Acupuncture Can Improve Sleep for Cancer Survivors With Chronic Pain

41% of the electroacupuncture group and 42.9% of the auricular acupuncture group participants had clinically meaningful improvements in sleep quality.

Here’s some relief: acupuncture has been shown to improve sleep quality for cancer survivors with comorbid sleep disturbance and chronic pain, potentially leading the way for other nonpharmacological methods of sustainable pain management, according to recent research.

A team at Memorial Sloan Kettering Cancer Center in New York City found that both electroacupuncture and auricular acupuncture offered “clinically meaningful” improvements in sleep quality when compared to usual care methods such as analgesic medications, physical therapy and glucocorticoid treatments.

The results, which showed that more than 40% of participants who received acupuncture treatments saw a clinically meaningful improvement in sleep quality, were released in a study published on March 29 in the journal Cancer.

“These findings suggest that acupuncture may be an evidence-based nonpharmacologic intervention to improve sleep health for cancer survivors with pain,” the authors wrote.

Analyzing the results of the Personalized Electroacupuncture Versus Auricular Acupuncture Comparative Effectiveness (PEACE) randomized clinical trial published in 2021, the 268-participant study found that patients with chronic musculoskeletal pain experienced improved sleep quality after both 10 and 24 weeks of acupuncture treatments.

Participants’ heightened sleep quality was even sustained after the end of the treatment, according to the study.

“Chronic pain and chronic symptoms are not just (caused) physiologically,” study co-author Dr. Jun J. Mao of the integrative medicine service, department of medicine, at Memorial Sloan Kettering Cancer Center, told CURE®. “There's a physiological etiology, there's also a learned component to it. Ultimately, those sensations (patients) experience centralize (in) our brain. So, by acupuncture stimulation on a weekly basis, somehow, we might rewire the brain circuit to ultimately lead to this sort of what I call ‘permanent improvement’ in the pain condition (and) sleep condition, which is really exciting.”

Sleep disturbance, according to the study, is a “common and persistent clinical complaint for 60% of cancer survivors.” Acupuncture, the authors wrote, is an appealing alterative to regular pain medication use, which is associated with sleep quality impairment.

“A lot of Americans take pills to sleep,” Mao said. “But you will know if you stop taking a pill that night, you sleep will get worse. So, I think this is why it's important to bring nonpharmacological treatments like this, to help to produce a more permanent, sustained benefit.”

The Memorial Sloan Kettering Cancer Center Study re-purposed the findings of the PEACE trial, which compared the effects of electroacupuncture, auricular acupuncture and usual care for cancer survivors experiencing chronic musculoskeletal pain.

The benefits were experienced by patients who received 10-week courses of either electroacupuncture, which involved 30-minute sessions of electrical stimulation to four points near the site of pain, and auricular acupuncture, a process developed by the United States military also known as “battlefield acupuncture” where up to 10 needles are inserted into the ear for three to four days.

Per the study’s findings, 41% of the electroacupuncture group and 42.9% of the auricular acupuncture group participants had clinically meaningful improvements in sleep quality, as opposed to 21.4% of the usual care group.

In addition to demonstrating the therapeutic power of acupuncture, the study invites exploration into other methods of pain relief for cancer survivors.

“There's an open therapeutic window to potentially introduce other techniques or combine other techniques,” Mao said. He cited cognitive behavioral therapy as an example of a nonpharmacological technique for treating pain-related insomnia.

“As humans also we have developed behaviors, in many cases what we call maladaptive behaviors, to cope with when we're not able to sleep,” said Mao. “So people start (doing things like) watching iPads in bed or looking at their phone in bed or (they) start worrying and planning activities in bad when they couldn't sleep or wake up in the middle of night. And then there are people who take a lot of naps during the day or like doze off right before bedtime, and then their sleep drive actually decreases that (much) further, (it’s) made their sleep very difficult.

“All of that then now becomes what we call behavioral. So those kinds of behaviors are not necessarily targeted by acupuncture, per se, right? Acupuncture targets your physiology and readings of pain (to) induce some sort of relaxational response. So I think there's a (need) really for some individuals, you really need to also bring the behavioral modification aspect to help them to improve their sleep.”

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