Effects of Circadian-Based Acupressure on Sleep Quality in Nursing Home Residents

NCT07349446 | Not Yet Recruiting DMC

• 4 other identifiers: 001/KEPK/IKI/E2/I/2026NSTC113-2628-B-038-003-MY3NSTC114-2314-B-038-094-MY301/UKKW/LPPM-FKIK/LIT/I/2026
• Study Type: interventional
• Target: 80
• Locations: 1 country
• Sites: 1

Brief Summary

This randomized controlled trial aims to evaluate the effectiveness of circadian-based acupressure compared with sham acupressure in improving sleep quality among nursing home residents. Additionally, the study will examine the effects of the intervention on insomnia severity, heart rate variability, and psychological distress, including depression, anxiety, and stress. A total of 80 older adults aged 60 years and above residing in a nursing home in Jakarta, Indonesia, will be randomly assigned to either the circadian-based acupressure group or the sham acupressure group. Participants in the intervention group will receive circadian-based acupressure twice daily, five days per week for four weeks, with acupoints selected and administered according to circadian meridian activity, while the control group will receive sham acupressure at non-acupuncture points with the same frequency and duration. Outcome measures will be assessed at baseline and immediately post-intervention.

Conditions

Poor Sleep Quality; Anxiety; Depression; Stress; Insomnia

Keywords

poor sleep quality; Insomnia; depression; anxiety; stress

Outcome Measures

Primary Outcomes (1)

• Sleep quality

  Sleep quality was measured using the Pittsburgh Sleep Quality Index (PSQI). The PSQI can be used to assess self- reported sleep quality and sleep disturbance in the preceding month. The scale comprises 19 items and the following seven dimensions: (1) subjective sleep quality, (2) sleep latency, (3) sleep duration, (4) sleep efficiency, (5) sleep disturbance, (6) sleeping medication use, and (7) daytime dysfunction. The items are rated on a four-point Likert scale with endpoints ranging from 0 to 3, and the overall score ranges from 0 to 20. A score of less than five indicates favorable sleep quality. The Indonesian version of the PSQI exhibited high validity and reliability (Cronbach's α = 0.720)

  Baseline (before intervention/0 weeks) and After Intervention (4 weeks)

Secondary Outcomes (3)

• Insomnia

  Baseline (before intervention/0 weeks) and After Intervention (4 weeks)

• Heart Rate Variability

  Baseline (before intervention/0 weeks) and After Intervention (4 weeks)

• Psychological distress

  Baseline (before intervention/0 weeks) and After Intervention (4 weeks)

Study Arms (2)

Circadian-based acupressure

EXPERIMENTAL

Participants in the Circadian-based Acupressure group will receive circadian-based acupressure twice daily, five days a week for four weeks.

Other: Circadian-based acupressure

Sham Acupressure

SHAM COMPARATOR

Sham Acupressure (placebo) group received massage at a non-acupuncture point.

Other: Sham Acupressure

Interventions

Circadian-based acupressure OTHER

Participants in the Circadian-based Acupressure group will receive circadian-based acupressure twice daily, five days a week for four weeks. Acupressure will be administered in the morning one hour after breakfast (at 11am) and in the evening one to two hours before bedtime (at 7 pm). Acupressure was performed by applying consistent fingertip pressure of 3-5 kg, with gentle rotational movements, on the selected acupoints. The selected acupoints were based on our network meta-analysis the most used acupoint: Sanyinjiao (SP6), Shenmen (HT7), Fengchi (GB20), and Neiguan (PC6). The accuracy of the acupressure was confirmed if the participants felt sore, numb, distended, or warm at the point of application. The duration of each session was limited to 3 minutes, with an interval of 5 seconds of pressure followed by a 1-second rest. Acupoints of Sanyinjiao and Shenmen will be apply at 11 am and Neiguan and Fengchi at 7 pm.

Circadian-based acupressure

Sham Acupressure OTHER

Sham Acupressure (placebo) group received massage at a non-acupuncture point, located 10 mm from the actual point, with the same frequency as the experimental group. According to traditional Chinese medicine, manipulation of non-acupuncture points should not elicit a sensation of de qi.

