In a summary of 46 randomized controlled trials through 2008 on acupuncture for insomnia involving 3811 patients, researchers searched PubMed, the Cochrane Library (2008 Issue 3), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan Fang Database. The methodological quality of trials was judged to be generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed a beneficial effect of acupuncture compared with no treatment (MD −3.28, 95% CI −6.10 to −0.46, p=0.02; 4 trials) and real acupressure compared with sham acupressure (MD −2.94, 95% CI −5.77 to −0.11, p=0.04; 2 trials) on total scores of Pittsburgh Sleep Quality Index.

Acupuncture was superior to medications regarding the number of patients with total sleep duration increased for >3 hours (RR 1.53, 95% CI 1.24–1.88, p<0.0001). However, there was no difference between acupuncture and medications in average sleep duration (MD −0.06, 95% CI −0.30–0.18, p=0.63). Acupuncture plus medications showed better effect than medications alone on total sleep duration (MD 1.09, 95% CI 0.56–1.61, p<0.0001). Similarly, acupuncture plus herbs was significantly better than herbs alone on increase of sleep rates (RR 1.67, 95% CI 1.12–2.50, p=0.01). There were no serious adverse effects with related to acupuncture treatment in the included trials. The authors concluded that acupuncture appears to be effective in treatment of insomnia while also recommending further large, rigorous designed trials.

Cao H, Pan X, Li H, Liu J. Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials. J Altern Complement Med. Nov 2009;15(11):1171-1186.

Physicians’ Religious and Spiritual Identification
Correlates to CAM Usage and Practice

In a national mail survey, general internists, rheumatologists, naturopaths, and acupuncturists were asked about their religious characteristics and their openness to integrating complementary and alternative medicine (CAM). Physician outcome measures were use of and attitudes toward six classes of CAM. Predictors were religious affiliation, intrinsic religiosity, spirituality, and religious traditionalism.

There was a 65% response. Naturopaths and acupuncturists were three times as likely as internists and rheumatologists to report no religious affiliation (35% versus 12%), but were more likely to describe themselves as very spiritual (51% versus 20%) and to agree they try to carry religious beliefs into life’s dealings (51% versus 44%). Among physicians, increased spirituality and religiosity coincided with more personal use of CAM and willingness to integrate CAM into a treatment program.

Curlin FA, Rasinski KA, Kaptchuk TJ, Emanuel EJ, Miller FG, Tilburt JC. Religion, Clinicians, and the Integration of Complementary and Alternative Medicines. J Altern Complement Med. 2009;15(9):987-994.

Grapefruit Extract Effective for Head Lice

Egyptian researchers studied 20 children aging 2-9 years old—four boys with short hair and 16 girls with long hair—in a clinical test on the efficacy of a product against head lice (Pediculus humanus capitis). Their hair was exposed to Licatack, a recently developed anti-louse medicinal product containing extracts of grapefruit and high quality shampoo components. Prior to this field trial, the product Licatack was tested dermatologically to be skin safe, receiving the grade “very good.” The children’s mothers combed the children’s hair prior to the start of the test in order to confirm that they were all lice-infested. The obtained lice were used for in vitro tests. All children were heavily infested. After combing and preservation of the living lice, the hair was wet with tap water. Then, 50 ml of the Licatack shampoo was placed onto the top of each child’s head. Then, the mothers distributed the rather fluid product all over the hair thoroughly from their base at the skin until the free end. During this process, a type of massage, the product became foamy and it was easily recognized where the product covered the hair, thus avoiding untreated spots.

The hair of half of the treated children were washed with tap water after 10 min of exposition; while in the other half of the children, the exposition period was prolonged to 20 min before washing. When combing the kids with a metal louse comb after the washing, the lice were found immobile and they did not recover during the following observation period of 4 h. Only two lice from the group with an exposition time of only 10 min showed some slight leg movements after they had been combed off, but they died within the next 2 h. Thus, this new anti-louse medicinal product has a very quick and efficient activity besides the advantage of being non-inflammable, skin safe, and pleasant smelling. None of the kids claimed any burning at the skin or other side effects, although the skin showed, prior to treatment, lots of scars due to louse bites. The dead lice always appeared considerably shrunken due to drying. The second treatment after 10 days revealed a few dead larval stages since, apparently, some larvae (apparently treated at an early stage of development when treated) had hatched from the extremely numerous nits in the period between first and second treatment. Experiments with cutoff nits, however, showed that the product also kills larval stages inside nits.

Abdel-Ghaffar F, Semmler M, Al-Rasheid K, Klimpel S, Mehlhorn H. Efficacy of a grapefruit extract on head lice: a clinical trial. Parasitol Res. Jan 2010;106(2):445-449.

Mild Stream Bathing Aid Recovery from Mental Fatigue

Bathing in hot water is very common in Japan; people bathe in order to clean their bodies and to recover from physical and mental fatigue. However, there have been few reports examining the effects of bathing on recovery from mental fatigue. The purpose of this study was to examine the effects of mild-stream bathing on recovery from mental fatigue. During mild-stream bathing, a mild stream continuously passes from the sole to the calf, thigh, waist and back, thus providing a massage function.

In a double-blinded, placebo-controlled, crossover experiment, 14 male healthy volunteers were randomized into normal bathing and mild-stream bathing experiments. After a fatigue-inducing mental task for 4 hours, subjects took a normal or mild-stream bath. Heart rate was higher, muscle stiffness in the waist was lower and plasma cortisol levels tended to be lower after mild-stream bathing when compared to normal bathing. In addition, after mild-stream bathing, mental task performance, as assessed by reaction times on an advanced trail making test, was better than that after normal bathing. The present results suggest that improved working memory processing, diminished waist muscle tone, and attenuated mental stress are induced by mild-stream bathing. Therefore, mild-stream bathing appears to be more effective for alleviating mental fatigue than normal bathing.

Mizuno K, Tanaka M, Tajima K, Okada N, Rokushima K, Watanabe Y. Effects of mild-stream bathing on recovery from mental fatigue. Med Sci Monit. Jan 2010;16(1):CR8-14.