Nada LukkahataiSchool of Nursing, Johns Hopkins University, Baltimore, MD, USA.

Funding

Optimizing Self-Monitoring Smartphone App to Promote Adherence to COVID-19 Preventative Behaviors in African AmericansR01AG056587 · NIA · UNIVERSITY OF TEXAS HLTH SCI CTR HOUSTON · PI JOHNSON, CONSTANCE MARGARET, LUKKAHATAI, NADA · 2018 to 2022
$3.8M
NIA NIH HHS R01 AG056587
6 · The paper itself

Abstract

Introduction: Insomnia is highly prevalent among older adults with chronic low back pain (cLBP), contributing to a cycle of heightened pain sensitivity, impaired physical function, and reduced quality of life. Auricular Point Acupressure (APA), a nonpharmacologic intervention for pain, has shown emerging evidence of improving sleep. We compared the effectiveness of targeted APA (T-APA) versus non-targeted APA (NT-APA) on insomnia in older adults with cLBP. Methods: This secondary analysis used data from a parent RCT, including 99 adults aged 60 or older with cLBP and clinical insomnia (Insomnia Severity Index [ISI]>7). Participants received four weeks of T-APA or NT-APA. Sleep outcomes (ISI, PROMIS-29 sleep disturbance) and pain outcomes (intensity, interference) were assessed at baseline and post-intervention, with pain examined as a mediator of sleep change. Results: The T-APA (n = 45) and NT-APA (n = 54) groups had similar baseline characteristics. Both groups showed significant reductions in sleep disturbance, pain interference, and pain intensity (p < 0.05). However, only the NT-APA group demonstrated significant improvement in ISI scores (p < 0.001, d = 0.50). No significant mediation effect of pain on sleep outcomes was found. Conclusions: APA may be an effective nonpharmacologic approach for improving sleep among older adults with cLBP. Unexpectedly, NT-APA showed greater improvements in insomnia compared to T-APA, suggesting mechanisms beyond traditional somatotopic theory. Further research is warranted to confirm these findings and explore the potential of point-specific versus non-specific APA protocols in treating insomnia. Trial ID: NCT03589703 (registration date: May 22, 2018). URL: https://clinicaltrials.gov/ct2/show/record/NCT03589703.

Indexed as

Auricular acupressureAuricular point acupressureChronic low back painEar acupointsInsomniaSleep disturbance

Identifiers

PMID41170529
PMCPMC12569834

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.