Authors
- . Mona Eidani
- . Simin Montazeri 1
- . Parvaneh Mousavi 2
- . Mohammad Hosein Haghighizadeh 3
- . Mahboubeh Valiani 4
1 PhD in Reproductive Health, Assistant Professor of Reproductive Health, Department of Midwifery, School of Nursing and Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
2 Midwifery Instructor, Department of Midwifery, School of Nursing and Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
3 Departement Biostatistics, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
4 Reproductive Sciences and Sexual Health Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
Abstract
BACKGROUND: Menopause is one of the developmental stages of women. One of the most common
problems during this period is sleep disorders. Sleep disorders can affect the quality of life of these
people. To improve sleep disorders, auriculotherapy has received less attention due to its low cost
and effectiveness, and side effects. Therefore, the aim of this study was to determine the effect of
auriculotherapy on improving sleep quality in postmenopausal women aged 45–60 years.
MATERIALS AND METHODS: The present study is a clinical trial study that was performed on
82 postmenopausal women aged 45–60 years under the auspices of health centers in Mahshahr
city, Iran from 2021–2022. Women with inclusion criteria were randomly divided into two groups
(intervention and control). The intervention group underwent auriculotherapy for 4 weeks. The St.
Petersburg Sleep Quality Questionnaire was completed by both groups at the beginning and 4 weeks
after the start of the intervention. Finally, the data were analyzed by SPSS software version 22 and
independent t‑test, paired t‑test and Chi‑square test.
RESULTS: At the beginning of the study, both groups were homogeneous in terms of demographic
variables. The results of data analysis using independent t‑test showed that before the intervention,
mental quality (P = 0.513), length of incubation period (P = 0.285), sleep duration (P = 0.121), sleep
efficiency (P=0.513), sleep disorders (P=0.685), use of sleeping pills (P=0.530), daily functioning(P=0.60),
and overall sleep quality score (P = 0.30) in the control and intervention groups were not statistically
significant.However, comparing the mean scores afterthe interventionin the control and interventiongroups
showed that mental quality (P < 0.001), incubation period (P < 0.001), sleep duration (P < 0.001), sleep
efficiency (P < 0.001), sleep disorders (P < 0.001), use of hypnotics (P=0.002), daily functioning (P=0.001),
overall sleep quality score (P < 0.001), sleep duration (P = 0.822), sleep efficiency (P = 0.889), sleep
disorders (P = 0.889), use of sleeping pills (P = 1.00), daily performance (P = 0.767), overall sleep quality
score (P = 0.69) were statistically significant between the two groups. In‑group comparison using paired
t‑test in the control group showed that mental quality (P = 0128), length of the incubation period (P = 1.00),
and before and afterthe intervention did not differ significantly in the mean scores. However, a within‑group
comparison in the intervention group showed that mental quality (P < 0.001), incubation period (P < 0.001),
sleep duration (P < 0.001), sleep efficiency (P < 0.001), sleep disorders (P = 0.003), use of sleeping
pills (P = 0.007), daily functioning (P < 0.001), and overall sleep quality score (P < 0.001) before and after
the intervention had a significant difference in the mean scores.
CONCLUSION: The results showed that auriculotherapy has significant effectiveness in improving the
quality of sleep, and its dimensions and can be used as an effective method in this area that can be
implemented at a low cost and easily. According to reports from participants and previous studies in this
field, auriculotherapy did not have any side effects and can be used as a safe way to improve sleep quality.
Keywords
using Salvia officinalis on sleep quality of postmenopausal
women. Iran J Obstet Gynecol Infertil 2020;23:50‑7.
2. Zarei J, Pourhosein R, Tarafdari A, Habibi Askarabad M,
Babakhani M. Development and evaluation of a bio‑psychological
model of sexual health for menopausal women: A mediating role
of cultural factors. J Res Psychol Health 2016;10:1‑11.
3. Shakiba M, Rouhbakhsh M, Kermansaravi F, Navidian A. The
effect of couple counseling on severity of menopausal symptoms
in women. Hayat 2019;25:25‑38.
