An interventional study of Acupuncture in Sleep Fragmentation and Poor Sleep Quality, sponsored by Chang Gung Memorial Hospital. Not yet recruiting at 2 sites in Taiwan. Open to participants aged 60 Years and older. Per ClinicalTrials.gov, last updated 2026-09-25.
Sponsored by Chang Gung Memorial Hospital · Not applicable, Interventional, and Treatment
This single-group pilot study will enroll 20 adults aged 60 years or older with persistent poor sleep. All participants will receive a standardized 6-week acupuncture program. The study will assess feasibility and preliminary changes in actigraphy-derived sleep fragmentation, self-reported sleep, brain DTI-ALPS imaging, internal jugular venous ultrasonography, and CERAD-NB word-list memory performance.
After written informed consent, participants will complete cognitive and mood screening. Baseline assessments include PSQI, ISI, ESS, CERAD-NB word-list memory testing, one night of home polysomnography, 7 days of actigraphy, brain MRI for the DTI-ALPS index, and internal jugular venous ultrasonography. Participants will then receive acupuncture twice weekly for 6 weeks, for 12 sessions, with each session lasting approximately 20 to 30 minutes. ISI will also be assessed at Weeks 2 and 4. At Week 6, baseline assessments will be repeated except for home polysomnography. PSQI, ISI, and ESS will be collected again approximately 3 months after treatment as an optional follow-up. Missing data from this optional follow-up alone will not exclude a participant from the per-protocol population. Exploratory analyses will examine whether actigraphy-derived physical activity and light exposure are associated with, or modify, changes in the registered sleep, imaging, and cognitive outcomes.
Exclusion Criteria:
Participants receive a 6-week standardized acupuncture program.
Procedure: Acupuncture
Participants will receive acupuncture at Baihui (GV20), Anmian (EX-HN22), Zusanli (ST36), and Taixi (KI3) twice weekly for 6 weeks, for a total of 12 sessions. Needles will be retained for approximately 20 to 30 minutes per session. No comparator arm is used in this pilot.
Change in 7-day mean wake after sleep onset from baseline to Week 6
Change equals the Week 6 mean minus the baseline mean. Wake after sleep onset (WASO) is the total minutes scored awake between sleep onset and final awakening for each valid night. Sleep is measured with Actiwatch 2 (Philips Respironics) worn on the nondominant wrist, recorded in 60-second epochs, and scored with Philips Actiware version 6.0.9 using sleep diaries. Each timepoint is the mean across all valid nights in the 7-day assessment window. A timepoint is valid if it includes at least 5 valid nights, including at least 1 weekend night; otherwise it is treated as missing. Unit: minutes.
Time frame: Baseline and Week 6
Change in 7-day mean sleep efficiency from baseline to Week 6
Change equals the Week 6 mean minus the baseline mean. Sleep efficiency is the percentage of time in bed scored as sleep for each valid night. Sleep is measured with Actiwatch 2 (Philips Respironics) worn on the nondominant wrist, recorded in 60-second epochs, and scored with Philips Actiware version 6.0.9 using sleep diaries. Each timepoint is the mean across all valid nights in the 7-day assessment window. A timepoint is valid if it includes at least 5 valid nights, including at least 1 weekend night; otherwise it is treated as missing. Unit: percentage points.
Time frame: Baseline and Week 6
Change in Pittsburgh Sleep Quality Index total score over time
The Pittsburgh Sleep Quality Index total score ranges from 0 to 21; higher scores indicate poorer sleep quality. Change at Week 6 and at the optional approximately 3-month post-treatment follow-up equals the respective follow-up score minus baseline.
Time frame: Baseline, Week 6, and approximately 3 months after treatment
Change in 7-day mean number of awakenings from baseline to Week 6
Change equals the Week 6 mean minus the baseline mean. Actiware-derived awakenings are counted for each valid night. Sleep is measured with Actiwatch 2 (Philips Respironics) worn on the nondominant wrist, recorded in 60-second epochs, and scored with Philips Actiware version 6.0.9 using sleep diaries. Each timepoint is the mean across all valid nights in the 7-day assessment window. A timepoint is valid if it includes at least 5 valid nights, including at least 1 weekend night; otherwise it is treated as missing. Unit: awakenings per night.
Time frame: Baseline and Week 6
Change in 7-day mean sleep fragmentation index from baseline to Week 6
Change equals the Week 6 mean minus the baseline mean. For each valid night, the Actiware 6.0.9 sleep fragmentation index is the sum of (1) the percentage of epochs classified as mobile during the sleep interval and (2) the percentage of all immobile bouts lasting no more than 1 minute. Higher values indicate greater sleep fragmentation. Actiwatch 2 is worn on the nondominant wrist and recorded in 60-second epochs. Each timepoint is the mean across valid nights in the 7-day window. A timepoint requires at least 5 valid nights, including at least 1 weekend night; otherwise it is missing. Unit: percentage points.
Time frame: Baseline and Week 6
Change in Insomnia Severity Index total score over time
The Insomnia Severity Index total score ranges from 0 to 28; higher scores indicate greater insomnia severity. Change at Weeks 2, 4, and 6 and at the optional approximately 3-month post-treatment follow-up equals the respective follow-up score minus baseline.
Time frame: Baseline, Weeks 2, 4, and 6, and approximately 3 months after treatment
Change in Epworth Sleepiness Scale total score over time
The Epworth Sleepiness Scale total score ranges from 0 to 24; higher scores indicate greater daytime sleepiness. Change at Week 6 and at the optional approximately 3-month post-treatment follow-up equals the respective follow-up score minus baseline.
Time frame: Baseline, Week 6, and approximately 3 months after treatment
Change in diffusion tensor imaging along the perivascular space index from baseline to Week 6
Change equals the Week 6 value minus the baseline value for the diffusion tensor imaging along the perivascular space (DTI-ALPS) index. Unit: unitless (dimensionless index).
Time frame: Baseline and Week 6
Change in side-specific internal jugular vein time-averaged mean blood-flow velocity from baseline to Week 6
Change equals the Week 6 value minus baseline for time-averaged mean velocity measured by pulsed-wave Doppler ultrasonography with the participant supine and the head in a neutral position. The left and right internal jugular veins are measured and analyzed separately; values are not combined by a simple bilateral average. Repeated measurements for each side are averaged. Unit: centimeters per second (cm/s).
Time frame: Baseline and Week 6
Change in side-specific internal jugular vein cross-sectional area from baseline to Week 6
Change equals the Week 6 value minus baseline for cross-sectional area measured by transverse B-mode ultrasonography with the participant supine and the head in a neutral position. The left and right internal jugular veins are measured and analyzed separately; values are not combined by a simple bilateral average. Repeated measurements for each side are averaged. Minimal transducer pressure is used to avoid vein compression. Unit: square centimeters (cm²).
Time frame: Baseline and Week 6
Change in CERAD-NB word-list memory composite score from baseline to Week 6
Change equals the Week 6 score minus baseline. The composite is the sum of word-list learning across 3 trials (0-30), delayed recall (0-10), and recognition discriminability (0-10), for a total range of 0-50; higher scores indicate better memory performance. Recognition discriminability is calculated as correct "Yes" responses plus correct "No" responses minus 10; values below 0 are scored as 0. Remote memory is not included in this composite.
Time frame: Baseline and Week 6
Proportion of participants completing at least 10 of 12 acupuncture sessions
Number of enrolled participants who complete at least 10 of the 12 planned acupuncture sessions divided by the total number enrolled, multiplied by 100. This threshold corresponds to at least 80% treatment adherence. Unit: percentage of participants.
Time frame: Through Week 6
Proportion of participants completing the Week 6 primary outcome assessment
Number of enrolled participants who complete the Week 6 assessment of the primary outcome, 7-day mean wake after sleep onset, divided by the total number enrolled, multiplied by 100. Unit: percentage of participants.
Time frame: Week 6
Proportion of participants with valid actigraphy data at both baseline and Week 6
Number of enrolled participants with valid actigraphy timepoints at both baseline and Week 6 divided by the total number enrolled, multiplied by 100. Each timepoint requires at least 5 valid nights, including at least 1 weekend night. Unit: percentage of participants.
Time frame: Baseline and Week 6
Plan to share: Undecided
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Chang Gung Memorial Hospital