经皮耳迷走神经刺激对老年2型糖尿病患者睡眠及自主神经功能的影响

doi:10.3969/j.issn.1003-9198.2026.06.008

Abstract

Abstract: Objective To observe the effects of transcutaneous auricular vagus nerve stimulation (taVNS) on sleep quality and autonomic nerve function in elderly patients with type 2 diabetes mellitus (T2DM). Methods Eighty elderly T2DM patients were selected and divided into taVNS group and control group according to a random number table. Participants in the taVNS group received taVNS at the left cymba conchae region. The control group underwent identical electrode placement with the device switched off after a brief ramp-up. The intervention was administered twice daily, five days a week, for four consecutive weeks. The ActiGraph accelerometer and the Pittsburgh Sleep Quality Index (PSQI) were used to record objective and subjective sleep conditions of the two groups, respectively. Heart rate variability (HRV) was monitored, and emotional status was assessed using Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Assessments were conducted at baseline, immediately after, and 12 weeks after the intervention. Adverse reactions were recorded in both groups. Results Compared with baseline, the taVNS group exhibited a decrease in total PSQI score, shortened sleep onset latency, reduced times of awakenings, prolonged total sleep time, improved sleep efficiency, increased proportion of deep sleep and rapid eye movement sleep, increased HRV-related parameter values, and decreased SAS and SDS scores on the day after treatment and 12 weeks after treatment(P<0.05). These improvements were significantly greater in the taVNS group than those in the control group at both time points (all P<0.05), expect for proportion of deep sleep and rapid eye movement sleep. No taVNS-related adverse reactions occurred. James' blinding index in this study was 0.16, indicating good blinding effectiveness. Conclusions Four weeks of continuous taVNS can safely and effectively improve sleep quality and autonomic nerve function, and alleviate anxiety and depression in elderly patients with T2DM.

Key words: transcutaneous auricular vagus nerve stimulation, sleep disorders, type 2 diabetes mellitus, autonomic function

CLC Number:

R 587.1

BAI Lili, WANG Xiaoliang, SHI Hongwei, HU Xiajuan, CAO Yuanyuan, CHENG Zhongjuan. Effect of transcutaneous aurcular vagus nerve stimulation on sleep and autonomic function in elderly patients with type 2 diabetes mellitus[J]. Practical Geriatrics, 2026, 40(6): 579-584.

References

[1] NCD Risk Factor Collaboration. Worldwide trends in diabetes prevalence and treatment from 1990 to 2022: a pooled analysis of 1108 population-representative studies with 141 million participants[J]. Lancet, 2024, 404(10467): 2077-2093.
[2] THALS C, SHITYAKOV S, SALVADOR E, et al. Heart rate variability, microvascular dysfunction, and inflammation: exploring the potential of taVNS in managing heart failure in type 2 diabetes mellitus[J]. Biomolecules, 2025, 15(4): 499.
[3] 陈盈欣, 胡欣, 李博, 等. 睡眠障碍对2型糖尿病的影响与治疗策略[J]. 中华糖尿病杂志, 2025, 17(3): 409-413.
[4] 罗彦相, 张佳, 蔡青云, 等. 糖尿病心脏自主神经病变的研究进展[J]. 中国心血管杂志, 2025, 30(1): 16-21.
[5] 陈昕露, 周艺铭, 韩雪, 等. 睡眠障碍与老年术后认知功能障碍的双向关联研究进展[J]. 实用老年医学, 2024, 38(5): 433-437.
[6] ZOU N, ZHOU Q, ZHANG Y, et al. Transcutaneous auricular vagus nerve stimulation as a novel therapy connecting the central and peripheral systems: a review[J]. Int J Surg, 2024, 110(8): 4993-5006.
[7] AHMED I, MUSTAFAOGLU R, ROSSI S, et al. Non-invasive brain stimulation techniques for the improvement of upper limb motor function and performance in activitiesof daily living after stroke: a systematic review and network meta-analysis[J]. Arch Phys Med Rehabil, 2023, 104(10): 1683-1697.
[8] COSTA V, GIANLORENÇO A C, ANDRADE M F, et al. Transcutaneous vagus nerve stimulation effects on chronic pain: systematic review and meta-analysis[J]. Pain Rep, 2024, 9(5): e1171.
[9] TAN C, QIAO M, MA Y, et al. The efficacy and safety of transcutaneous auricular vagus nerve stimulation in the treatment of depressive disorder: a systematic review and meta-analysis of randomized controlled trials[J]. J Affect Disord, 2023, 337: 37-49.
[10] 《中国老年型糖尿病防治临床指南》编写组. 中国老年2型糖尿病防治临床指南(2022年版)[J]. 中国糖尿病杂志, 2022, 30(1): 2-51.
[11] ZHANG S, ZHAO Y, QIN Z, et al. Transcutaneous auricular vagus nerve stimulation for chronic insomnia disorder: a randomized clinical trial[J]. JAMA Netw Open, 2024, 7(12): e2451217.
[12] 周航, 王丽琼, 屠建锋, 等. 针刺随机对照试验中盲法评价现状与方法学思考[J]. 中医杂志, 2024, 65(19): 1978-1982, 1987.
[13] LI L, XU D, XU M, et al. Insomnia and its risk factors in patients with type 2 diabetes:a cross-sectional study[J]. Sleep Med, 2025, 131: 106484.
[14] LIU C, CHEN S, ZHANG Y, et al. Transcutaneous auricular vagus nerve stimulation (taVNS) for insomnia disorder: a narrative review of effectiveness, mechanisms and recommendations for clinical practice[J]. Nat Sci Sleep, 2025, 17: 1327-1344.
[15] MA C, ZHOU N, MA K, et al. Neural pathways from hypothalamic orexin neurons to the ventrolateral preoptic area mediate sleep impairments induced by conditioned fear[J]. Front Neurosci, 2023, 17:1122803.
[16] ZHAO B, BI Y, CHEN Y, et al. Altered functional connectivity of the thalamus in patients with insomnia disorder after transcutaneous auricular vagus nerve stimulation therapy[J]. Front Neurol, 2023, 14: 1164869.
[17] 陈兰英, 张旭, 肖志娟, 等. 尼麦角林联合经皮耳迷走神经电刺激治疗脑卒中患者认知功能障碍的疗效及其作用机制分析[J]. 川北医学院学报, 2025, 40(1): 85-88.
[18] WANG J Y, ZHANG Y, CHEN Y, et al. Mechanisms underlying antidepressant effect of transcutaneous auricular vagus nerve stimulation on CUMS model rats based on hippocampal α7nAchR/NF-κB signal pathway[J]. J Neuroinflammation, 2021, 18(1): 291.

Effect of transcutaneous aurcular vagus nerve stimulation on sleep and autonomic function in elderly patients with type 2 diabetes mellitus

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