Key Finding
Acupressure probably improves sleep quality by 3.51 points on the Pittsburgh Sleep Quality Index and increases quality of life scores by 9.66 points in hemodialysis patients compared to no treatment.
Patients undergoing hemodialysis (HD) often struggle with poor sleep and mental health challenges, and standard medications can have unwanted side effects. Researchers wanted to know if acupressure—a gentle therapy involving pressure on specific body points—could help improve these problems. This comprehensive review analyzed 27 studies involving over 2,000 hemodialysis patients to evaluate acupressure's effectiveness for sleep quality, mental health, and overall quality of life.
The researchers found that compared to receiving no treatment, acupressure probably improves sleep quality and overall quality of life in HD patients. Sleep quality improved by an average of 3.51 points on the Pittsburgh Sleep Quality Index, a meaningful change that patients would likely notice. Quality of life scores also increased significantly. However, acupressure appeared to have little impact on actual sleep duration, mental health symptoms, or social functioning.
When compared directly to sleep medications, acupressure showed similar results, suggesting it works about as well as pharmaceutical options. Importantly, very few adverse effects were reported with acupressure, making it a potentially safer alternative to medications that can cause side effects.
What this means for patients: If you're on hemodialysis and struggling with sleep problems, acupressure may offer a safe, drug-free option to improve your sleep quality and overall well-being. While it may not dramatically increase how long you sleep or resolve mental health issues, many patients find the improvement in sleep quality meaningful. To explore this option, work with a qualified acupuncturist or acupressure practitioner experienced in treating patients with kidney disease.
This systematic review and meta-analysis evaluated acupressure efficacy for hemodialysis patients experiencing sleep disturbances and mental health disorders. Following PRISMA guidelines, researchers analyzed 27 trials encompassing 2,037 participants from seven databases through March 2025. Moderate-certainty evidence demonstrated that acupressure versus waiting-list controls significantly improved sleep quality (WMD -3.51 points on the 21-point PSQI scale, 95% CI -4.14 to -2.89) and quality of life (WMD 9.66 points on the 100-point SF-36 scale, 95% CI 6.65 to 12.66). Low-certainty evidence suggested minimal impact on sleep duration, mental health, and social functioning. Compared to medication, acupressure showed no significant differences in outcomes, with very limited adverse event data (RR 0.21, 95% CI 0.01 to 4.27). Clinical takeaway: Acupressure represents a likely effective, low-risk adjunctive therapy for improving subjective sleep quality and quality of life in HD patients, though superiority over pharmacological interventions remains unestablished.
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