Sham Acupressure

Eligibility Criteria

• Age: 60 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• age ≥60 years
• ability to communicate and complete the questionnaires in Indonesian
• had lived in the nursing home for at least 3 months,
• had a Mini-Mental State Examination score of ≥25, had self-reported PSQI Indonesian version scores of ≥5 (where higher scores indicate worse sleep) over the past 4 weeks,
• agreed to participate in the research

Sponsors & Collaborators

• Taipei Medical University: lead
• Krida Wacana Christian University: collaborator

Study Sites (1)

Jl. Bina Marga No.58 7 6 7, RT.7/RW.5, Cipayung, Kec. Cipayung, Kota Jakarta Timur, Daerah Khusus Ibukota Jakarta 13840

Jakarta, DKI Jakarta, 12840, Indonesia

Location

Related Publications (16)

• Soldatos CR, Dikeos DG, Paparrigopoulos TJ. The diagnostic validity of the Athens Insomnia Scale. J Psychosom Res. 2003 Sep;55(3):263-7. doi: 10.1016/s0022-3999(02)00604-9.

  PMID: 12932801 BACKGROUND

• Soldatos CR, Dikeos DG, Paparrigopoulos TJ. Athens Insomnia Scale: validation of an instrument based on ICD-10 criteria. J Psychosom Res. 2000 Jun;48(6):555-60. doi: 10.1016/s0022-3999(00)00095-7.

  PMID: 11033374 BACKGROUND

• Setyowati A, Chung MH. Validity and reliability of the Indonesian version of the Pittsburgh Sleep Quality Index in adolescents. Int J Nurs Pract. 2021 Oct;27(5):e12856. doi: 10.1111/ijn.12856. Epub 2020 Jul 7.

  PMID: 32632973 BACKGROUND

• Schlaeger JM, Gabzdyl EM, Bussell JL, Takakura N, Yajima H, Takayama M, Wilkie DJ. Acupuncture and Acupressure in Labor. J Midwifery Womens Health. 2017 Jan;62(1):12-28. doi: 10.1111/jmwh.12545. Epub 2016 Dec 21.

  PMID: 28002621 BACKGROUND

• Reza H, Kian N, Pouresmail Z, Masood K, Sadat Seyed Bagher M, Cheraghi MA. The effect of acupressure on quality of sleep in Iranian elderly nursing home residents. Complement Ther Clin Pract. 2010 May;16(2):81-5. doi: 10.1016/j.ctcp.2009.07.003. Epub 2009 Aug 19.

  PMID: 20347838 BACKGROUND

• Raana HN, Fan XN. The effect of acupressure on pain reduction during first stage of labour: A systematic review and meta-analysis. Complement Ther Clin Pract. 2020 May;39:101126. doi: 10.1016/j.ctcp.2020.101126. Epub 2020 Feb 29.

  PMID: 32379664 BACKGROUND

• Geng SH, Liu L, Lin ZM, Zhang H, Mei RG, Liu X, Liu JC, Huang GR, Zhang WC. A review of novel research technology to explore the mystery of traditional Chinese medicine: Terahertz. Medicine (Baltimore). 2023 Nov 17;102(46):e35870. doi: 10.1097/MD.0000000000035870.

  PMID: 37986326 BACKGROUND

• Pangaribuan SM, Wu TY, Herlianita R, Jao YL, Lee HC, Hasan F, Mukminin MA, Chiu HY. Global occurrence rates of sleep disturbances among institutionalized older adults: A systematic review and meta-analysis. Sleep Med Rev. 2025 Jun;81:102091. doi: 10.1016/j.smrv.2025.102091. Epub 2025 Apr 11.

  PMID: 40239318 BACKGROUND

• Luo J, Feng L, Wang L, Fang Z, Lang J, Lang B. Restoring brain health: Electroacupuncture at GB20 and LR3 for migraine mitigation through mitochondrial restoration. Brain Circ. 2024 Jun 26;10(2):154-161. doi: 10.4103/bc.bc_95_23. eCollection 2024 Apr-Jun.

