Investigator(s)
| Submitter |
Kezang Tshering FoTM, KGUMSB Kezang Tshering 
|
| Principal Investigator |
Kezang Tshering FoTM, KGUMSB Kezang Tshering
|
Title(s) and abstract
| Scientific title | Acupuncture and Hot Oil Compression Therapy in Treating Insomnia Associated with Loong (Wind) Disorder among Older Adults in Bhutan: An Observational Cohort Study. |
| Public title | Acupuncture and Hot Oil Compression Therapy in Treating Insomnia Associated with Loong (Wind) Disorder among Older Adults in Bhutan: An Observational Cohort Study. |
| Background | World Health Organization defines insomnia as taking longer than 30 minutes to fall asleep, unintentional awakening during the night, lasting more than 30 minutes, and less than 6.5 hours of total sleep( WHO 1993). The causative factors include disorders like depression, anxiety, withdrawal symptoms, and alcohol problems( Espie, Kyle, Hanus & Cape 2024). Symptoms include daytime sleepiness, irritability, depression and anxiety, gastrointestinal problems, cognitive dysfunction, sleep anxiety, using medication as an intervention, difficulty in socializing, and keeping up with daily work Insomnia affects one-third of the total population of the world( Wade, 2010). In America, nearly 70 million people, 40% of Chinese adults, 30% of Indian adults, and 56.1-61.1% of Nepalese, suffer from some sort of insomnia. Occurs more in adults above 60 demographically and more in women. Insomnia is one of the health problems faced by older adults in Bhutan and around the globe (Dorji, 2017). In a recent study conducted among 142 patients reported insomnia cases, 73 were female, and 69 were male. (Dorji, 2017). Adults above 60 are considered wind in nature, according to Sowa Rigpa. Acupuncture has been widely practiced in Bhutan (NTMH) for insomnia associated with wind disorder since its inception in 2014. Hot oil compression therapy is also commonly used in Bhutanese traditional medicine in treating insomnia associated with wind disorders. The demand for both therapies has been on the rise. Therefore, there is a need to conduct a study on the efficacy of acupuncture in comparison with HOC in treating insomnia in elderly people to report the outcome and also act as evidence for future researchers. |
| Objectives | Acupuncture therapy, which is a widely used therapy in TCM, is also practiced in Bhutan and can be availed from the National Traditional Medicine Hospital, Thimphu. Hot Oil Compression has been the best among other available TM therapies in treating insomnia in elderly people. There has been an increasing number of patients with insomnia availing of acupuncture services and hot oil compression therapy services. This study will be the first of its kind in the country and scientific evidence of the effectiveness of acupuncture vs. HOC in treating insomnia in older adults. With the emergence of scientific evidence, it will help in elevating the quality of care. To determine whether acupuncture is more effective than hot oil compression in treating insomnia associated with wind disorder among elderly people in Bhutan. General Objectives include evaluating the efficiency and safety of acupuncture compared to hot oil compression in treating insomnia. |
| Study Methods | This study will be conducted at NTMH from August 2024 to February 2025 with a Sample size of a total of 200 participants(sample size (n) will be 200 (100:100). Sampling Method: A consecutive sampling method will be employed for this study. Research instruments: A structured questionnaire consisting of two parts (Part I & II) will be used in this study. Part I contains information on the demographic profile of the participants and will be collected only before the treatment begins. Part II contains the SleepMed insomnia index to assess insomnia. SleepMed insomnia index contains 10 questions, each item assessed on a 5-point Likert Scale where (0 indicates No problem with my sleep, 1 = Slight problem with my sleep, 2 = Moderate problem with my sleep, 3 = Moderately severe problem with my sleep, 4 = Severe problem with my sleep affecting all parts of my life). Sleep cycle: Sleep tracker, a free app, and user-friendly. This app will be installed on individual participants' phones, and they will be taught how to use it. SleepMed index will be used before the treatment and after the 6th and 14th days of the treatment. Recruitment strategy: The diagnosis will be confirmed by a senior physician of NTMH. Randomization and Follow-up: The participants will be randomly assigned either to the Acupuncture & HOC group or to the HOC group, using the simple randomization technique (100 persons in each group). The treatment group will be sent to the acupuncture for 30 minutes and 5-10 minutes in HOC per day for 6 days. The control group will receive only HOC therapy of 5-10 minutes per session for 6 days. Both groups will be assessed, and a sleep tracker app will also be used to evaluate the outcome. Data entry and analysis will be done using EpiData and SPSS software. |
| Expected outcomes and use of results | I have hypothesized that acupuncture is equal to or more effective in initiating sleep, reducing unintentional awakening, and improving the duration of sleep among elderly people suffering from insomnia with wind disorder than hot oil compression. Aupuncture therapy, which has been in practice at National Traditional Medicine Hospital, Thimphu, since 2014. HOC has been the best among other available TM services to treat insomnia in elderly people, practiced since the 1970s. There has been an increasing number of patients with insomnia availing both therapies. The study will be the first of its kind in the country to explain the outcome of the mentioned therapies for insomnia. To date, patients don't avail of both therapies on the same day as there is no practice trend. If the study proves effective, patients can expect to avail themselves of both therapies on the same day. Therefore, NTMH can adapt a new treatment practice for wind associated insomnia in order adults. |
| Keywords | Acupuncture; Hot oil compression; Traditional Medicine. |
Research Details
| Student research | Yes |
| Institution: Zhejiang Chinese Medical University, Hangzhou, China. | |
| Academic degree: Master | |
| Supervisor of the student(s) | |
| Full Name and title: Dr. Shao Xiaomie Professor, ZCMU Zhejiang, Hangzhou | |
| Email: udkeza@gmail.com | |
| Start Date | 01-Sep-2022 |
| End Date | 01-Jul-2025 |
| Key Implementing Institution | ZCMU, Zhejang, Hangzhou |
| Multi-country research | No |
| Nationwide research | No |
| Bhutan | |
| Research Domain(s) | Non-communicable diseases & Healthy Lifestyles |
| Research field(s) | Other (Traditional Medicine) |
| Involves human subjects | Yes |
| Operational Research | |
| Data Collection | Primary data |
| Proposal reviewed by other Committee | No |