Comparing the Effects of Acupressure and Clonazepam Tablets on Sleep Quality of Hemodialysis Patients: A Randomized Controlled Trial
Abstract
Objective: The current study aimed to compare the impact of acupressure and clonazepam tablets on the quality of sleep in hemodialysis patients in light of the rising prevalence of chronic kidney disease (CKD), the high prevalence of sleep disturbance in these patients, and the side effects of hypnotic drugs.
Method: A total of 60 patients were selected for this randomized, controlled clinical trial and randomly assigned to two groups. For two weeks during the researcher's evening shift, one group received acupressure (six spots bilaterally for three minutes each day). The opposing group was administered clonazepam tablets (0.5 mg) for two weeks. The Pittsburgh Sleep Quality Index (PSQI), which measures sleep quality, was used to compare sleep in the two groups before and after the intervention.
Results: There was no statistically significant difference between the two groups prior to the intervention (P = 0.75) in terms of the mean pre-intervention PSQI scores for the acupressure and clonazepam groups, which were 15.83 ± 1.51 and 16.17 ± 0.91, respectively. However, the average PSQI scores after the intervention in the clonazepam and acupressure groups were 13.25 ± 2.88 and 8.97 ± 4.29, respectively, indicating a statistically significant difference (P < 0.0001). Both the acupressure and the clonazepam groups showed improvements in their post-intervention sleep quality among the patients. However, when the percentage changed in the mean scores of the total score and all of the PSQI components were calculated for each group, it became clear that acupressure was more effective at enhancing sleep than clonazepam tablets.
Conclusion: The findings of the present investigation demonstrate that acupressure has a greater impact on patients’ sleep quality compared to clonazepam tablets. Depending on the circumstances, acupressure can be used as a simple, safe, and non-drug way to enhance hemodialysis patients' quality of sleep.
Tayebi A, Kasra Dehkordi A, Ebadi A, Sahraei H, Einollahi B. The effect of aromatherapy with lavender essential oil on depression, anxiety and stress in hemodialysis patients: A clinical trial. Evid. Based Care J. 2015;5(2):65-74.
Kanani M, Mazloum S, Emami A, Mokhber N. The effect of aromatherapy with orange essential oils on anxiety in patients undergoing hemodialysis. JSUMS. 2012;19(13):249-257).
Hydarinia Naieni Z, Nobahar M, Ghorbani R. The relationship between sleep quality in patients' undergoing hemodialysis at different therapeutic'shifts. Koomesh. 2016;18(1):42-50.
Einollahi B, Motalebi M, Rostami Z, Nemati E, Salesi M. Sleep quality among Iranian hemodialysis patients: a multicenter study. Nephrourol Mon. 2015;7(1):e23849.
Zarurati M, Pishgooie SAH. The effect of music therapy on comfort level and some vital signs of patients undergoing hemodialysismodialysis. Mil Caring Sci. 2017;3(4):221-32.
Arzhangi R, Ghasemi S, Mohammadi S, Norouzi M, Norouzi K. Investigating the relationship between health literacy and quality of life on hemodialysis patients in selected medical centers under the auspices of Ardabil University of Medical Sciences. IJRN. 2022;8(2):21-31.
Molaie E, Royani Z, Moujerloo M, Behnampour N, Golage J, Khari M. Anxiety, depression and quality of sleep related to fatigue in patients undergoing hemodialysis. J Res Dev Nurs Midw. 2014;11(1):99-107.
Zheng C, Xu J, Chen C, Lin F, Shao R, Lin Z, et al. Effects of sleep disorders and sedative-hypnotic medications on health-related quality of life in dialysis patients. Int Urol Nephrol. 2019;51(1):163-74.
Najafi Z, Tagharrobi Z, Shahriyari-Kale-Masihi M. Effect of aromatherapy with Lavender on sleep quality among patients undergoing hemodialysis. KAUMS Journal (FEYZ). 2014;18(2):145-50.
Shibata S, Tsutou A, Shiotani H. Relation between sleep quality and daily physical activity in hemodialysis outpatients. Kobe J Med Sci. 2014;59(5):E161-6.
Mirghaed MT, Sepehrian R, Rakhshan A, Gorji H. Sleep Quality in Iranian Hemodialysis Patients: A Systematic Review and Meta-analysis. Iran J Nurs Midwifery Res. 2019;24(6):403-9.
vatandoost s, Mohammadi H, nouri b, mohammadi bolbanabad a, zamani p. Relation between dialysis adequacy and sleep quality in hemodialysis patients. The J Urmia Nurs Midwifery Fac. 2018;16(1):30-7.