4. Alirezaei S, Safaei M, Rajabzadeh S. The Relationship Between
Sexual Performance and Attitude Toward Menopause in
Postmenopausal Women Referred to Health Centers Of Torbat
Heydariyeh in 2017. Salmand: Iranian Journal of Ageing
2020;14:510-9.
5. Bahri N, Afiat M, Aghamohamadian H, Delshad
Noughabi A, Bahri N. Investigating the relationship between
severity of menopausal symptoms and depression, anxiety
and other menopausal symptoms. Iran J Obstet Gynecol Inferti
2013;16:14‑20.
6. Elvsky S, MaAuley E. Personality, menopausal symptoms, and
physical activity outcomes in middle‑aged women. Pers Individ
Dif 2009;46:123‑8.
7. JahanfarSh, RamezaniTehrani F, Hashemi SM. Early complications
of menopause among women in Tehran. J Reprod Infertil
2002;3:31‑40.
8. Ebrahimi M. Taghizadeh M. The effect of soy protein on
menopausal symptoms in postmenopausal women Urmia. Hakim
2008;11:16‑20.
9. MohammadiZeidi I, Pakpur Hajji A, MohammadiZeidi B.
Reliability and validity of the Persian version of the
health‑promoting lifestyle questionnaire. J Mazandaran Univ
Med Sci 2012;21:156‑62.
10. Azhari S, Ghorbani M, Esmaeili H. Evaluation of the relationship
between lifestyle and quality of sleep in postmenopausal women.
Iran J Obstet Gynecol Inferti 2014;17:7‑14.
11. Gholami M, Moallem SA, Afshar M, Etemad L, Karimi G.
Gestational exposure to silymarin increases susceptibility of
BALB/c mice fetuses to apoptosis. Avicenna J Med Biotechnol
2017;9:66‑70.
12. Saeidi R, Tafazoli M, Gholami M, Mazloom R. New treatment for
nipple soreness in breastfeeding mothers: A clinical trial study.
Iran J Neonatol 2015;6:48‑51.
13. Nedrow A, Miller J, Walker M, Nygren P, Huffman LH,
Nelson HD. Complementary and alternative therapies for the
management of menopause‑related‑symptoms: A systematic
evidence review. Arch Intern Med 2002;122:1141‑24.
14. Gooneratne NS. Complementary and alternative medicine for
sleep disturbances in older adults. Clin Geriatr Med 1002;12:111‑2.
15. Taibi DM, Landis CA, Petry H, Vitiello MV. A systematic review
of valerian as a sleep aid: Safe but not effective. Sleep Med Rev
1007;11:102‑10.
16. Baldo TD, Schneider MK, Slyter M. The impact of menopause:
Implications for mental health counselors. J Ment Health Couns
2003;25:311.
17. RossouwJE, AndersonGL, PrenticeRL, LaCroixAZ, KooperbergC,
Stefanick ML, et al. Risks and benefits of estrogen plus progestin
in healthy postmenopausal women: Principal results From the
Women’s Health Initiative randomized controlled trial. JAMA
2002;288:321‑33.
18. Glass J, Lanctôt KL, Herrmann N, Sproule BA, Busto UE. Sedative
hypnotics in older people with insomnia: Meta‑analysis of risks
and benefits. BMJ 2005;331:1169.
19. Vieira A, Reis AM, Matos LC, Machado J, Moreira A. Does
auriculotherapy have therapeutic effectiveness? An overview of
systematic reviews. Complement Ther Clin Pract 2018;33:61‑70.
20. Graça BC, Nascimento VF, Felipe RN, Andrade AC, Atanaka M,
Terças‑Trettel AC. Use of auriculotherapy to control of low back
pain, anxiety and stress of professionals of the correctional system.
BrJP 2020;3:142‑6.
21. Iranian Herbal Medicine Society‑Hop 2012. Available
from: http://ihms.ir/herb/74‑bin hop‑vine
‑hop.html. [Last accessed on 2012 May 12].
