Using acupressure to modify alertness in the classroom: A single-blinded, randomized, cross-over trial

Richard E. Harris, Joanne Jeter, Paul Chan, Peter Higgins, Feng Ming Kong, Reza Fazel, Candace Bramson, Brenda Gillespie, Khawaja Afzal Ammar, Michelle Anderson, Ghassan Bachuwa, Adnan Beg, Devin Brown, Linda Brubaker, Steven Bruch, Giani Cazan-London, Bobby Clark, Paul Cronin, Brian DeSmet, Gary HammanBrent Hollenbeck, Jaquelyn Hunt, Susan Johnson, Sucheta Joshi, Liise Kayler, Aine Kelly, Kim Kenton, Wendy Marder, Mary Marzec, Gisele Neiva, Amanda Peltier, Panduranga Rao, Erik Roys, Joel Rubenstein, Jonathan Segal, T. P. Singh, Maran Thamilarasan, Courtney Thornburg, Kevin Townsend, Robert Welch, Jinping Xu, Najeeb Zoubi

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background: Previous reports have suggested that acupressure is effective in reducing pain and improving sleep quality; however, its effects on alertness have not been characterized. Objectives: The aim of this study was to determine whether two different acupressure treatments have opposing effects on alertness in a full-day classroom setting. Design: This was a cross-over (two-treatments; three periods), single-blinded, randomized trial. Setting: The University of Michigan School of Public Health was the setting. Subjects: Students attending a course in clinical research design and statistical analysis at the University of Michigan participated in the study. Interventions and outcome measures: Blinded subjects were randomized to two acupressure treatment sequences: stimulation-relaxation-relaxation or relaxation-stimulation-stimulation. Acupressure treatments were self administered over 3 consecutive days. Pre- and post-treatment alertness scores were assessed each day using the Stanford Sleepiness Scale (SSS). Changes in the SSS score (afternoon - morning) were analyzed using a mixed regression model of fixed and random effects. Important factors that were expected to affect alertness, such as caffeine and previous night's sleep, were also assessed. Results: Baseline characteristics and protocol compliance were similar between the two sequences. Stimulation acupressure treatment yielded a 0.56-point greater difference in score on the SSS, corresponding to less fatigue, compared to the relaxation acupressure treatment (p = 0.019). Day of study (p -0.004) and hours of overnight sleep (p = 0.042) also significantly affected the change in SSS scores. Incorporating participants' beliefs as to which treatment they received did not significantly alter the observed treatment effect. Conclusions: Acupressure at stimulation and relaxation points has differential effects on alertness in a classroom setting. Further research is necessary to confirm these findings and to determine whether stimulation and relaxation acupressure are equally effective in influencing alertness.

Original languageEnglish (US)
Pages (from-to)673-679
Number of pages7
JournalJournal of Alternative and Complementary Medicine
Issue number4
StatePublished - Aug 2005

ASJC Scopus subject areas

  • Complementary and alternative medicine


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