2023 Sleep Medicine Clinics

Acupuncture may enhance the effectiveness of cognitive-behavioral therapy for people suffering from insomnia and related conditions.

The research methodology used in this paper is mainly a theoretical analysis and discussion of the potential synergistic effects of combining cognitive-behavioral therapy for insomnia (CBT-I) and acupuncture. This involves analysis of the current evidence base for the efficacy of acupuncture in treating insomnia and related conditions, along with examination of the practical, logistical, and regulatory aspects of combining these two treatments.

In the discussion of their results, the researchers found that there is a growing body of evidence that supports the potential benefit of acupuncture in treating insomnia and its comorbidities, enhancing the current standard treatment approach of CBT-I. This appears to be an innovative approach that could potentially enhance the treatment effectiveness and outcomes for those struggling with insomnia, though it concurrently raises complex issues in terms of its practical and regulatory implementation.

Acupuncture as an Adjunct Treatment to Cognitive-Behavioral Therapy for Insomnia Kutana S, Mao JJ, Garland SN

2022 Medicine

High prevalence of insomnia, anxiety, and depression among perimenopausal women, emphasizing the importance of exploring acupuncture as a potential green therapy for effectively addressing these interconnected issues.

This passage discusses the prevalence of insomnia among perimenopausal women, its association with anxiety and depression, and the potential of acupuncture as a green therapy for treating these issues. The passage outlines the objectives and methods of a systematic review aiming to evaluate the efficacy of acupuncture in improving sleep quality and alleviating anxiety and depression in perimenopausal women, highlighting the need for safer alternatives to conventional medications and the significance of such a study.

Can acupuncture improve sleep quality and anxiety among women during perimenopause? Ping Y, Liang C, Fan X, Zhang L, Ying D, Wang Z

2021 Frontiers in Aging Neuroscience

Stroke patients who received acupuncture had a lesser risk of insomnia across various demographic and medical variables.

The study data was derived from the case database of a Chinese hospital, featuring stroke patients diagnosed between 2010 and 2019. These patients were sorted into two groups: one which received acupuncture and one which did not. The sorting was performed using a propensity score matching technique. Comparisons were made between the two groups using the incidence of insomnia as the primary indicator, with Cox regression analysis and the Kaplan-Meier method serving as the main analytical tools.

The results indicated that stroke patients who underwent acupuncture treatments were less susceptible to insomnia as compared to counterparts who didn't receive acupuncture treatment. This decrease in the incidence of insomnia was observed across various categories such as genders, age groups, stroke types and stroke locations, with the acupuncture group displaying a significantly lesser cumulative incidence of insomnia.

Acupuncture Reduced the Risk for Insomnia in Stroke Patients: A Propensity-Score Matched Cohort Study Qiu X, Han NS, Yao JX, Yu FR, Lin YY, Zhuang X

2021 Complementary Therapies in Medicine

Lavandula angustifolia essential oil inhalation seemed to enhance overall sleep patterns, quality, and efficiency in postmenopausal women with insomnia.

Methodology: 35 postmenopausal women, clinically diagnosed with insomnia, were recruited and divided into two groups - an Aroma Group and a Placebo Group - for a double-blind, randomized controlled trial. Over 29 days, participants in the Placebo Group inhaled sunflower oil, while participants in the Aroma Group inhaled lavender oil. Both groups were given sleep hygiene guidelines before embarking on the trial and received follow-up on a weekly basis. Evaluations were performed both pre- and post-intervention.

Discussion of Results: No significant differences were noted between the two groups in terms of sleep quality. However, certain tendencies were observed. Aroma Group participants showed a noteworthy reduction in the time taken to fall asleep, depression levels and postmenopausal symptoms such as hot flashes. Moreover, polysomnography data showed increased sleep efficiency in comparison to initial levels. The improvement in sleep quality over time was observed in both groups, indicating that sleep hygiene instruction and weekly follow-ups played a significant role in influencing sleep patterns and quality.

Lavender essential oil on postmenopausal women with insomnia: Double-blind randomized trial dos Reis Lucena L, dos Santos-Junior JG, Tufik S, Hachul H

2020 Annals of Palliative Medicine

Acupuncture treatment of insomnia is efficacious, not because of its placebo effect.

Acupuncture is a common alternative therapy for clinical treatment of insomnia. As the underlying mechanism is yet unclear, its efficacy is often considered as placebo effect. To clarify whether acupuncture treatment of insomnia is only due to its placebo effect, a systematic review and a meta-analysis were designed based on the comparison between acupuncture and sham acupuncture.

