Meta-analysis of ear acupoint therapy to treat sleep disorders in hemodialysis patients

Background:To evaluate the therapeutic effect of auricular therapy on sleep disorders in hemodialysis patients using meta-analysis methods,and to provide evidence-based support for clinical practice.Methods:PubMed,Embase,Cochrane Library,Chinese Biomedical Literature Database,China Journal Full-text Database,Chinese Science and Technology Journal Full-text Database,and Wanfang Resource Database were searched up to February 2023.Randomized controlled trials of auricular therapy for sleep disorders in hemodialysis patients were collected and included in the study.Meta-analysis was performed using RevMan 5.3 software.Results:587 patients from 7 randomized controlled trial studies were included.The auricular therapy group had better sleep conditions than the conventional care group,as evaluated by the Pittsburgh Sleep Quality Index,in terms of total Pittsburgh Sleep Quality Index score(mean difference(MD)=–5.11,95%confidence interval(CI)(–5.25,–4.96),P<0.00001),subjective sleep quality(MD=–0.64,95%CI(–0.72,–0.56),P<0.00001),falling asleep time(MD=–0.37,95%CI(–0.49,–0.26),P<0.00001),sleep time(MD=–0.38,95%CI(0.44,–0.32),P<0.00001),sleep efficiency(MD=–0.15,95%CI(–0.23,–0.07),P<0.0001),sleep disturbances(MD=–0.18,95%CI(–0.28,–0.09),P=0.0002),daytime dysfunction(MD=–0.89,95%CI(–1.18,–0.6),P<0.00001),and hypnotic medication(MD=–0.22,95%CI(–0.4,–0.03),P=0.02).Conclusion:Auricular therapy is an effective method for improving sleep quality in hemodialysis patients,providing evidence-based support for clinical practice.