The efficacy of acupuncture for patients with mild to moderate obstructive sleep apnea syndrome: A protocol for a randomized controlled clinical trial

Introduction: Obstructive sleep apnea syndrome (OSAS) is considered a major public health issue due to its high prevalence and severe consequences. Several published studies have revealed that electro-acupuncture may relieve OSAS symptoms. However, the mechanism of electro-acupuncture in the treat-ment of patients with OSAS remains unclear.Methods and analysis: We evaluated the efficacy and mechanism of electro-acupuncture in the treatment of patients with OSAS. This was a two-group parallel randomized controlled trial. Sixty patients with OSAS will be randomly divided into an electro-acupuncture or shallow acupuncture group in a proportion of 1:1, and the patients will be administered 36 sessions of electro/shallow acupuncture treatment (three times a week for 12 weeks, 20 min for each session). The Epworth Sleepiness Scale (ESS) will be used as the primary outcome. Secondary outcomes will include polysomnography (PSG), sleep quality, emotional state, and cognitive function. In addition, patients will receive neuroimaging scanning before and after the entire acupuncture treatment to evaluate neuroplasticity changes, including gray matter density, white matter integrity, and functional connections.Expected outcomes: We believe that the use of electro-acupuncture will be more effective in patients with mild to moderate OSAS and that the cognitive and emotional status of patients will improve after acupuncture treatment. In addition, we aim to clarify which brain areas can be altered by acupuncture in patients with OSAS.Discussion: This randomized clinical trial aims to explore the curative effect and central mechanism of acupuncture treatment for OSAS. We will explore gray matter density, white matter integrity, and func-tional connections of the brain using fMRI technology. The results of this study will be significant to the guidelines for clinical OSAS treatment.(c) 2022 Published by Elsevier B.V. on behalf of World Journal of Acupuncture Moxibustion House.