Compared to the sham groups, acupuncture significantly decreased the PSQI score (P<0.0001). A subgroup analysis showed that the selection of sham acupuncture methods did not affect the results of PSQI. A subgroup of two trials with a total of 141 participants with major depressive disorder did not show any significant reductions in total PSQI scores (P=0.11). In addition, a significant difference was detected in the change of Insomnia Severity Index (ISI) scores (362 adult patients, 4 trials) between acupuncture and sham acupuncture (P<0.0001). The PSG and actigraphy data from acupuncture and the sham did not reveal any significant differences in the sleep structure changes.

For the selection of sham acupuncture, both methods performed similarly in a clinical setting. Moreover, insomnia patients with major depression disorder were not recommended to use only acupuncture treatment.

Placebo effect of acupuncture on insomnia: a systematic review and meta-analysis Liu C, Xi H, Wu W, Wang X, Qin S, Zhao Y, Zheng S, Wan Q, Xu L.

2020 Nature and Science of Sleep

Ten sessions of electroacupuncture can improve the sleep quality of patients with insomnia without serious adverse effects.

Results of the current trial provide supportive evidence that electroacupuncture can be an effective, safe, and well-tolerated non-pharmacological intervention for insomnia, using validated placebo control and validated subjective questionnaires. Further long-term studies with objective sleep measures are needed for a more definitive conclusion.

Efficacy and Safety of Electroacupuncture for Insomnia Disorder: A Multicenter, Randomized, Assessor-Blinded, Controlled Trial Lee B, Kim BK, Kim HJ, Jung IC, Kim AR, Park HJ, Kwon OJ, Lee JH, Kim JH.

2020 Integrative Cancer Therapies

Tian Wang Bu Xin Dan can potentially alleviate symptoms of cancer-related insomnia similarly to cognitive-behavioral therapy.

In this study, 22 participants were divided equally between a group given Cheonwangbosimdan and a control group who received cognitive-behavioral therapy for insomnia. Participants in the Cheonwangbosimdan group were required to consume the herbal liquid daily and participate in weekly visits for a period of four weeks. Conversely, the control group underwent behavioral therapy sessions 4 times over the same four-week period.

The outcomes from these interventions were evaluated using key indices that measured participants' insomnia severity, sleep quality, fatigue, anxiety, and overall performance status. With the focus being on changes observed from the inception of the trial to the end, these measurements were taken at the conclusion of the fifth week. While no significant difference was found between the two study groups, both displayed a positive trend towards alleviating the symptoms of cancer-related insomnia, with anxiety levels markedly lower in the treatment group.

Comparative Effectiveness of Cheonwangbosimdan (Tian Wang Bu Xin Dan) Versus Cognitive-Behavioral Therapy for Insomnia in Cancer Patients: A Randomized, Controlled, Open-Label, Parallel-Group, Pilot Trial Moon SY, Jerng UM, Kwon OJ, Jung SY, Lee JY, Yoon SW, Shin WC, Byun JI, Lee JH

2019 Evidence-Based Complementary and Alternative Medicine

Acupuncture therapy is an effective and safe treatment for chronic pain-related insomnia.

In our current study, we pooled the data from nine studies involving 944 patients. Our pooled analysis indicated that acupuncture treatment was significantly better than drugs group in improving effective rate and cure rate and in debasing PSQI score and VAS score. In addition, compared with sham acupuncture, manual acupuncture treatment has an advantage in improving the effective rate and reducing the PSQI score, but the two groups have no statistical significance in improving the cure rate. In this meta-analysis, only four studies reported relevant adverse events. The combined data showed no significant difference in adverse reactions between acupuncture group and control group. Therefore, we can carefully recommend that acupuncture is as safe as control group for CPRI. In addition, adverse events were relatively mild, mainly including bruises, soreness, nausea, dizziness, and other discomforts. These adverse events can be effectively avoided by strengthening the aseptic operation specification, and improving the professional ability of doctors. Based on the findings of our included studies, we propose that acupuncture is an effective and safe therapy for patients with CPRI.

Acupuncture for Chronic Pain-Related Insomnia: A Systematic Review and Meta-Analysis Fushui Liu, Jianyu You, Qi Li, Ting Fang, Mei Chen, Nana Tang, Xiaojun Yan

2018 Medicine

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes.

