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. 2009 Nov;15(11):1171-86.
doi: 10.1089/acm.2009.0041.

Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials

Huijuan Cao  1 , Xingfang Pan, Hua Li, Jianping Liu
Affiliations

Acupuncture for treatment of insomnia: a systematic review of randomized controlled trials

Huijuan Cao et al. J Altern Complement Med. 2009 Nov.

Abstract

Background: Acupuncture is commonly used in treating insomnia in China, and clinical studies have shown that acupuncture may have a beneficial effect on insomnia compared with Western medication.

Methods: We included randomized controlled trials on acupuncture for insomnia. We searched PubMed, the Cochrane Library (2008 Issue 3), China Network Knowledge Infrastructure (CNKI), Chinese Scientific Journal Database (VIP), and Wan Fang Database. All searches ended in December 2008. Two authors extracted data and assessed the trials' quality independently. RevMan 5.0.17 software was used for data analysis with effect estimate presented as relative risk (RR) and mean difference (MD) with a 95% confidence interval (CI).

Results: Forty-six (46) randomized trials involving 3811 patients were included, and the methodological quality of trials was generally fair in terms of randomization, blinding, and intention-to-treat analysis. Meta-analyses showed a beneficial effect of acupuncture compared with no treatment (MD -3.28, 95% CI -6.10 to -0.46, p = 0.02; 4 trials) and real acupressure compared with sham acupressure (MD -2.94, 95% CI -5.77 to -0.11, p = 0.04; 2 trials) on total scores of Pittsburgh Sleep Quality Index. Acupuncture was superior to medications regarding the number of patients with total sleep duration increased for >3 hours (RR 1.53, 95% CI 1.24-1.88, p < 0.0001). However, there was no difference between acupuncture and medications in average sleep duration (MD -0.06, 95% CI -0.30-0.18, p = 0.63). Acupuncture plus medications showed better effect than medications alone on total sleep duration (MD 1.09, 95% CI 0.56-1.61, p < 0.0001). Similarly, acupuncture plus herbs was significantly better than herbs alone on increase of sleep rates (RR 1.67, 95% CI 1.12-2.50, p = 0.01). There were no serious adverse effects with related to acupuncture treatment in the included trials.

Conclusions: Acupuncture appears to be effective in treatment of insomnia. However, further large, rigorous designed trials are warranted.

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Figures

FIG. 1.
FIG. 1.
The process of study selection. RCTs, randomized controlled trials.
FIG. 2.
FIG. 2.
Top 10 points used for meridian acupuncture treatment.
FIG. 3.
FIG. 3.
Top five points for auricular acupuncture treatment.
FIG. 4.
FIG. 4.
Funnel plot of 10 randomized controlled trials for the outcome of number of patients with sleeping time increased over 3 hours. SE, standard error; RR, relative risk.
See this image and copyright information in PMC

References

    1. Doghramji K. The epidemiology and diagnosis of insomnia. Am J Managed Care. 2006;12:S214–S220. - PubMed
    1. Pei L. Insomnia [in Chinese] Chin Med Press Sci Technol. 2005;6:2–3.
    1. Tang JL. Wang S. Clinical evidence [in Chinese] Peking Univ Med Press. 2008;1:778–780.
    1. Wang QC. Therapeutics of acupuncture [in Chinese] China Press Traditional Chin Med. 2003;1:1–3.
    1. Pi M. Du SH. Zhang Y. Study of therapeutic effect of acupuncture on insomnia and its effect on γ-amino butyric acid [in Chinese] J Jiangxi Coll Traditional Chin Med. 2000;12:160.

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