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Feasibility Study of Acupuncture for Reducing Sleep Disturbances and Hot Flashes in Postmenopausal Breast Cancer Survivors

Otte, Julie L. PhD, RN; Carpenter, Janet S. PhD, RN, FAAN; Zhong, Xin MSN, RN; Johnstone, Peter A. S. MD, FACR

doi: 10.1097/NUR.0b013e318229950b
Feature Article

Objectives: The present study was a feasibility study of a tailored acupuncture intervention in postmenopausal breast cancer survivors (BCSs) reporting sleep disturbances and hot flashes. Objectiveswere (1) to describe patterns of acupuncture point use; (2) evaluate outcome expectancy, credibility, and acceptability relative to the intervention; and (3) evaluate patterns of symptom change over time.

Design: This was a single-group, nonrandomized, quasi-experimental 8-week study.

Sample/Setting: Ten BCSs with both sleep disturbances and hot flashes were referred to any of 4 Midwestern community acupuncturists.

Methods: Assessments were done at baseline (weeks 1, 2), during treatment (weeks 3, 4), and after treatment (weeks 5, 8). Acupuncture treatment was tailored to the individual by community acupuncturists and provided as 3 sessions within a 2-week period (weeks 3, 4). Patients wore a wrist actigraph during weeks 1, 2, 3, 4, 5, and 8 and a sternal skin conductance monitor for 24 consecutive hours during weeks 1, 2, 3, 4, 5, and 8. Subjective data were obtained by questionnaire at weeks 1, 2, 3, 4, 5, and 8.

Findings: Women were a mean age of 53 years, with an average 6.75 years since diagnosis. A mean of 10 needles were used per session, with the most common points located in the lung or lung meridian. Breast cancer survivors had high expectancy that acupuncture would decrease their symptoms, believed it was a credible treatment, and felt it an acceptable form of treatment. Three significant patterns of symptom change were noted from baseline: an increase in the number of minutes it took to fall asleep after treatment (from week 5 to 8; P = .04), a decrease in the percentage of time awake after sleep onset from baseline to follow-up 2 (week 8; P = .05), and a decrease in the number of hot flashes from baseline to follow-up 1 (week 5; P = .02).

Implications for Nursing: Findings may be used by clinical nurse specialists to consider recommending acupuncture to improve sleep and reduce hot flashes in BCSs.

Conclusions: Acupuncture treatment seems to be a feasible treatment option for highly motivated BCSs with sleep disturbances and hot flashes but needs to be further evaluated in a larger, randomized, controlled clinical trial.

Author Affiliations: Postdoctoral Fellow and Assistant Professor (Dr Otte), and Professor (Dr Carpenter), Indiana University, Bloomington; Master's Student (Ms Zhong), and Professor and Director (Dr Johnstone), Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis.

Funding was received from the National Institutes of Health (KL2 RR025760) and National Cancer Institute (R25 CA117865).

The authors report no conflicts of interest.

Correspondence: Julie L. Otte, PhD, RN, 1111 Middle Dr, NU 442, Indianapolis, IN 46202 (

© 2011 Lippincott Williams & Wilkins, Inc.