Randomized Controlled Clinical Study on Electroacupuncture Treatment of Hypertension Combined with Insomnia

OBJECTIVE To observe the effect of electroacupuncture on insomnia symptoms and blood pressure levels in patients with hypertension and insomnia.

METHODS A randomized controlled clinical trial was conducted. A total of 60 patients with hypertension and insomnia were enrolled in Jiangsu Province Hospital of Chinese Medicine from December 2021 to December 2022 and randomly divided into a treatment group and a control group at a ratio of 1:1, with 30 cases in each group. During the treatment period, 2 cases dropped out of the control group and 1 case dropped out of the treatment group. Both groups of patients received sleep and hypertension health education and conventional hypertension drug treatment. The treatment group was given electroacupuncture intervention, and the control group was given sham electroacupuncture intervention. The treatment course of both groups was 4 weeks. Before and after treatment, the Pittsburgh Sleep Quality Index (PSQI), Insomnia Severity Index (ISI) scale and portable polysomnography (PPSG) were used to evaluate the changes in sleep quality of the two groups of patients; home blood pressure measurement (HBPM) was adopted to evaluate the changes in blood pressure levels of the two groups of patients. Spearman correlation analysis and linear regression analysis were used to study the relationship between blood pressure levels and PPSG parameters.

RESULTS After treatment, only the sleep onset latency (SOL) and sleep efficiency (SE) of the control group were significantly improved (P < 0.05); the PSQI, ISI scores, morning and night systolic blood pressure (SBP), and diastolic blood pressure (DBP) of the treatment group were significantly reduced (P < 0.01), which was better than that of the control group (P < 0.05, P < 0.01); the sleep parameters of PPSG were significantly improved (P < 0.01), which was better than that of the control group (P < 0.05, P < 0.01). The results of Spearman correlation analysis showed that the morning SBP level of patients before treatment was related to the wake time after sleep onset (WASO) and the number of micro-arousals (MAS). After treatment, the decrease in the morning SBP of patients was related to the reduction of MAS and the shortening of SOL.

CONCLUSION Electroacupuncture can effectively improve the insomnia symptoms and blood pressure levels of patients with hypertension. Its therapeutic mechanism may be related to reducing the number of MAS and improving the degree of sleep fragmentation.