22. Bernardo‑Filho M, de Sá‑Caputo DdC, Marin PJ, Chang S. The
mechanism of auriculotherapy: A case report based on the fractal
structure of meridian system. Afr J Tradit Complement Altern
Med 2014;11:30‑7.
23. Cha NH, Park YK, Sok SR. Effects of auriculo acupressure
therapy on stress and sleep disturbance of middle‑aged women
in South Korea. Holist Nurs Pract 2017;31:102‑9.
24. Baccetti S, Da Fre M, Becorpi A, Faedda M, Guerrera A,
Monechi MV, et al. Acupuncture and traditional Chinese medicine
for hot flushes in menopause: A randomized trial. J Altern
Complement Med 2014;20:550‑7.
25. de Amorim Aroxa FH, de Oliveira Gondim ITG, Santos ELW,
de Sales MdGW, Asano AGC, Asano NMJ. Acupuncture as
adjuvant therapy for sleep disorders in Parkinson’s disease.
J Acupunct Meridian Stud 2017;10:33‑8.
26. Dong G‑J, Di C, Yue D, Zhang J, Wang F‑C. Scalp acupuncture
for sleep disorder induced by pre‑examination anxiety in
undergraduates. World J Acupunct Moxibustion 2018;28:156‑60.
27. Paknahad Z, Tarrahi M, Shaghaghi F, Safinejad H, Asadi L,
Mohebbi‑Dehnavi Z. The role of micronutrients in male and
female fertility: A review study. Iran J Obstet Gynecol Inferti
2021;24:87‑98.
28. Golmakani N, Shaghaghi F, Ahmadi Z, Gholami M, Kamali Z,
Mohebbi‑Dehnavi Z. Investigating the relationship between the
dimensions of mindfulness and maternal attachment to the fetus
during pregnancy. J Educ Health Promot 2021:30;10:433.
29. Morin CM, Bootzin RR, Buysse DJ, Edinger JD, Espie CA,
Lichstein KL. Psychological and behavioral treatment of
insomnia:update of the recent evidence (1998-2004). Sleep
2006;29:1398-414.
30. Chueh KH, Chang CC, Yeh ML. Effects of auriculo acupressure on
sleep quality, anxiety, and depressed mood in RN‑BSN students
with sleep disturbance. J Nurs Res 2018;26:10‑7.
31. Suen LKP, Molassiotis A, Yueng SKW, Yeh CH. Comparison
of magnetic auriculotherapy, laser auriculotherapy and
their combination for treatment of insomnia in the elderly:
A double‑blinded randomised trial. Evid Based Complement
Alternat Med 2019;2019:1‑19. doi: 10.1155/2019/3651268.
32. Salles F, Oliveira J, Cesar I. Evaluation of the Effect of
Auriculotherapy on Pain Control and Sleep Quality in Chronic
Patients 2017;19:2471-4.
33. Avis NE, Legault C, Coeytaux RR, Pian‑Smith M, Shifren JL,
Chen W, et al. A randomized, controlled pilot study of
acupuncture treatment for menopausal hot flashes. Menopause
2008;15:1070‑8.
34. Ozgoli G, Armand M, Heshmat R, alavi majd H. Acupressure
effect on sleep quality in menopausal women. complementary
Medicine Journal. 2012;2 (3):212‑24
35. Mirzaei M, Gholamrezaei E, Bidaki R, Fallahzadeh H, Ravaei J.
Quality of sleep and methods of management of sleep disorders
in elderly of Yazd city in 2016. JSSU 2017;25:467‑75.
36. Akbari S, Bolori B, Hagigi KH. The relationship between sleep
disorders in the last month of pregnancy and delivery in pregnant
women referred to health centers in the city of Saggez. J Ilam Uni
Med Sci 2008;15:816.
37. Bandad R, Abedian Z, Hasanabadi H. Sleep pattern associated
with depression during the third trimester of pregnancy.
J Behboud 2006;9:41‑51.
38. Verlag GT. Ear Acupuncture: A Precise Pocket Atlas Based on
the Works of Nogier/Bahr. Thieme. 2nd ed, NY. 2008. p. 198‑9.
