Critical Analysis of a Journal Article on Sleep Patterns and Insomnia

This report presents a critical analysis of a journal article titled "Sleep patterns in a randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for insomnia" by Bergdahl, Broman, Berman, Haglund, von Knorring, & Markström, (2017). The analysis examines the study's methodology, including the use of auricular acupuncture and cognitive behavioral therapy (CBT-i) to investigate their impact on sleep patterns. The report evaluates the literature review, research question, and potential biases, such as gender bias in participant selection. It assesses the study's reliability and validity, discussing the use of actigraphy and other instruments. The analysis also considers the graphical representation of data and the interpretation of results, highlighting the strengths and limitations of the research. The author concludes by summarizing the research's key findings and its contribution to understanding sleep patterns and insomnia management.

Running Head: CRITICAL ANALYSIS OF A JOURNAL ARTICLE 1
Critical analysis of a journal article
Author’s Name
Institutional Affiliation
Date

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 2
Critical analysis of a journal article
In entirety, this paper will critically analyze a journal article titled “Sleep patterns in a
randomized controlled trial of auricular acupuncture and cognitive behavioral therapy for
insomnia” by Bergdahl, Broman, Berman, Haglund, von Knorring, & Markström, (2017). Sleep
patterns can be regular or irregular, and this depends on the state of mind. Based on this article,
the authors believe that auricular acupuncture influences sleep patterns. In my extensive
research, auricular acupuncture is defined as a microsystem technique that allows insertion of
needs into some points especially those altered with bioelectrical conductance on the outer part
of an ear (Litscher & Rong, 2016). This procedure is believed to relieve pain, minimize insomnia
by calming the mind. Primarily, Bergdahl et al., (2017) examine how sleep patterns after AA
(auricular acupuncture) and CBT-i (cognitive behavior therapy for insomnia) are impacted in
long-term and short-term timelines.
Nevertheless, the decision to choose this article was informed by the fact that it is
discussing insomnia and AA. Through the article, I can understand how sleep patterns are likely
to be affected after an individual is administered AA and CBT-i. I also chose this journal article
because it gives a detailed analysis of how sleep patterns are likely to be affected leading to
insomnia. I sometimes experience insomnia, and in all probability, this informed my chose of
this article to help me understand how I can manage my sleep patterns to prevent insomnia.
A detailed look at the article reveals that the authors conducted some online research. A
topic like this has been previously researched and any new research it is conceivable to refer to
existing research. Although the literature review section is missing, the authors extensively used
secondary sources to support their analysis. In the reference section, there are 42 resources used.

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 3
These sources have been covered in in-text citation right from the introduction. This implies that
the authors carried out secondary research or literature review on the same topic before carrying
out their experiment. In his book on literature review, Hart, (2018) mentions that literature
review can be done if it is necessary. This would mean that the authors found it indispensable to
use existing literature to build up their research. Several studies or research, have carried out a
literature review on the topic of sleep patterns. Hence, by carrying out a literature review,
Bergdahl, et al., (2017) gives the research an organized flow. A majority of readers will always
want to examine the literature review section of research to get some information they can link to
new research. Most importantly, the authors were able to use secondary sources to detail
information about AA, sleep patterns and insomnia; hence the literature review was adequately
done since the authors used 42 references.
The quality of the literature research was high, going by the references used. According
to the study of Bergdahl, et al., (2017) it was asserted that insomnia influences several aspects of
life-based on the review of some research they conducted. My analysis of the 42 references used
in this research show that these are high quality references. Research gains credence if scholarly
and credible sources are used. O'Leary, (2017) insist that while doing research, the writers should
use appropriate sources to evidence their arguments. Equally, in this research, the authors used
academic and scholarly sources primarily to give their research credibility. In a similar vein,
these references are relevant given that they are scholarly and shaped the reasoning and analysis
of the authors throughout their research period.
However, looking at the research, there was no specific section for the hypothesis to
guide readers to understand the basis for the research. Fortunately, in the abstract-first sentence

