The effect of wet cupping therapy on patients' symptom level and sleep quali̇ty in restless leg syndrome

Introduction: Restless leg syndrome (RLS) is a chronic disease that goes with abnormal sensations in the extremities. Usually, the symptoms become evident at night, which causes discomfort and desire to move. Treatment is also carried out to alleviate the symptoms, as the causes of RLS symptoms have not yet been clarified. In this study, we aimed to investigate the effectiveness of cupping therapy, which has been used in East Asia and the Middle East for centuries but has started to attract attention in Europe in the last century. Materials and Methods: Our study was carried out in Ankara City Hospital Neurology and Family Medicine Polyclinics between January 2019 and December 2019. Two patient groups with the diagnosis of Restless Leg Syndrome were created. The first group consists of patients who received pramipexole therapy in their current form, and the second group consists of patients who received no treatment. Both groups received 2 sessions of cupping therapy at one-month intervals. Pittsburgh Sleep Quality Index (PSQI), Restless Leg Syndrome Severity Scale (RLSSS), and Numerical Evaluation Scale for Pain (NES) were applied to the patients before and after wet cupping therapy. The data were transferred to the IBM SPSS package program, and statistical analyzes were made. Results: There are two groups of eight in our study. There was no statistically significant relationship between the groups in terms of gender, co-morbid disease, and family history. When the levels of RLSSS before and after applying two sessions of wet cupping therapy were compared, there was a decrease in RLS severity levels in four categories (The need to act due to RLS, sleep disturbance due to RLS, the daily average severity of RLS complaints, and RLS severity scale total score )with significant difference (p=0.0157, p=0.026, p=0.034, p=0.025, respectively). When the levels in the RLSSS categories of the second group before and after the two sessions of wet cupping therapy were applied, there was a significant decrease in HBS severity levels in six categories (The rate of RLS complaints, the need to act due to RLS, sleep disturbance due to RLS, fatigue, and drowsiness due to RLS, the frequency of RLS complaints, the average daily severity of RLS complaints) (p=0.047, p=0.024, p=0.034, p=0.046, p=0.034, p=0.041, respectively). When the PSQI category intensities of the second group before and after applying two sessions of wet cupping therapy were compared, it was found statistically significant between sleep latency, daytime dysfunction, and PSQI total category intensity (p=0.041, p=0.024, p=0.025, respectively). A statistically significant relationship was found between the RLSSS scores of the first and second group patients after two sessions of wet cupping therapy (p=0.012). The RLSSS scores of the second group were found to be lower after cupping therapy. Conclusion: In conclusion, wet cupping therapy was more effective in reducing symptoms in the group that received no treatment. Especially patients with RLS who have mild complaints can be offered wet cupping therapy to reduce symptoms. With well-designed scientific studies investigating the effectiveness of cupping therapy, it is thought that the mechanism of action of this therapy will become more apparent and can be applied more effectively and safely. Keywords: Restless leg syndrome, cupping therapy, sleep quality