Pan Hong-hong, Jin Ze, Wang Yu-lin

1 Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China

2 The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China

Electroacupuncture Treatment for Obstructive Sleep Apnea Syndrome

Pan Hong-hong1, Jin Ze2, Wang Yu-lin2

1 Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China

2 The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine, Harbin 150040, China

Acupuncture Therapy; Electroacupuncture; Sleep Apnea, Obstructive

Obstructive sleep apnea syndrome (OSAS) means that patients suffer from repetitive pauses in breathing, even hypoxemia and hypercapnia because of upper airway obstruction during sleep. The clinical symptoms are known as snoring, awakening from difficulty breathing, daytime sleepiness, morning headaches, memory loss, hypertension, pulmonary hypertension, pulmonary heart disease, and severe symptoms like arrhythmia and even sudden death in sleep. Therefore, the OSAS causes widespread concern among the patients and the medical workers.

Although surgery has been a major treatment of OSAS, it can’t easily be accepted by patients because of high surgical risk[1]. Since June 2009, we started to treat OSAS with electroacupuncture, and reported it as follows.

1 Clinical Materials

1.1 Inclusion criteria[2]

The patients should be diagnosed with OSAS by polysomnographic monitor, having accompanied clinical symptoms such as snoring, awakening from difficulty breathing, frequent nocturia, morning dizziness, headache, daytime sleepiness and so on, while the pharyngeal obstruction is not very severe.

1.2 General data

A total of 16 patients who met the inclusion criteria are selected. All of them were outpatients and in-patients of No.5 Wards of Acupuncture Department in the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from June 2009 to January 2011, including 10 males and 6 females; their ages range from 21 to 63 years old with an average of 37.

2 Treatment Methods

Acupoints: Baihui (GV 20), Yintang (GV 29), bilateral Fengchi (GB 20), C2-6Jiaji (EX-B 2) points, Taiyang (EX-HN 5), Hegu (LI 4), Neiguan (PC 6).

Operations: Patients were in a lateral and comfortable position. After routine disinfection, a sterile needle of 0.30 mm in diameter and 40 mm in length was punctured into the acupoint. When puncturing Baihui (GV 20), the needle body and the skin formed a 15° angle, and the needle was pierced into the skin about 1 cun; inserted the needle into Yintang (GV 29) while pinching the skin, and horizontally inserted into 1 cun; for Taiyang (EX-HN 5), theneedle body and the skin formed a 45° angle, and was inserted into about 0.5 cun; the needle was perpendicularly into Fengchi (GB 20) about 1 cun; and the Jiaji (EX-B 2) points were perpendicularly punctured about 1 cun; for Hegu (LI 4), the needle body and the skin formed a 45° angle, and was inserted about 1 cun; for Neiguan (PC 6), the needle was perpendicularly punctured about 1 cun. It was better that patients had the local sense of soreness but could tolerate it, and were in sleep state after the treatment. The needles in Jiaji (EX-B 2) points were connected to the electroacupuncture (EA) instrument with intermittent wave election, and the needles were retained for 40 min, and the therapy was repeated once per day, and the patients could get 1 day rest after continuous 6-day treatments. And the whole treatment course was composed of 18-day treatments.

3 Therapeutic Effects

3.1 Efficacy criteria[2-3]

Markedly effective: Significant improvement in subjective symptoms of snoring and apnea. The Apnea Hyponea Index (AHI) decreases by 50% or more. The lowest nighttime sleep oxygen saturation (SaO2) increases by 20%.

Effective: Improvement in subjective symptoms, AHI decreases by 20% to 50%, and SaO2increases by 10%.

Invalid: Symptoms alleviate, but no change in AHI and SaO2.

3.2 Results

In all the 16 cases, 11 cases showed marked effect, 3 cases were effective, and 2 cases were invalid, with a total effective rate of 87.5%.

4 Discussion

Patients with OSAS have the characteristics of familial aggregation and genetic factors, and most of them have a pathological basis of the stenosis of the upper respiratory tract, especially the nasopharynx, such as obesity, allergic rhinitis, tonsil hypertrophy, tongue hypertrophy, tongue fall and so on. In addition, it is related to the combined effects of nervous, humoral, and endocrine factors[4].

According to traditional Chinese medicine theory, it is believed that the ‘excess yin qi’ and ‘Wei-Defensive qi stagnation’ are the basis of the incidence of the disease with phlegm-damp excess as the major factor[5]. In this treatment, puncturing Taiyang (EX-HN 5) can regulate yin-yang, adjust qi movement, aiming at permanent cure, thus can adjust the excitation and inhibition of the respiratory center in the cerebral cortex, and strengthen breath control. Fengchi (GB 20) accompanied with Hegu (LI 4) can remove phlegm and expel wind, dredge collaterals and facilitate passage, and significantly improve ventilation status. Baihui (GV 20), Yintang (GV 29) and Neiguan (PC 6) together can regulate brain spirit, dredge heart collaterals to achieve tranquilization effect. Cervical Jiaji (EX-B 2) points can dredge the meridians and collaterals of the neck, regulate yin-yang, as well as the autonomic nervous function, and the effect increases when combined with EA stimulation[6-7].

The results of this study indicate that acupuncture combined with EA treatment for OSAS can significantly improve patients’ subjective symptoms and improve the patient’s quality of life. This treatment can be regarded as an effective way of treating OSAS, and is worthy of further study.

[1] Chen BY. The development and prospect in obstructive sleep apnea syndrome field. Linchuang Neike Zazhi, 2012, 29(4): 233-236.

[2] Sleep Respiratory Disorder Study Group of Respiratory Disease Branch of Chinese Medical Association. The guidelines of diagnosis and treatment for obstructive sleep apnea syndrome (draft). Zhonghua Jiehe He Huxi Zazhi, 2002, 25(4): 195-198.

[3] Han ZW, Liu LT. Uvulopalatopharyngoplasty for obstructive sleep apnea syndrome. National Conference Proceedings of Special Academic Seminar on Obstructive Sleep Apnea Syndrome, 2002: 35.

[4] Lu ZY, Zhong NS. Internal Medicine. 7th Edition. Beijing: People's Medical Publishing House, 2008.

[5] Zhang YB, Hong YB. Exploration of traditional Chinese medicine therapies for sleep apnea syndrome. Zhongguo Yiyao Xuebao, 2001, 16(5): 53-56.

[6] Lin C, Wang Y, Wang SS, Li XL, Ye YM. Follow-up study on electroacupuncture for cognitive impairment to obstructive sleep apnea-hypopnea syndrome. Shanghai Zhenjiu Zazhi, 2012, 31(9): 649-651.

[7] Wang Y, Geng HY, Ye YM, Li J. Follow-up study on acupuncture in treating stroke comorbid with sleep apnea hypoventilation syndrome. Shanghai Zhenjiu Zazhi, 2011, 30(4): 220-222.

Translator: Deng Ying

R246.1

B

Date: November 20, 2012

Author: Pan Hong-hong, 7-year student of grade 2005

Jin Ze, M.D., chief physician.

E-mail: kimhlj@hotmail.com