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Comparative effectiveness of electro-acupuncture versus gabapentin for sleep disturbances in breast cancer survivors with hot flashes: a randomized trial

Garland, Sheila N. PhD1,2; Xie, Sharon X. PhD3; Li, Qing MSc4; Seluzicki, Christina MA5; Basal, Coby BSc4; Mao, Jun J. MD, MSCE5

doi: 10.1097/GME.0000000000000779
Original Articles

Objective: Sleep disturbance is a major consequence of hot flashes among breast cancer survivors. This study evaluated the effects of electro-acupuncture (EA) versus gabapentin (GP) for sleep disturbances among breast cancer survivors experiencing daily hot flashes.

Methods: We analyzed data from a randomized controlled trial involving 58 breast cancer survivors experiencing bothersome hot flashes at least two times per day. Participants were randomly assigned to receive 8 weeks of EA or daily GP (total dose of 900 mg/d). The primary outcome was change in the total Pittsburgh Sleep Quality Index (PSQI) score between groups at week 8. Secondary outcomes include specific PSQI domains.

Results: By the end of treatment at week 8, the mean reduction in PSQI total score was significantly greater in the EA group than the GP group (−2.6 vs −0.8, P = 0.044). The EA also had improved sleep latency (−0.5 vs 0.1, P = 0.041) and sleep efficiency (−0.6 vs 0.0, P = 0.05) compared with the GP group. By week 8, the EA group had improved sleep duration, less sleep disturbance, shorter sleep latency, decreased daytime dysfunction, improved sleep efficiency, and better sleep quality (P < 0.05 for all) compared with baseline, whereas the GP group improved in duration and sleep quality only (P < 0.05).

Conclusions: Among women experiencing hot flashes, the effects of EA are comparable with GP for improving sleep quality, specifically in the areas of sleep latency and efficiency. Larger randomized controlled trials with longer follow-ups are needed to confirm this preliminary finding.

1Department of Psychology

2Division of Oncology, Memorial University, St. John's, Newfoundland, Canada

3Department of Biostatistics and Epidemiology

4Department of Family Medicine and Community Health, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA

5Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY.

Address correspondence to: Jun J. Mao, MD, MSCE, Memorial Sloan Kettering Cancer Center, The Bendheim Center for Integrative Medicine, 1429 First Avenue, New York, NY 10021. E-mail:

Received 10 June, 2016

Revised 7 September, 2016

Accepted 7 September, 2016

Q.L., C.S., and J.J.M. conceived of the study and participated in its design and coordination. S.N.G., S.X.X., Q.L., C.B., and J.J.M. performed the statistical analyses and interpretation. S.N.G., C.S., and J.J.M. drafted the manuscript. All authors read and approved the final manuscript. S.N.G. and J.J.M. are responsible for the overall content.

Funding/support: J.J.M. is a recipient of the NCCAM K23 AT004112 award. This manuscript is also supported in part by a grant from the National Institutes of Health/National Cancer Institute Cancer Center (P30 CA008748).

Clinical trial registration: NCT01005108.

Financial disclosure/conflicts of interest: None reported.

© 2017 by The North American Menopause Society.