39. Arai YC, Sakakima Y, Kawanishi J, Nishihara M, Ito A,
Tawada Y, et al. Auriculo acupuncture at the “shenmen” and
“point zero” points induced parasympathetic activation.
Evid Based Complement Alternat Med 2013;2013:945063. doi:
10.1155/2013/945063.
40. Lan Y, Wu X, Tan HJ, Wu N, Xing JJ, Wu FS, et al. Auriculo
acupuncture with seed or pellet attachments for primary
insomnia: A systematic review and meta‑analysis. BMC
Complement Alternat Med 2015;15:103.
41. RenR, ZhangJ, ZhangT, PengY, TangC, ZhangQ. Auriculotherapy
for sleep quality in people with primary insomnia: A protocol for
a systematic review and meta‑analysis. Medicine (Baltimore)
2019;98:e14621.
42. Pourmohammadi M, Tagharrobi Z, Sharifi K, Sooki Z,
Zare Joshaghani F. Effect of auriculotherapy on sleep quality in
elderly with chronic low back pain: A single‑blind randomized
clinical trial. CMJA 2021;10:308‑27.
43. GarnerBK, HopkinsonSG, KetzAK, LandisCA, TregoLL. Auriculo
acupuncture for chronic pain and insomnia: A randomized clinical
trial. Med Acupunct 2018;30:262‑72.
44. Yeh CH, Suen LKP, Shen J, Chien LC, Liang Z, Glick RM, et al.
Changes in sleep with auriculo point acupressure for chronic low
back pain. Behav Sleep Med 2016;14:279‑94.
45. Suen LKP, Molassiotis A, Yeh CH, Yeung SKW. Auriculotherapy
for insomnia in elderly people: A 6 week, double‑blinded,
randomised pilot study. Lancet 2017;390:S58.
46. Wu Y, Zou C, Liu X, Wu X, Lin Q. Auricular acupressure helps
improve sleep quality for severe insomnia in maintenance
hemodialysis patients: A pilot study. J Alternat Complement Med
2014;20:356‑63.
47. Wang Y, Zhang J, Jin Y, Zhang Q. Auriculo acupressure therapy
for patients with cancer with sleep disturbance: A systematic
review and meta‑analysis. Evid Based Complement Alternat Med
2021;2021:3996101. doi: 10.1155/2021/3996101.
48. Huang J, Shen M, Qin X, Huang Y. Effectiveness of auriculo
acupuncture for insomnia: An overview of systematic reviews.
Evid Based Complement Alternat Med 2020;2020:6920902. doi:
10.1155/2020/6920902.
49. Yoon HG, Park H. The effect of auriculo acupressure on sleep in
breast cancer patients undergoing chemotherapy: A single‑blind,
randomized controlled trial. Appl Nurs Res 2019;48:45‑51.
50. Wang LW, Cheng Z, Sun L. Ear acupressure, heart rate,
and heart rate variability in patients with insomnia. Evid
Based Complement Alternat Med 2013;2013:4. 763631. doi:
10.1155/2013/763631.
51. Cheung MC, Chan AS, Yip J. Microcurrent stimulation at shenmen
acupoint facilitates EEG associated with sleepiness and positive
mood: A randomized controlled electrophysiological study.
Evid Based Complement Alternat Med 2015;2015:182837. doi:
10.1155/2015/182837.
52. Spence DW, Kayumov L, Chen A. Acupuncture increases
nocturnal melatonin secretion and reduces insomnia and
anxiety: A preliminary report. J Neuropsychiatry Clin Neurosci
2004;16:19‑28.
53. Yeh CH, Chien LC, Lin WC, Bovbjerg DH, Van Londen GJ. Pilot
randomized controlled trial of auriculo point acupressure to
manage symptom clusters of pain, fatigue, and disturbed sleep
in breast cancer patients. Cancer Nursg 2016;39:402‑10.
54. Chung K, Yeung WF, Zhang S, Zhang Z, Wong M, Lee W, et al.
Acupuncture for persistent insomnia associated with major
depressive disorder: A randomised controlled trial. Hong Kong
Med J 2016;22(Suppl 2):S9‑14.
)