Authors
Eunbin Kwag, Rose Wy Fok, Qing SLi, Raymond E Baser, Sheila N Garland, Kevin T Liou, Jun J Mao, Kelly McConnell
Published in
Journal of pain and symptom management. Jul 18, 2026. Epub Jul 18, 2026.
Abstract
Symptoms of insomnia affect over half of patients with advanced cancer and frequently co-occur with other conditions, particularly pain. Effective and well-tolerated treatments are needed. This study compared acupuncture and massage therapy for insomnia symptoms with comorbid pain and examined the relationship between sleep and pain.
Data were drawn from a multicenter pragmatic randomized clinical trial comparing acupuncture and massage therapy for pain in advanced cancer. Among 300 participants, 234 with baseline insomnia (ISI ≥ 8) were included. Participants received 10 weeks of treatment with follow-up to 26 weeks. Insomnia symptoms were measured using the Insomnia Severity Index (ISI). Linear mixed-effects models evaluated longitudinal changes. Responder analyses defined ISI responders as ≥8-point reduction or ISI <8, and pain responders as ≥30% reduction in Brief Pain Inventory (BPI) severity at week 10.
Both acupuncture and massage significantly improved ISI scores at week 10 (-3.86 and -3.83; both p<0.0001) with no between-group differences (p=0.91). ISI responder rates were similar (35.1% vs 33.3%), while BPI responder rates were higher (48.0% vs 62.9%). Pain responders had greater improvements in insomnia at week 10 (Δ=-2.97; p=0.0003), though attenuated by week 26. Insomnia responders showed greater reductions in pain at week 10 and 26 (both p<0.0001).
Acupuncture and massage improved insomnia in patients with advanced cancer. Sleep and pain showed a bidirectional relationship, supporting integrative approaches targeting symptom clusters.
PMID:
42471129
Bibliographic data and abstract were imported from PubMed on 19 Jul 2026.
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