Soleimani M, Asgari M, Imani A, Tammadon M. The effect of cool temperature dialysate on sleep quality in hemodialysis patients. J Adv Med Biomed Res. 2017;25(111):128-38.
Mahmoud MM, AboZead SE, Mohammad WH, El-all A, Abd ElRazik H. Assessment Quality of Sleep in Patients undergoing Hemodialysis. Assiut sci nurs j. 2019;7(17):74-80.
Wu Y, Yang L, Li L, Wu X, Zhong Z, He Z, et al. Auricular acupressure for insomnia in hemodialysis patients: study protocol for a randomized controlled trial. Trials. 2018;19(1):171.
Shen K, Cho Y, Pascoe EM, Hawley CM, Oliver V, Hughes KM, et al. The SIESTA Trial: A Randomized Study Investigating the Efficacy, Safety, and Tolerability of Acupressure versus Sham Therapy for Improving Sleep Quality in Patients with End-Stage Kidney Disease on Hemodialysis. Evid Based Complement Alternat Med. 2017;2017:7570352.
Arache W, Laboudi F, Ouanass A, el kabbaj D. Poor quality of sleep in patients on chronic hemodialysis. Ibnosina J Med Biomed Sci. 2019;11(1):20 - 4.
Kasra Dehkordi A, Ebadi A, Sahraei H, Einollahi B. Effects of aromatherapy with lavender on sleep quality of hemodialysis patients (A Clinical Trial). Nurs midwifery res j. 2016;13(11):995-1003.
Arab Z, Shariati A, Bahrami H, Asayesh H, Vakili M. The effect of acupressure on quality of sleep in hemodialysis patients. The J Urmia Nurs Midwifery Fac. 2012;10(2);237-45.
Dashti-Khavidaki S, Chamani N, Khalili H, Hajhossein Talasaz A, Ahmadi F, Lessan-Pezeshki M, et al. Comparing effects of clonazepam and zolpidem on sleep quality of patients on maintenance hemodialysis. Iran J Kidney Dis. 2011;5(6):404-9.
Kamrani F, Nazari M, Sahebalzamani M, Amin G, Farajzadeh M. Effect of aromatherapy with lemon essential oil on anxiety after orthopedic surgery. Iran Rehabil J. 2016;2(4):26-31.
Wang X, Gu J, Liu J, Hong H. Clinical evidence for acupressure with the improvement of sleep disorders in hemodialysis patients: A systematic review and meta-analysis. Complement Ther Clin Pract. 2020;39:101151.
Rehman IU, Wu DB, Ahmed R, Khan NA, Rahman AU, Munib S, et al. A randomized controlled trial for effectiveness of zolpidem versus acupressure on sleep in hemodialysis patients having chronic kidney disease-associated pruritus. Medicine (Baltimore). 2018;97(31):e10764.
Shahdadi H, Allah-yari J, Mansouri A. Effect of acupressure on sleep quality in patients with diabetes mellitus. J Diabetes Nurs. 2017;5(2):78-85.
Shafiee-Darabi S-M, Khankeh H, Fallahi-Khoshknab M, Soltani P-R. Effect of acupressure on pain and fatigue in people with chronic heart failure. J Cardiovasc Nurs. 2015;3(4):14-22.
Emamverdi M, Mohammadpour A, Badiee Aval S, Sajjadi M. Comparing the effects of reflexology massage and acupressure on the quality of sleep in hemodialysis patients: A randomized clinical trial. J Maz Univ Med. 2019;29(176):34-46.
Aslani MA, Hanifi N, Ahmadi F, Fallah R. Effect of Acupressure on Amount of Gastric Emptying in Mechanically Ventilated Patients Hospitalized in Intensive Care Units. Hayat. 2014;20(2):69-81.
Dincer B, İnangil D, İnangil G, Bahçecik N, Ayaz EY, Arslanoğlu A, et al. The effect of acupressure on sleep quality of older people: A systematic review and meta-analysis of randomized controlled trials. Explore (NY). 2022;18(6):635-45.
Nasiri E, Raei M, Vatani J, Khajeh-Kazemi R. The effect of acupressure on sleep quality in hemodialysis patients. Shahroud University of Medical Sciences,Iran. 2011;11(5):236-40.
