{"doi":"10.1016/j.sleepx.2025.100158","title":"Effectiveness of acupressure at different ear acupoints on Insomnia: A secondary analysis of a randomized controlled trial","abstract":"Insomnia is highly prevalent among older adults with chronic low back pain (cLBP), contributing to a cycle of heightened pain sensitivity, impaired physical function, and reduced quality of life. Auricular Point Acupressure (APA), a nonpharmacologic intervention for pain, has shown emerging evidence of improving sleep. We compared the effectiveness of targeted APA (T-APA) versus non-targeted APA (NT-APA) on insomnia in older adults with cLBP. This secondary analysis used data from a parent RCT, including 99 adults aged 60 or older with cLBP and clinical insomnia (Insomnia Severity Index [ISI]>7). Participants received four weeks of T-APA or NT-APA. Sleep outcomes (ISI, PROMIS-29 sleep disturbance) and pain outcomes (intensity, interference) were assessed at baseline and post-intervention, with pain examined as a mediator of sleep change. The T-APA (n=45) and NT-APA (n=54) groups had similar baseline characteristics. Both groups showed significant reductions in sleep disturbance, pain interference, and pain intensity (p<0.05). However, only the NT-APA group demonstrated significant improvement in ISI scores (p<0.001, d=0.50). No significant mediation effect of pain on sleep outcomes was found. APA may be an effective nonpharmacologic approach for improving sleep among older adults with cLBP. Unexpectedly, NT-APA showed greater improvements in insomnia compared to T-APA, suggesting mechanisms beyond traditional somatotopic theory. Further research is warranted to confirm these findings and explore the potential of point-specific versus non-specific APA protocols in treating insomnia. NCT03589703 (registration date: May 22, 2018) https://clinicaltrials.gov/ct2/show/record/NCT03589703 • Insomnia is highly prevalent among individuals with chronic low back pain (cLBP). • Existing pharmacological and behavioral interventions for sleep are limited, highlighting the need for more accessible and safer alternatives. • Auricular point acupressure (APA) is a promising, non-invasive, and nonpharmacologic intervention for pain management with emerging evidence to support its potential role in improving sleep. • This secondary analysis provides preliminary evidence that APA may show effectiveness in managing insomnia in older adults with cLBP.","journal":"Sleep Medicine X","year":2025,"id":578040,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9604,"is_data_producer":true,"deposit_databanks":{"ClinicalTrials.gov":["NCT03589703"]},"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":1487738,"name":"Giulia Castelli","orcid":null,"position":1,"is_corresponding":false},{"id":1487391,"name":"Aomei Shen","orcid":"0000-0003-0569-8746","position":2,"is_corresponding":false},{"id":981541,"name":"Junxin Li","orcid":"0000-0001-9798-5456","position":3,"is_corresponding":false},{"id":947908,"name":"Jennifer Kawi","orcid":"0000-0003-3359-1946","position":4,"is_corresponding":false},{"id":330718,"name":"Hulin Wu","orcid":"0000-0002-5809-5407","position":5,"is_corresponding":false},{"id":379506,"name":"Paul J. Christo","orcid":"0000-0001-6488-5272","position":6,"is_corresponding":false},{"id":492540,"name":"Claudia M. Campbell","orcid":"0000-0002-5420-4207","position":7,"is_corresponding":false},{"id":367324,"name":"Johannes Thrul","orcid":"0000-0001-8929-9579","position":8,"is_corresponding":false},{"id":514749,"name":"Constance Johnson","orcid":"0000-0003-3162-3932","position":9,"is_corresponding":false},{"id":379504,"name":"Nada Lukkahatai","orcid":"0000-0003-3820-1812","position":10,"is_corresponding":false},{"id":1287658,"name":"Jingyu Zhang","orcid":"0000-0002-5815-6644","position":0,"is_corresponding":true}],"reference_count":30,"raw_metadata":null,"created_at":"2026-07-19T02:58:16.148027Z","pmid":"41170529","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}