Overactive bladder is stated as the occurrence of urinary urgency which will cause negative impacts and decrease patients’ health-related quality of life. The aim of this systematic review is to assess the efficiency and safety of acupuncture for adults with overactive bladder (OAB) comparing with sham-acupuncture, drugs, and acupuncture plus drugs.

Acupuncture might have effect in decreasing the number of micturition episodes, incontinence episodes, and nocturia episodes. However, the evidence is insufficient to show the effect using acupuncture alone or the additional effect to drugs in treating OAB.

Acupuncture for adults with overactive bladder: A systematic review and meta-analysis of randomized controlled trials Zhao Y, Zhou J, Mo Q, Wang Y, Yu J, Liu Z.

2017 Journal of Physics Conference Series

Acupuncture treatment effectively improved the quality of sleep and the quality of life for chronic hemodialysis patients.

Twenty-eight hemodialysis patients suffering from insomnia were divided randomly into two groups, an acupuncture group (n = 15) who received acupuncture treatment at the points HT7 Shenmen, PC6 Neiguan, GV20 Baihui, and EX-HN1 Sishenchong, anda control group (n = 13) who underwent a sham procedure in which a needle was inserted into an elastic bandage at the same points. The acupuncture treatment was done during hemodialysis twice a week for five weeks. PSQI scores and the WHOQOL-BREF were assessed before treatment, after the fifth treatment, and at the end of the treatment. Significant differences were found in the PSQI score and in the WHOQOL-BREF between the acupuncture group and the control group by the end of the period of treatment. Acupuncture treatment effectively improved the quality of sleep and the quality of life for these chronic hemodialysis patients.

The effect of acupuncture treatment for insomnia in chronic hemodialysis patients J A Widjaja, C Simadibrata, A Srilestari, M B H Marbun

2015 Sleep Medicine

Chinese herbal medicine was superior to placebo and benzodiazepine drugs and was superior to benzodiazepines and psychotherapy alone as an adjunct therapy in terms of subjective sleep quality and quantity and safety.

In this study, we systematically reviewed 79 RCTs investigating a variety of Chinese herbal medicine (CHM) treatments for participants with insomnia. We also performed meta-analyses to estimate the efficacy of CHM on subjective sleep quality assessed by validated instruments, patient-rated sleep parameters, clinician-reported severity, and PSG results, as well as to determine the safety of CHM.

Overall, this systematic review and meta-analysis showed that CHM was superior to placebo and benzodiazepine drugs (BZDs) when used as a monotherapy and was superior to BZDs and psychotherapy alone as an adjunct therapy in terms of subjective sleep quality and quantity and safety. CHM was not associated with more benefit than non-BZDs, although the risks were less. These results suggest that CHM could be a promising alternative therapy with a good benefit–risk ratio.

Updated clinical evidence of Chinese herbal medicine for insomnia: a systematic review and meta-analysis of randomized controlled trials Xiaojia Ni, Johannah Linda Shergis, Xinfeng Guo, Anthony Lin Zhang, Yan Li, Chuanjian Lu, Charlie Changli Xue

2010 Journal of Medicinal Food

Tart cherry juice blend yielded modest improvements in sleep for older adults with insomnia, exhibiting effects similar to or better than natural products like valerian and melatonin.

In the pilot study, 15 older adults who were suffering from chronic insomnia but were otherwise healthy participated in a randomized, double-blind, crossover design. The study lasted for 6 weeks, with each participant receiving both the proprietary tart cherry juice blend and a placebo for 2 weeks with a 2-week washout period between the two treatments. Sleep continuity and insomnia severity were evaluated by analyzing 2-week mean values derived from daily sleep diaries and the Insomnia Severity Index respectively.

The tart cherry juice blend was found to bring significant improvements in all assessed sleep variables before and after treatment. These improvements were particularly noticed in reducing insomnia severity, specifically the minutes awake after sleep onset, compared to placebo. Sleep latency, total sleep time, or sleep efficiency didn't show any notable improvements compared to placebo. The benefits of the tart cherry juice on sleep for older adults with insomnia were in the range of effect sizes seen in studies using valerian or melatonin, which are the most commonly studied natural products for insomnia. But these effects were considerably less than evidence-based insomnia treatments such as hypnotic agents and cognitive-behavioral therapies.

Effects of a Tart Cherry Juice Beverage on the Sleep of Older Adults with Insomnia: A Pilot Study Pigeon WR, Carr M, Gorman C, Perlis ML