Acupressure and Sleep Quality in Elderly Care

This study was carried out in a prospective randomized controlled experimental design in order to evaluate the effect of acupressure on sleep quality and day sleepiness in individuals living in an elderly care center. The study sample consisted of 75 elderly individuals, 38 in experimental and 37 in control groups, who met the inclusion criteria, living in three different care institutions in Düzce. The data were collected using the Elderly Information Form, the Pittsburgh Sleep Quality Index (PSQI), and the Epworth Sleepiness Scale (ESS). Twelve sessions of acupressure were applied to the individuals in the experimental group every other day three times a week for four weeks. Acupressure was applied to Shenmen (HT7), Neiguan (P6), and Sanyinjiao (SP6) acupressure points. The PSQI and ESS were applied on the elderly in the experimental group before and after the application, and on the elderly in the control group before the application and at the end of the 12-session acupressure application in the experimental group. The PSQI and ESS were applied in both groups again one month after the last application. It was found that subjective sleep quality and sleep duration increased, sleep latency decreased, habitual sleep efficiency was regulated, and sleep disorders and daytime dysfunction declined through the application of acupressure in the elderly receiving institutional care. It was determined that the total PSQI score decreased and the quality of sleep increased in the experimental group following the application. Moreover, the ESS score and day sleepiness decreased in the experimental group following the application. Consequently, it was concluded that acupressure could be a supplementary and supportive method to be used for sleep disorders in the elderly.

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Key information

Conditions

Sleep Disorders Dyssomnias Mental Disorders Nervous System Diseases Neurologic Manifestations Pathological Conditions, Signs and Symptoms Signs and Symptoms Sleep Disorders, Intrinsic Sleep Initiation and Maintenance Disorders Sleep Wake Disorders

Age range

65 year and older

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

stanbul University-Cerrahpaşa, Istanbul, Turkey (Türkiye)

Who can participate

Healthy volunteers accepted: Yes

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

Age 65 years and older
Able to provide informed consent
Living in the nursing home during the study period
Willing to participate in acupressure sessions and assessments
Adequate cognitive ability to complete questionnaires (PSQI, ESS)

Exclusion criteria

Severe cognitive impairment or dementia preventing questionnaire completion
Presence of acute psychiatric disorder or severe communication difficulties
Current use of sedative/hypnotic medications affecting sleep quality
Severe medical conditions (e.g., terminal illness, unstable cardiovascular disease) that contraindicate participation

Treatment and study plan

Acupressure Therapy

Behavioral

The intervention consisted of acupressure therapy applied to Shenmen (HT7), Neiguan (P6), and Sanyinjiao (SP6) points. Sessions were administered three times per week, every other day, for four consecutive weeks, totaling 12 sessions. Each session lasted approximately 20 minutes and was performed by a trained researcher. Participants were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Epworth Sleepiness Scale (ESS) before and after the intervention

Other names: Manual Acupressure Therapy, Acupressure at HT7, P6, SP6 Points

Primary outcomes

Primary Outcome Measure

Time frame: Baseline (pre-intervention) and 4 weeks after intervention

Change in sleep quality assessed by the Pittsburgh Sleep Quality Index (PSQI). The Pittsburgh Sleep Quality Index (PSQI) was developed in 1989 by Buysse and colleagues to assess sleep quality. The scale provides a quantitative measure that allows the identification of "good sleep" and "poor sleep." It evaluates sleep quality, sleep quantity, the presence of sleep disturbances, and their severity over the past month. The scale consists of 24 questions, 19 of which are self-report items. The remaining 5 items are answered by a bed partner or roommate, used solely for clinical information, and are not included in the scoring. The PSQI includes seven components evaluating different aspects of sleep: Subjective Sleep Quality, Sleep Latency, Sleep Duration, Habitual Sleep Efficiency, A PSQI score of 5 or higher reflects clinically significant impairment in sleep quality. Based on these thresholds, sleep quality is categorized as good (0-4 points) or poor (5-21 points).

Secondary outcomes

Secondary Outcome Measure

Time frame: Baseline (pre-intervention) and 4 weeks after intervention

Change in daytime sleepiness assessed by the Epworth Sleepiness Scale (ESS). Epworth Sleepiness Scale (ESS) The Epworth Sleepiness Scale (ESS) was developed by Johns in 1991 to assess general daytime sleepiness in adults. The scale consists of 8 self-report items. The Cronbach's alpha reliability coefficient of the ESS was reported as 0.88 in individuals with sleep disorders (Johns, 1991). The ESS evaluates an individual's general level of daytime sleepiness. It assesses the likelihood of dozing off or falling asleep in 8 different everyday situations, asking participants to rate their likelihood of falling asleep on a typical day when they are not excessively tired. Each item is scored between 0 and 3, and the total score ranges from 0 to 24. A total score between 2 and 10 indicates normal daytime sleepiness, whereas a score of 11 or higher suggests increased daytime sleepiness.

Sponsors and collaborators

Lead sponsor

Duzce University

Other

Registry information

Official study title

The Effect of Acupressure on Sleep Quality Among Elderly People in Institutional Care

Acronym: ASEQ

Important dates

Study start: 2018
Primary completion: 2018
Study completion: 2018
First posted: Dec 11, 2025
Registry last updated: Dec 19, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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Completed