Auricular Acupressure Improves Sleep in Older Adults With Osteoarthritis

Shot of an unrecognisable senior man suffering from wrist pain
Researchers examined the effects of auricular acupressure on sleep and pain in older adults with osteoarthritis who reside in nursing homes.

Auricular acupressure therapy improved sleep and pain among older adult patients with osteoarthritis (OA) who reside in nursing homes, according to study findings published in Explore.

Researchers sought to assess the effects of auricular pressure on sleep quality and pain scores in older adults with OA and conducted a randomized, single-blinded, and placebo-controlled trial from June 1, 2020, to October 18, 2020.

A total of 52 older adult patients with OA who lived 4 different nursing homes in Korea were included in the study. Participants were randomly assigned to either the treatment group (n=26) or the control group (n=26). The mean age in the treatment group was 73.38±4.54 years and 79.27±4.50 years in the control group.

The study patients applied auricular acupressure themselves using a vaccaria seed attached to a 0.6×0.6 cm piece of tape to the specified reflex zones for 2 minutes in 2-second intervals 4 times daily for 5 days. A rest period of 2 days was included to minimize the risk for dermatologic allergic reaction. Those in the control group applied the tapes to zones that were irrelevant to sleep and joint pain.

The Pittsburgh Sleep Quality Index (PQSI) was used to score sleep quality. Following 4 weeks of treatment, the PQSI of both groups was examined; visual analogue scale (VAS) scores and pressure pain threshold (PPT) were assessed weekly. Postexamination was conducted after 8 weeks, when melatonin levels, VAS scores, and PPT were measured. Actigraphy, PSQI, and polysomnography (PSG) were also evaluated during this time.

The difference in change in PQSI scores between the study groups was statistically significant (Z=-3.53, P <.001; Z=-4.72, P <.001, respectively) after 4 weeks and 8 weeks. Sleep efficiency showed significant improvement (Z=-2.03, P =.042), as did the difference in sleep latency between the groups (Z=-3.03, P =.002). Melatonin levels increased as well (Z=-3.75, P <.001). When analyzed using actigraphy, the difference in sleep efficiency before and after treatment between the groups was significant (Z=4.52, P <.001). In addition to the difference in sleep latency between the groups, melatonin level differences increased for the treatment and control groups (Z=-4.69, P <.001; Z=-3.75, P <.001, respectively).

Subjective pain ratings via VAS scores decreased sharply following treatment with auricular acupressure (F=13.66, P <.001). Regarding objective pain, shoulder PPT improved (t=-21.59, P =.001) after 4 weeks. The differences in change of lumbar PPT and knee PPT after 3 weeks were also increased significantly (t=2.73, P =.002; t=3.07, P =.003, respectively).

Limitations of the study included the self-reporting method, which the study patients may have misinterpreted due to lack of understanding of the survey options. There was also variation in individual lifestyles, sleep statuses, and pain perception levels among the study patients.

The study authors concluded, “[Auricular acupressure] applied to exact reflexology pressure points based on scientific evidence can improve sleep and reduce pain in [older adult patients with OA] who live in nursing homes.” They recommend using auricular acupressure as a nonpharmacological alternative intervention for pain and sleep management.


Lee WJ, Park H. Effects of auricular acupressure on sleep and pain in elderly people who have osteoarthritis and live in nursing homes: A randomized, single-blind, placebo-controlled trial. Explore (NY). Published online July 5, 2022. doi:10.1016/j.explore.2022.07.001