Diagnosis and treatment of primary insomnia with acupuncture: A survey of TCM practitioners

By Inbal Sivan - Online MSc - Advanced Oriental Medicine

Abstract

Background

The two most common treatments for primary insomnia are pharmacology and cognitive behavioural therapy. Acupuncture offers a drug-free and scalable alternative to these. However, current research cannot be easily translated into clinical settings and does not provide clear guidance on the most efficacious treatment approach.

Aims and objectives

This study aims to improve the external validity of research on Traditional Chinese Medicine (TCM)-based acupuncture as a treatment for primary insomnia. Two research questions focus on how TCM practitioners diagnose and treat primary insomnia and on which sources of information they use to make treatment decisions.

Methodology

A cross-sectional quantitative survey comprised of 26 questions was conducted, using professional Facebook groups for recruitment. Data analysis included univariate and bivariate analysis, and thematic analysis.

Findings

The survey was completed by 75 practitioners, which resulted in 68 valid questionnaires. Responses revealed wide variation in treatment approaches such as acupoint selection and frequency of sessions. Most respondents used pulse and tongue diagnosis but there was no common approach to the use of supplementary diagnostic questions. In descending order, the most common information sources chosen were own clinical experience (53respondents), textbooks (48), journal articles (41), and clinical research (33).

Conclusion

Whereas the absence of a common approach to diagnosis and treatment may be a barrier to the promulgation of evidence-based acupuncture, it is worth considering whether consensus is appropriate for TCM, which views each individual as distinct. Moreover, the survey responses suggest that highlighting research results in textbooks could help to promote awareness of evidence in this area. Three further insights emerge from this analysis. First, some response variation reflects shortcomings in the survey design and methodology. Second, country of practice and training appear to affect how practitioners treat. Third, the research of acupuncture in isolation may be inconsistent with clinical practice, given the prevalence of co-interventions.