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 4
the authors indicated that they are investigating “the aim of the study was to examine how sleep
patterns were affected in a short objectively- and long-term perspective after auricular
acupuncture (AA) and cognitive behavioral therapy for insomnia (CBT-i)” Bergdahl, et al.,
(2017). In all probability, this was a research question/hypothesis for this research. Thus, the
research question for the journal article was clear despite it being mentioned in the abstract.
Based on PICOT, the research question for this journal article was focused on intervention and
outcome. The interventions in this question include AA and CBT-i, while the result would
consist of the effect on sleep patterns.
Nevertheless, during research Bergdahl, et al., (2017) used RCT (randomized controlled
study) employing actigraphy to assess the research question stated earlier. D'Angelo et al., (2019)
define actigraphy as a non-invasive method used to monitor human activity cycles or rest. To
collect data on human rest or gross motor activity, actigraph unit a research participant will wear
it on the wrist. The research had a handful of participants, composed of 51 women and nine men.
Those who participated in the study had must have experienced insomnia for over six months.
The participants averagely had used non-bensodiazepine hypnotics for 7.3 years. Another twist
was that even after receiving pharmacological treatment the participant continued to suffer
symptoms of insomnia to a point some considered to terminate their treatment. Although the
researchers carried out their research productively, bias was apparent. It is clear why the research
recruited 51 women out 60 participate in the study. This clearly shows gender bias given that
Bergdahl et al., (2017) opted to exclude men from this critical research. One would have
expected 30 men and 30 women to take part in this research. Cislak, Formanowicz, & Saguy,
(2018) indicate that for long time research has been discriminated against women. Women have
been excluded from many studies. However, this gender bias in research is slowly ending.

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 5
Despite the research being biased especially against women, it was unfair for Bergdahl, et al.,
(2017) to openly discriminate against men. This research would have been balanced if the
researchers gave both women and men equal representation. If it were difficult to provide fair
representation in the study, it would be plausible if more than nine men took part in the research.
The recruitment for participation in this research was fair given that the researchers ran
an advertisement in the local paper as well as in outpatient sleep clinic. This could mean that the
research did not provide preferential treatment for women. The ad must have reached both men
and women at the same time. It is likely that men ignored the calls that they participate in this
research. In some instances, men have the propensity for ignoring things, and it is possible that
some snubbed it, giving women more chances to participate in the research. More importantly,
the research did not coerce in any individual to participate in the study. It was open to all and
sundry. The fact that the subjects of this research were informed that this was voluntary research
to some level exonerates the researcher from bias. Denzin, & Giardina, (2016) argue that it is an
ethical act to allow people to elect whether to participate in research or not. Besides, informed
consent adds credibility to the research. Similarly, in the Bergdahl, et al., (2017) provided space
for informed consent where participants were given actigraph to put on the wrist. In this case, no
individual could allege or accuse the researchers of unethical practice since the researchers
ensured that those who participate do it voluntary and on informed consent.
According to the research, only 204 people showed interest in the study following an
advertisement to invite an individual to take part in the survey (Bergdahl et al., 2017). Out of the
total number of individuals that showed interest in 67 were eligible. Based on these numbers, one
can conclude that the reason why the research had a few participants was due to lack of

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 6
qualification and disinterest. If a majority of people signed to take part in this research, it would
have been possible to get a considerable number of participants. The number of participants can
determine the accuracy of the study. If they are few, sometimes people cannot trust the findings
or individuals can dismiss the results.
The instructions given to the participants were simple. The researchers gave them
actigraph, which they were worn for seven days non-stop. By doing this, the researchers’
primary objective was to record 24-hour activity patterns, with a focus on sleep periods. By
repeatedly collecting data or retesting the experiment the authors achieved internal reliability
(Heale, & Twycross, 2015). For research to be considered reliable, it has to retest findings. Seven
days was enough time to understand sleep patterns. In this case, the researchers ensured that the
activity patterns of participants were recorded day and night to allow them to collect data that is
consistent, measurable and reliable. Equally, this research had validity considering that it used
the right instruments to register data. Actigraphy is the right instrument to measure sleep
patterns, and its use made this research valid. Also, other approaches like Zhongyan Taihe
acupuncture needles were used for this research. These needs are the right ones to use when
administering AA. Substantially, research can gain validity through the use of right instruments
to measure or collect data (Noble, & Smith, 2015).
It is not clear that if the research participants had their behaviors changed. In Rosenthal
and Hawthorn effects the responses of participants are likely to change. According to Zaccara,
Giovannelli, Giorgi, Franco, & Gasparini, (2016) Rosenthal effect occurs when some changes in
the behaviors of participants arise to fulfill the researchers’ expectations. Hawthorn effect occurs

