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circadian
desynchronosis
AURICULOTHERAPY
AND AIRCREW WITH CIRCADIAN DESYNCHRONOSIS: AEROMEDICAL IMPLICATIONS
James R. Little, Lieutenant Colonel, USAF,
MC, SFS
Richard C. Niemtzow, Colonel, USAF, MC, FS
ABSTRACT
Auricular
electrotherapy may offer an effective, drug-free alternative or complementary
treatment for circadian desynchronosis (jetlag). During operational
flight missions, 5 aircrew members were treated for circadian desynchronosis
using a Pointer Plus device. All members reported restful, restorative
sleep without adverse effects. All participants expressed future preference
for auricular therapy over pharmacotherapy for circadian desynchronosis.
KEY WORDS
Circadian
Desynchronosis, Jet Lag, Reflex Somatotopic System, Auricular Acupuncture,
Electro-Auriculotherapy, SedativeHypnotics, Pharmacotherapy, Aircrew,
Aeromedical Implications, Alternative Medicine, Complementary Medicine
INTRODUCTION
Auricular
acupuncture is based on a reflex somatotopic system organized on the
surface of the external ear. Auricular acupuncture is known to augment
and prolong the efficacy of regular acupuncture therapy, especially
in the areas of traumatic pain management, as well as other organic
and functional problems. Currently, the United States Air Force (USAF)
authorizes the controlled use of certain sedative-hypnotics during military
operations for circadian desynchronosis (jet lag). As in the civilian
sector, military members seek drug-free, alternative forms of therapy.
If proven effective, the use of auricular electrotherapy is an appealing
alternative and/or complement to jet lag management. An opportunity
to evaluate this treatment modality availed itself in the military flying
population, which is described herein.
CASE REPORT
Auricular
electrotherapy was performed on 5 USAF aircrew members suffering from
circadian desynchronosis during flight operations into Southwest and/or
Southeast Asia. The treatment group
desired a drug-free treatment for jet lag and declined the usual pharmacotherapy
regimen as authorized by the USAF. Consent was obtained from all participants.
Auriculotherapy was not performed within 12 hours of expected flight
duty operations.
TREATMENT
A Pointer Plus device was used to treat
ear points. Shen Men, Point Zero, Sleep Disorder I and 2, as well as
the Pineal Gland.1 The Pointer
Plus is an electronic ear stimulator and point detector with the following
output: a frequency of 10 Hz, a pulse width of 220 microseconds, and
a pulse shape of an asymmetric biphasic square wave. Each point was
treated for approximately 20 to 30 seconds.
RESULTS
Five
aircrew members suffering from circadian desynchronosis during flight
operations reported restful, restorative sleep with auricular electrotherapy.
The somnifacient-inducing effects of auricular therapy were noted within
1 to 3 minutes of treatment. The average sleep period for the group
was 6 hours. No significant adverse effects were noted or reported by
aircrew members.
Aircrew
members reported satisfaction at the efficacy and effectiveness of auriculotherapy
versus pharmacotherapy. Participants expressed future preference for
auriculotherapy over pharmacotherapy for jet lag management.
DISCUSSION
Further
evaluation comparing sedative-hypnotics, auriculotherapy, and placebo,
as well as studying a larger population, is indicated. Only physicians
properly trained in auriculotherapy are encouraged to use this modality.
Improper auricular stimulation may adversely affect aircrew health,
flying safety, and/or mission accomplishment.
CONCLUSION
Based
on this very small case series, it is believed that auricular electrotherapy
may be a promising, effective, and dirug-free alternative treatment
modality for jet lag management.
REFERENCE
1. Oleson
T. Auriculotherapy Manual: Chinese and Western Systems of Ear Acupuncture.
2nd ed. Los Angeles, Calif: Health Care Altematives, Inc; 1996:176-177,
180, 194-195.
AUTHORS' INFORMATION
Dr James
Little is a Lieutenant Colonel in the United States Air Force Medical
Corps, and is the Deputy Chief of Aerospace Medicine Branch for Headquarters,
Air Education and Training Command, Randolph Air Force Base, Texas.
Dr Little is residency-trained in Family Practice, Aerospace Medicine,
and Occupational Medicine, with a Master's Degree in-Public Health,
Harvard School of Public Health.
James R. Little, MD, MPH,
Lt Col, USAF, MC, SFS HQ AETC/SGPA
63 Main Circle, Suite 3
Randolph AFB, TX 78150-4549
Phone: 210-652-3536 - Fax: 210-652-8968 E-mail: jim.little@randolph.af.mil
Dr Richard Niemtzow
is a Colonel in the United States Air Force, on special acupuncture
assignment with the United States Navy. Dr Niemtzow practices acupuncture
full-time with oncology patients at the Naval Medical Center, San Diego,
California.
Richard C. Niemtzow, MD,
PhD MPH
1835 East Main Street
El Cajon, CA 92021-5255
Phone: 619-447-6806 - Fax: 619-447-6881 E-mail: N5ev@aol.com
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