Objective

2

To observe the effects of electroacupuncture (EA) on sleep quality

cognitive function

sleep process and structure

as well as cerebral hemodynamics in elderly patients with maintenance hemodialysis (MHD).

Methods

2

Sixty elderly MHD patients were randomized into an EA group (30 cases) and a sham acupuncture group (30 cases). EA was applied at Sishencong (EX-HN1) in the EA group

with continuous wave

in frequency of 2 Hz and in current of 1 mA. Sham acupuncture was applied at distal non-meridian and non-acupoint points in the sham acupuncture group

same EA parameters were given

and the electrical stimulation was stopped after 30 seconds. Both groups were intervened for 30 min per session

once daily

5 days per week

for a total of 4 weeks. Before and after treatment

the scores of Pittsburgh sleep quality index (PSQI)

insomnia severity index (ISI)

Montreal cognitive assessment-basic (MoCA-B)

mini-mental state examination (MMSE) were observed

and the incidence of sleep disorders was calculated based on PSQI score; the indexes of sleep process (sleep onset latency [SOL]

total sleep time [TST]

sleep efficiency [SE]) and sleep structure (percentages of stage 1 sleep [N1]

stage 2 sleep [N2]

stage 3 sleep [N3] and rapid eye movement sleep [REM] in TST) were observed by polysomnography system; and the cerebral hemodynamic indexes (mean blood flow velocity [Vm] of middle artery

regional cerebral blood flow [rCBF] and regional cerebral blood volume [rCBV]) were detected by transcranial Doppler ultrasound in the two groups.

Results

2

After treatment

the PSQI score

incidence of sleep disorders and ISI score in the EA group were decreased (

P

<

0.05)

while the scores of MoCA-B and MMSE were increased compared with those before treatment (

P

<

0.05); in the EA group

the PSQI score

incidence of sleep disorders and ISI score were lower

while the scores of MoCA-B and MMSE were higher than those in the sham acupuncture group (

P

<

0.001). Compared before treatment

SOL was shortened

TST was prolonged

the percentage of N1 in TST was decreased

the percentages of N2

N3 and REM in TST were increased

and SE was improved in the EA group after treatment (

P

<

0.05); after treatment

all indexes of sleep process and structure in the EA group were superior to those in the sham acupuncture group (

P

<

0.001

P

<

0.01). After treatment

the Vm of middle artery

rCBF and rCBV in the EA group were increased compared with those before treatment (

P

<

0.05); the Vm of middle artery

rCBF and rCBV in the EA group were higher than those in the sham acupuncture group (

P

<

0.001).

Conclusion

2

EA can regulate sleep process and structure

and improve sleep quality and cognitive function in elderly MHD patients

which may be related to the improvement of cerebral hemodynamics.