Effectiveness of Acupuncture and Acupressure for Improving the Sleep Quality of Menopausal Women: A Meta-Analysis

Abstract

Background: Various pharmacological and non-pharmacological treatments are utilized to address sleep disorders. This meta-analysis aimed to evaluate the effects of acupuncture and acupressure on enhancing sleep quality in menopausal women.

Methods: A systematic search was conducted using multiple databases, including Scopus, MEDLINE/PubMed, Cochrane CENTRAL, ProQuest, Google Scholar, and Iranian databases (SID, Iranmedex, Magiran) with no date restrictions up to July 2024. Studies published in both Persian and English were included in this meta-analysis. The search utilized keywords such as acupuncture, acupressure, sleep quality, insomnia, menopause, and sleep disorders. A pairwise random-effects meta-analysis was performed to calculate the mean difference (MD) and 95% confidence intervals (95% CIs).

Results: The analyses indicated that both acupuncture and acupressure effectively improved sleep quality in menopausal women. Eight trials with 499 participants demonstrated that acupressure significantly enhanced sleep quality (MD=-2.33, 95% CI=-3.27 to -1.38; I²=94%, P<0.001, n=8). Additionally, six trials with 344 participants showed that acupuncture enhanced sleep quality (MD=-3.47, 95% CI=-5.06 to -1.88; I²=97%, P<0.001, n=6).

Conclusion: The findings revealed that acupressure and acupuncture might improve sleep quality in menopausal women. However, there was a high heterogeneity between studies, and further research is required to confirm the findings of the present study.

Keywords: Acupressure; Acupuncture; Menopause; Meta-analysis; Sleep quality.

Figure 1

The flow diagram shows the study selection strategies according to the PRISMA guidelines.

Figure 2

The forest plots display the comparison of acupuncture and placebo [(MD=-3.47, 95% CIs=-5.06 to -1.88]; I²=97%, P<0.001).

Figure 3

The forest plots show the comparison of acupressure versus placebo [(MD=-2.33, 95% CIs=-3.27 to -1.38]; I²=94%, P<0.001).

Figure 4

a) The risk of bias graph illustrates the comparison between acupuncture and placebo, and b) The summary of the risk of bias provides an overview of this comparison.

Figure 5

a) The risk of bias graph illustrates the comparison between acupressure and placebo, and b) The summary of the risk of bias provides an overview of the comparison between acupressure and placebo.

Figure 6

The Leave-one-out sensitivity analysis shows the impact of removing each study on the results for the acupuncture and placebo groups.

Figure 7

The Leave-one-out sensitivity analysis shows the impact of removing each study on the results for the acupressure and placebo groups.

Figure 8

(a) Forest plots show subgroup analyses of acupressure versus placebo (MD=-3.48, 95% CI=-4.75 to -2.20; I²=70%, P<0.001). (b) Forest plots show subgroup analyses of auricular acupressure versus placebo (MD=-2.58, 95% CI=-3.80 to -1.36; I²=94%, P<0.001)

Figure 9

This figure displays funnel plots for the comparison of acupuncture versus placebo (panel a) and acupressure versus placebo (panel b). In panel (a), the analysis of acupuncture showed no significant publication bias, with Egger’s test (P=0.619) and Begg’s test (P>0.999), indicating no need for additional studies according to the trim-and-fill test. In panel (b), Egger’s test for acupressure indicated significant publication bias (P=0.022), while Begg’s test was not significant (P=0.173), and the trim-and-fill test did not add any studies, suggesting no publication bias.