Effects of auricular acupressure on polysomnography-assessed sleep, blood glucose, and stress in elderly patients with type 2 diabetes and insomnia: a randomized controlled trial

Abstract

Objective Elderly patients with type 2 diabetes frequently experience stress and sleep disorders, leading to poor glycemic control. Auricular acupressure, a non-pharmacological intervention, shows potential for improving blood glucose and sleep quality. This study aimed to comprehensively evaluate the combined effects of auricular acupressure on blood glucose, sleep, and stress, using objective measures. Methods A randomized, single-blind, sham-controlled trial included 44 elderly individuals (65-85 years old) with type 2 diabetes and insomnia (PSQI >= 5). Participants were randomly assigned to an intervention or sham control group. The 8-week intervention involved specific therapeutic ear points. Sleep quality was assessed subjectively (PSQI) and objectively (polysomnography); postprandial blood glucose, weekly; and stress levels, via questionnaires (PSS, DASS-21) and brainwave analysis (EEG). Data underwent statistical analysis. Results The intervention group demonstrated significant improvements in objective sleep measures. Specifically, deep sleep duration (SWS) significantly increased by 12.64% (|t|=2.585,p = 0.001), and sleep efficiency (SE) showed significant differences (|t|=2.354,p = 0.019). Postprandial blood glucose levels significantly decreased in the intervention group (F = 4.73,p = 0.032), while increasing in the sham control group. Objective stress indices from EEG also improved, with physical stress decreasing (left brain |t|=4.608,p < 0.001; right brain |t|=5.539,p < 0.001) and stress resistance increasing (left brain |t|=3.696,p < 0.001; right brain |t| =3.771,p < 0.001). However, no significant differences were observed in subjective stress scores between groups. No adverse events were found in either group during the whole study. Conclusion Auricular acupressure is an effective and safe non-pharmacological intervention for improving objective sleep quality, lowering postprandial blood glucose, and reducing physiological stress in elderly patients with type 2 diabetes and insomnia. Clinical Trial Registration https://cris.nih.go.kr/cris/search/detailSearch.do?seq=27425&search_page=M&search_lang=&class_yn=, identifier KCT0009524.