Complementary Therapies in Clinical Practice xxx (xxxx) xxx Please cite this article as: Mohammad Reza Asgari, Complementary Therapies in Clinical Practice, https://doi.org/10.1016/j.ctcp.2019.101066 Available online 23 October 2019 1744-3881/© 2019 Elsevier Ltd. All rights reserved. Comparing acupressure with aromatherapy using Citrus aurantium in terms of their effectiveness in sleep quality in patients undergoing percutaneous coronary interventions: A randomized clinical trial Mohammad Reza Asgari a, b , Ahmad Vafaei-Moghadam c , Hassan Babamohamadi a, b, * , Raheb Ghorbani d, e , Ravanbakhsh Esmaeili f a Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran b Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran c Critical Care Nursing, Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran d Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran e Department of Epidemiology and Statistics, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran f Orthopedic Research Center, Mazandaran University of Medical Sciences, Sari, Iran A R T I C L E INFO Keywords: Sleep quality Aromatherapy Citrus aurantium Acupressure Visual analog scale Percutaneous coronary intervention ABSTRACT Introduction: Poor sleep quality is prevalent in candidates for percutaneous coronary interventions (PCIs). The present study was conducted to compare aromatherapy with acupressure in terms of their effectiveness in sleep quality in patients undergoing PCIs. Materials and methods: The present study was conducted on 85 patients undergoing PCIs and randomly assigned, using block randomization, to fve groups, namely (1)aromatherapy, (2)placebo aromatherapy, (3)acupressure, (4)placebo acupressure (acupressure applied to a point not traditionally associated with improving sleep) and (5) control. The intervention groups received aromatherapy or acupressure or placebo from 10pm to 8am the following day. The control group received only routine care. Sleep quality was measured in the patients using a visual analog scale (VAS) that was completed by them before and after the intervention. Results: The mean pretest score of sleep quality was 2.91 � 0.53 in the aromatherapy group, 2.84 � 0.47 in the placebo aromatherapy group, 2.98 � 0.59 in the acupressure group, 2.75 � 0.41 in the placebo acupressure group and 2.88 � 0.41 in the controls. ANOVA suggested no signifcant differences among these groups in the pretest (P ¼ 0.746). The mean posttest score of sleep quality was 3.72 � 1.84 in the aromatherapy group, 3.70 � 1.83 in the placebo aromatherapy group, 7.35 � 0.99 in the acupressure group, 2.67 � 0.41in the placebo acupressure group and 2.72 � 0.34 in the controls, suggesting signifcant differences among the fve groups based on the ANOVA results showed signifcant differences among the fve groups (P < 0.001). The mean posttest score of sleep quality was higher than the pretest score by 4.37 in the acupressure group compared to in the other groups (P < 0.001). Conclusion: The present fndings provided scientifc evidence for the benefts of using different methods, including acupressure, for sleep quality in patients undergoing PCIs. Iranian Registry of Clinical Trials Number: IRCT201707248665N6. * Corresponding author. Education and Research Campus, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, 5 kilometers of Damghan road, Semnan, 3513138111, Iran. E-mail addresses: asgari5000@gmail.com (M.R. Asgari), ahmadmoghaddam24@gmail.com (A. Vafaei-Moghadam), babamohamadi@semums.ac.ir (H. Babamohamadi), Ghorbani.raheb93@gmail.com (R. Ghorbani), esmaeili@mazums.ac.ir (R. Esmaeili). Contents lists available at ScienceDirect Complementary Therapies in Clinical Practice journal homepage: http://www.elsevier.com/locate/ctcp https://doi.org/10.1016/j.ctcp.2019.101066 Received 8 August 2019; Received in revised form 12 October 2019; Accepted 21 October 2019