Folstein M. A practical method for grading the cognitive state of patients for the children. J Psychiatr Res. 1975;12:189-98.
Mitchell AJ. A meta-analysis of the accuracy of the mini-mental state examination in the detection of dementia and mild cognitive impairment. J Psychiatr Res. 2009;43(4):411-31.
Mitchell AJ, Malladi S. Screening and case finding tools for the detection of dementia. Part I: evidence-based meta-analysis of multidomain tests. Am J Geriatr Psychiatry. 2010;18(9):759-82.
Stephan BC, Matthews FE, McKeith IG, Bond J, Brayne C. Early cognitive change in the general population: how do different definitions work? J Am Geriatr Soc. 2007;55(10):1534-40.
Seyedian M, Falah M, Nourouzian M, Nejat S, Delavar A, Ghasemzadeh H. Validity of the Farsi version of mini-mental state examination. J Med Counc Iran. 2008;25(4):408-14.
Gaudreau JD, Gagnon P, Harel F, Tremblay A, Roy MA. Fast, systematic, and continuous delirium assessment in hospitalized patients: the nursing delirium screening scale. J Pain Symptom Manage. 2005;29(4):368-75.
Ghana S, Saeedi S, Sanagoo A. The incidence of delirium in patients after surgery in recovery room. Jorjani Biomed J. 2012;1(1):23-9.
Farrahi J, Nakhaee N, Sheibani V, Garrusi B, Amirkafi A. Psychometric properties of the Persian version of the Pittsburgh Sleep Quality Index addendum for PTSD (PSQI-A). Sleep Breath. 2009;13(3):259-62.
Safa A, Adib-Hajbaghery M, Fazel-Darbandi A. The relationship between sleep quality and quality of life in older adults.IJPN 2015;3(3):53-62.
Farhadi Nasab A, Azimi H. Study of patterns and subjective quality of sleep and their correlation with personality traits among medical students of hamadan university of medical sciences. Avicenna J Clin Med. 2008;15(1):11-5.
Shariati A, Jahani S, Hooshmand M, Khalili N. The effect of acupressure on sleep quality in hemodialysis patients. Complement Ther Med. 2012;20(6):417-23.
Aygin D, Şen S. Acupressure on Anxiety and Sleep Quality After Cardiac Surgery: A Randomized Controlled Trial. J Perianesth Nurs. 2019;34(6):1222-31.
Jokar A, Zynali F, Akbarzade M, Zare N. Comparison of the effects of acupressure at Yong Quan (KI-1) and Hegu (LI-4) acupoints on hot flashes in menopaus: clinical trial. J Adv Med Biomed Res. 2017;25(108):1-10.
Adib-Hajbaghery M, Etri M, Hosseinian M. The effect of acupressure on the Pericardium 6 point on pain, nausea and vomiting after appendectomy. J. Complement. Med. 2012;2(2):171-82.
Akbarzadeh R, koushan M, Rakhshani M, Hashemi NS. Effect of the benson relaxation technique on quality of sleep in patients with chronic heart disease. Quarterly Journal of Sabzevar University of Medical Sciences. 2014;21(3):492-500.
Yeung WF, Ho FYY, Chung KF, Zhang ZJ, Yu BYM, Suen LKP, et al. Self‐administered acupressure for insomnia disorder: a pilot randomized controlled trial. J Sleep Res. 2018;27(2):220-31.
Rueff-Barroso CR, Delpupo FVB, Fazan VPS, Nascimento SRR, Nunes LF, Montenegro RN, et al. Clinical and anatomical aspects of anterior dislocation of the pisiform bone. J Morphol Sci. 2019;36(2):134-7.
Kilduff TS, Mendelson WB, editors. Chapter 41 – Hypnotic Medications: Mechanisms of Action and Pharmacologic Effects2017.
Arun R, Venkateshan M. Effectiveness of Acupressure on Quality of Sleep of Hemodialysis Patients. Int J Nurs Educ. 2019;11(1).
Files | ||
Issue | Vol 18 No 4 (2023) | |
Section | Original Article(s) | |
DOI | https://doi.org/10.18502/ijps.v18i4.13632 | |
Keywords | ||
Acupressure Clonazepam Hemodialysis Renal Dialysis Sleep Quality |
Rights and permissions | |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |