The Siesta Trial-a Randomised Study Investigating The Efficacy, Safety And Tolerability Of Acupressure Versus Sham Therapy For Improving Sleep Quality In Patients With End-stage Kidney Disease On Haemodialysis

ObjectivesTo compare the effectiveness of real acupressure versus sham acupressure therapy in improving sleep quality in patients receiving haemodialysis (HD) or haemodiafiltration (HDF).MethodsA multi-centre, single-blind, randomised controlled trial was conducted in two Australian dialysis units located in Princess Alexandra Hospital and Logan Hospital, respectively. Forty-two subjects with self-reported poor sleep quality were randomly assigned to real (n=21) or sham (n=21) acupressure therapy delivered thrice weekly for four consecutive weeks during routine dialysis sessions. The primary outcome was the Pittsburgh Sleep Quality Index (PSQI) score measured at week four and adjusted for baseline measurements. Secondary outcomes were quality of life (QOL) (SF-8), adverse events and patient acceptability (Treatment Acceptability Questionnaire, TAQ).ResultsThe two groups were comparable on global PSQI scores (difference 0.19, 95%CI-1.32-1.70) and on the subscale scores. Similar results were observed for QOL both in the mental (difference-3.88,95%CI-8.63-0.87) and the physical scores (difference 2.45,95%CI-1.69-6.58). There were no treatment-related adverse events and acupressure was perceived favourably by participants.ConclusionAcupressure is a safe, well tolerated and highly acceptable therapy in adult haemodialysis patients in a Western healthcare setting with uncertain implications for therapeutic efficacy.