Therapeutic Efficacy Observation on Combined Aerobic Exercise with Auricular Point Sticking for Insomnia in College Students

1 Xiasha Health Center, Zhejiang Economic and Trade Polytechnic, Hangzhou 310018, China

2 Tongde Hospital of Zhejiang Province, Hangzhou 310012, China

CLINICAL STUDY

Therapeutic Efficacy Observation on Combined Aerobic Exercise with Auricular Point Sticking for Insomnia in College Students

Chen Hong-lei1, Song Qing2

1 Xiasha Health Center, Zhejiang Economic and Trade Polytechnic, Hangzhou 310018, China

2 Tongde Hospital of Zhejiang Province, Hangzhou 310012, China

Author: Chen Hong-lei, attending physician.

E-mail: pharmac2010@163.com

Objective: To observe the clinical efficacy of aerobic exercise combined with auricular point sticking for insomnia in college students.

Methods: A total of 128 cases from Zhejiang Economic and Trade Polytechnic were randomly allocated into an observation group and a control group. The 64 cases in the observation group were treated with auricular point sticking plus aerobic exercise, while the 64 cases in the control group were treated with auricular point sticking alone. The clinical efficacies in the two groups were compared after treatment.

Results: The total effective rate in the observation group was 96.9%, versus 70.3% in the control group, showing a statistically significant difference (P＜0.05).

Conclusion: Combining aerobic exercise and auricular point sticking has accurate effect on insomnia in college students and is better than auricular point sticking alone.

Exercise; Auricular Point Sticking; Insomnia; College Students

Today insomnia has become a global public issue. Patients with mild insomnia may experience difficulty falling asleep, difficulty maintaining asleep or frequent awakenings. Patients with severe insomnia cannot sleep throughout the night, coupled with symptoms such as dizziness, poor memory and palpitations[1]. Previous studies have proven that insomnia is very common among college students, not only affecting their academic performance but also leading to anxiety, depression or even suicidal behavior[2]. Sleeping pills can have immediate effect but cannot cure insomnia. Besides, patients can become dependent on these pills. As a non-invasive physical therapy, auricular point sticking is helpful for insomnia and has no adverse reactions[3-4]. This study aims to observe the therapeutic efficacy of aerobic exercise combined with auricular point sticking for insomnia and thus come up with a safe, convenient, effective non-drug therapy.

1 Clinical Materials

1.1 Diagnostic criteria

Patients in both groups were measured using the internationally recognized SPIEGEL scale[5]. This scale includes six items, namely sleep-onset latency, total sleep time, awakening times, sleep quality,dreams and after-sleep feeling. Insomnia can be diagnosed if the score≥12.

Mild insomnia: SPIEGEL score≥12 but＜18.

Moderate insomnia: SPIEGEL score≥18 but＜24.

Severe insomnia: SPIEGEL score≥24.

1.2 Inclusion criteria

Those who met the above diagnostic critera; having typical insomnia symptoms that occur at least twice a week for at least 6 months; male and female college students; agreed to participate in this study.

1.3 Exclusion criteria

Those who didn’t meet the above diagnostic and inclusion criteria; having systemic conditions that affect sleep such as surgery, pain and cough; having taken sleeping pills over the last week; having complications of mental disorders and major acute heart failure or respiratory failure; having a poor compliance.

1.4 General data

A total of 128 cases at Zhejiang Economic and Trade Polytechnic were randomly allocated into an observation group and a control group. Sixty-four cases in the observation group were treated with auricular point sticking plus aerobic exercise, while 64 cases in the control group were treated with auricular point sticking alone. There were no statistically significant differences in gender, age, school year and insomnia severity between the two groups (P＜0.05), indicating that the two groups were comparable (Table 1).

Table 1. Between-group comparison of general data

2 Treatment Methods

2.1 Observation group

2.1.1 Aerobic exercise

Under instructions of the researchers, students were guided to perform fast walking, jogging, ball games and aerobic body-building exercise in indoor stadium on the campus of Zhejiang Economic and Trade Polytechnic. During exercise, the pulse was monitored to control exercise intensity. The intensity is supposed to increase gradually. The target heart rate was determined by Karvonen maximum heart rate (HR) reserve percentage[6].

Target HR ＝ (220 － Age － Resting HR) × 60% ＋ Resting HR.

Students were asked to warm up 3-5 min before aerobic exercise and then gradually increase the intensity to the target heart rate. Then exercise for 30 min for one or multiple times. The interval time was not calculated.

The aerobic exercises began 7 pm from Monday to Friday and lasted 45-60 min, 5 d made up one treatment course, for a total of 4 courses. There was a 2-day interval between two courses.

2.1.2 Auricular point sticking

Points: Shenmen (TF4), Sympathetic (AH6a), Heart (CO15), Liver (CO12), Kidney (CO10) and Central Rim (AT2,3,4i).