  PMID: 39036293 BACKGROUND

• Li LW, Harris RE, Tsodikov A, Struble L, Murphy SL. Self-Acupressure for Older Adults With Symptomatic Knee Osteoarthritis: A Randomized Controlled Trial. Arthritis Care Res (Hoboken). 2018 Feb;70(2):221-229. doi: 10.1002/acr.23262. Epub 2017 Dec 29.

  PMID: 28437570 BACKGROUND

• Lee WJ, Park H. Effects of auricular acupressure on sleep and pain in elderly people who have osteoarthritis and live in nursing homes: A randomized, single-blind, placebo-controlled trial. Explore (NY). 2023 Mar-Apr;19(2):214-222. doi: 10.1016/j.explore.2022.07.001. Epub 2022 Jul 5.

  PMID: 35835645 BACKGROUND

• Lee IS, Ryu Y, Chae Y. Oversimplifying the name of the 12 meridian channels. Integr Med Res. 2023 Dec;12(4):101002. doi: 10.1016/j.imr.2023.101002. Epub 2023 Oct 21. No abstract available.

  PMID: 37953755 BACKGROUND

• Lai FC, Chen IH, Chen PJ, Chen IJ, Chien HW, Yuan CF. Acupressure, Sleep, and Quality of Life in Institutionalized Older Adults: A Randomized Controlled Trial. J Am Geriatr Soc. 2017 May;65(5):e103-e108. doi: 10.1111/jgs.14729. Epub 2017 Feb 2.

  PMID: 28152177 BACKGROUND

• Hmwe NT, Subramanian P, Tan LP, Chong WK. The effects of acupressure on depression, anxiety and stress in patients with hemodialysis: a randomized controlled trial. Int J Nurs Stud. 2015 Feb;52(2):509-18. doi: 10.1016/j.ijnurstu.2014.11.002. Epub 2014 Nov 11.

  PMID: 25468282 BACKGROUND

• Hmwe NTT, Browne G, Mollart L, Allanson V, Chan SW. Acupressure to improve sleep quality of older people in residential aged care: a randomised controlled trial protocol. Trials. 2020 Apr 25;21(1):360. doi: 10.1186/s13063-020-04286-2.

  PMID: 32334620 BACKGROUND

• Bourgeois J, Elseviers MM, Van Bortel L, Petrovic M, Vander Stichele RH. Sleep quality of benzodiazepine users in nursing homes: a comparative study with nonusers. Sleep Med. 2013 Jul;14(7):614-21. doi: 10.1016/j.sleep.2013.03.012. Epub 2013 May 18.

  PMID: 23692988 BACKGROUND

MeSH Terms

Conditions

Anxiety Disorders; Depression; Sleep Initiation and Maintenance Disorders

Condition Hierarchy (Ancestors)

Mental Disorders; Behavioral Symptoms; Behavior; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders; Nervous System Diseases

Study Officials

• Santa Maria Pangaribuan, M.Sc

  Taipei Medical University, Taiwan

  PRINCIPAL INVESTIGATOR

Central Study Contacts

SANTA MARIA PANGARIBUAN, M.Sc

CONTACT

+6285132499047; maria.pangaribuan@ukrida.ac.id

Hsiao Yean Chiu, PhD

CONTACT

+886-2-27361661; hychiu0315@tmu.edu.tw

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, OUTCOMES ASSESSOR
• Masking Details: Participant will be blinded to group allocation. Outcome assessors will remain blinded to group allocation until the end of the study, therapists will be aware of group assignments due to the nature of the intervention.
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal Investigator, Registered Nurse

Model Details: Two arm parallel group designs: (1) Circadian-based acupressure intervention, and (2) Sham acupressure.

Study Record Dates

• First Submitted: January 9, 2026
• First Posted: January 16, 2026
• Study Start: January 20, 2026
• Primary Completion (Estimated): June 30, 2026
• Study Completion (Estimated): June 30, 2026
• Last Updated: January 20, 2026

Record last verified: 2026-01

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL
• Time Frame: Beginning 9 months and ending 60 months following article publication.
• Access Criteria: Investigators whose proposed use of the data has been approved by an independent review committee ("learned intermediary") identified for this purpose, for example, for a meta-analysis or other study.

Locations

ID (1)