Efficacy of acupuncture in insomnia treatment

Researchers from China analyzed randomized controlled trials (RCTs) that explored the effectiveness and safety of acupuncture as as treatment for primary insomnia. Their article appeared in The Journal of Alternative and Complementary Medicine.

• Acupuncture is widely used in Asia as an alternative treatment for insomnia. Its use in western countries is also increasing.
• For their analysis, the researchers searched 11 databases for studies conducted from January 2008 to October 2017. Two of the authors independently extracted data and assessed the risk of bias.
• The researchers performed statistical analysis using RevMan 5.3 software, combined data in a meta-analysis according to pre-defined protocol and performed trial sequential analysis when appropriate.
• They also conducted Grading of Recommendations Assessment, Development, and Evaluation to assess the quality of evidence.
• The researchers analyzed a total of 73 RCTs involving 5,533 participants.
• Pooled results showed that real acupuncture exerted better effects than no treatment on reducing Pittsburgh Sleep Quality Index (PSQI) scores with “very low quality” evidence.
• Meanwhile, acupuncture plus medications reduced PSQI scores more effectively than medications alone. Acupuncture also proved more beneficial than the drug estazolam.
• In addition, low-quality evidence showed less adverse events from acupuncture than western medications.

Based on these findings, the researchers concluded that acupuncture can safely improve the PSQI scores of patients with insomnia. However, the quality of evidence they obtained varied from very low to low due to the potential risk of bias and inconsistency among included trials. The researchers believe that a large sample size and rigorously designed RCTs are needed to for further evaluation.

Journal Reference:

Cao HJ, Yu ML, Wang LQ, Fei YT, Xu H, Liu JP. ACUPUNCTURE FOR PRIMARY INSOMNIA: AN UPDATED SYSTEMATIC REVIEW OF RANDOMIZED CONTROLLED TRIALS. The Journal of Alternative and Complementary Medicine. 09 May 2019;25(5):451–474. DOI: 10.1089/acm.2018.0046