Method: UseWang Bu Liu Xing(Semen Vaccariae) for auricular points sticking. Press once a day, 30-60 s for each point and change once a day. Two ears were treated alternately. Five days constituted one treatment course. There was a 2-day interval between two courses. Patients were treated for 4 courses.

2.2 Control group

Auricular point sticking alone was employed for patients in the control group, using the same points, method and treatment courses as the observation group.

3 Treatment Results

3.1 Therapeutic efficacy criteria

This was made according to the therapeutic efficacy criteria for insomnia in theCriteria for Treatment Effect Evaluation of Mental Disorders[7].

Recovery: Patients restore normal sleep or have more than 6-hour sound refresh sleep.

Marked effect: Patients have better sleep quality and the sleep time is increased by over 3 h.

Improvement: The sleep time is increased by less than 3 h.

Failure: Insomnia remains unchanged or becomes worse.

3.2 Statistical method

The SPSS 17.0 version software was used for statistical analysis,t-test andZ-test for measurement data and numeration data,for expression of measurement data and percentage for expression of numeration data. APvalue of ＜0.05 indicates a statistical significance.

3.3 Results

3.3.1 Between-group comparison of therapeutic efficacy

The total effective rate in the observation group was 96.9%, versus 70.3% in the control group, showing a statistically significant difference (P＜0.05), (Table 2).

3.3.2 Between-group comparison of SPIEGEL scores before and after treatment

Intra-groupt-test has shown that the SPIEGEL scores in both the control group and the observation group were significantly decreased (P＜0.05,P＜0.01), indicating that both methods are effective. Before treatment, there were no between-group statistical significances in SPIEGEL scores (P＞0.05). After treatment, the SPIEGEL score in the observation group was significantly lower than that in the control group (P＜0.05). Also, there was a statistical significance in the difference value of SPIEGEL score between the two groups (P＜0.05), indicating a better effect in the observation group than that in the control group (Table 3).

Table 2. Between-group comparison of therapeutic efficacy (case)

Table 3. Between-group comparison of SPIEGEL scores before and after treatment (point)

Table 3. Between-group comparison of SPIEGEL scores before and after treatment (point)

Note: Intra-group comparison before and after treatment, 1) P＜0.01, 2) P＜0.05; compared with control group, 3) P＜0.05

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4 Discussion

Clinically, sleeping pills are often prescribed for insomnia patients. Despite their immediate effects, patients may become dependent on these pills. What’s more, they cannot cure insomnia and may affect students’ life and study. We’ve designed a non-drug intervention for insomnia among college students. Results have shown that the total effective rate of the observation group was significantly higher than that of the control group. This has indicated that aerobic exercise combined with auricular point sticking could work accurately for insomnia among college students and showed a better effect than auricular point sticking alone.

As an invasive physical therapy, auricular point sticking is effective for insomnia and has no side effects[3-4]. According to Chinese medicine, all twelve regular meridians gather at the ears. As a result, stimulating specific ear points can activate meridians and harmonize yin and yang. Shenmen (TF4), sympathetic (AH6a), Heart (CO15), Liver (CO12), Kidney (CO10) and Central Rim (AT2,3,4i) were employed in this study to tranquilize the mind and improve the sleep quality. As a fire organ, the heart houses the mind. As a water organ, the kidney stores essence. Coordination between the heart and kidney guarantees a peaceful mind. In five-element theory, the liver is wood and wood produces fire, tonifying the liver can benefit the heart. Heart (CO15), Central Rim (AT2,3,4i), Liver (CO12) and Kidney (CO10) were used to tonify the heart and spleen and coordinate the heart and kidney[8-11].

Aerobic exercise refers to the use of oxygen to adequately meet energy demands during exercise via aerobic metabolism. With its relatively low intensity, rhythm and an extended period of time, aerobic exercise has been proven to be helpful for anxiety and depression in college students[6]. Directly or indirectly controlled by the nervous system, aerobic exercise can effectively increase blood flow to the brain, regulate the cerebral cortex and balance excitation and inhibition. Through appropriate aerobic exercise, people may feel tired and fall asleep quickly[12]. The aerobic exercise in this study was performed around 7 pm from Monday to Friday. Because of its convenience and moderate intensity, the aerobic exercise in this study was easily accepted by students.

In summary, combined auricular point sticking and aerobic exercise in this study obtained a significantly better effect than auricular point sticking alone and avoided the side effects of sleeping pills. This safe, convenient and effect non-drug intervention works well for insomnia among college students and therefore deserves further study and application.

Conflict of Interest

The authors declare that there is no potential conflict of interest.

Acknowledgments

This work was supported by Zhejiang Economic and Trade Polytechnic.

Statement of Informed Consent

All of the patients in the study signed the informed consent.

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Translator:Han Chou-ping

R245.32

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Date:December 5, 2013