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 7
when participants change their behavior because they are being investigated. In the analysis of
this journal article, it is clear if at any point these effects occurred. However, there is a high
likelihood of participants to change their behavior because they are studied. If this happens, it
can affect the outcome of the research, or the results can look skewed.
Graphically, this research is organized, and this makes the understanding of the study
more accessible. There is a flowchart-like graphic representation of some information in the
study. The visual representation simplifies the recruitment of participants. It appears the
decision to represent the participants in such a way was to justify that the researchers had wished
to have more participants recruited, but they were unable to do so. The information is broken
down so evidently so that any person who would question why such a handful sample was taken
to participate in this vital research.
Further, the data is adequately tabulated, showing how information was collected,
calculated and analyzed. Graphic representation of data or information makes it easier to read,
understand and analyze. Bergdahl et al., (2017) in this article were to make readers understand so
easily how their data was recorded and findings determined. Sometimes data/information
represented in text only may not appeal to the eye. Thus, it was plausible to represent this raw
data on the table and show calculations done to arrive at findings and conclusion. Although some
readers may find it hard to understand data represented on table or graphs, it is a clear way of
recording and presenting information (Beck, Burch, & Weiskopf, 2017). Fortunately, the
headings of the tables and other graphic representations were adequately identified and described
to guide readers.

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 8
To sum up, the data for this research was appropriately interpreted. The researchers were
systematic in the study, and that is why they were able to record their findings accurately despite
using a handful sample. The researchers appeared informed and knowledgeable about the
research question, and that is why there were significant limitations documented. The research
achieved both external and internal validity, and this made it possible to show that AA and CBT-
i are likely to influence sleep patterns. Medical practitioners should see this research as crucial
when treating insomnia which can significantly affect the patient. Insomnia can affect a patient
or even a healthy person, and for that matter, this research bears clinical significance.
Summarily, the quality of this article is high. It carries critical information that can be used in
assessing sleep patterns and it can also be used as a guide in managing sleep disorders. Also, this
research adds essential information to study of insomnia.

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 9
References
Bergdahl, L., Broman, J. E., Berman, A. H., Haglund, K., von Knorring, L., & Markström, A.
(2017). Sleep patterns in a randomized controlled trial of auricular acupuncture and
cognitive behavioral therapy for insomnia. Complementary therapies in clinical practice,
28, 220-226.
Beck, F., Burch, M., Diehl, S., & Weiskopf, D. (2017, January). A taxonomy and survey of
dynamic graph visualization. In Computer Graphics Forum (Vol. 36, No. 1, pp. 133-159).
Cislak, A., Formanowicz, M., & Saguy, T. (2018). Bias against research on gender bias.
Scientometrics, 115(1), 189-200.
D'Angelo, V., Beccuti, G., Berardelli, R., Karamouzis, I., Zichi, C., Giordano, R., ... & Arvat, E.
(2019). Is Associated With Sleep Alterations Detected By Wrist Actigraphy. Pituitary. 18
(6) pp: 893-897.
Denzin, N. K., & Giardina, M. D. (2016). Introduction: Ethical futures in qualitative research.
In Ethical futures in qualitative research (pp. 9-44). Routledge.
Hart, C. (2018). Doing a literature review: Releasing the research imagination. Sage.
O'Leary, Z. (2017). The essential guide to doing your research project. Sage.
Heale, R., & Twycross, A. (2015). Validity and reliability in quantitative studies. Evidence-
based nursing, 18(3), 66-67.

CRITICAL ANALYSIS OF A JOURNAL ARTICLE 10
Litscher, G., & Rong, P. J. (2016). Auricular acupuncture. Evidence-Based Complementary and
Alternative Medicine, 2016.
Noble, H., & Smith, J. (2015). Issues of validity and reliability in qualitative research. Evidence-
based nursing, 18(2), 34-35.
Zaccara, G., Giovannelli, F., Giorgi, F. S., Franco, V., & Gasparini, S. (2016). Analysis of
nocebo effects of antiepileptic drugs across different conditions. Journal of neurology,
263(7), 1274-1279.