The effects of acupuncture versus sham/placebo acupuncture for insomnia: A systematic review and meta-analysis of randomized controlled trials.

Acupuncture has been found to be an effective treatment for insomnia. but it is not clear whether acupuncture is just a placebo effect. We aimed to compare the efficacy and safety of acupuncture and sham/placebo acupuncture. We searched the Central Register of Controlled Trials of Medline, EMBASE, and Cochrane from database inception through March 16, 2020 for randomized controlled trials (RCTs) that compared acupuncture therapy with sham/placebo acupuncture or no treatment. Restricted to English language. Cochrane risk of bias tool was used to analyze risk of bias of the included randomized controlled trials (RCT). Data analysis was performed with Review Manager 5.3. A total of 15 studies involving 1108 patients. Meta-analysis results showed that acupuncture therapy was superior to sham/placebo acupuncture in terms of improving Pittsburgh sleep quality index (PSQI), insomnia severity index (ISI), total sleep time (TST), sleep-onset latency (SOL), wake after sleep onset (WASO), sleep efficiency (SE), even during the follow-up period, acupuncture therapy was superior to sham/placebo acupuncture on PSQI. Due to the obvious heterogeneity of the study, (1) for primary outcome (PSQI):subgroup analysis based on the type of acupuncture and placebo acupuncture showed that acupuncture was superior to placebo acupuncture lower PSQI: acupuncture was superior to placebo acupuncture (3RCTs,MD = -7.34,95% [-8.02,-6.66],I2 = 86%) and minimal acupuncture (5RCTs,MD = -3.29,95% [-3.95, -2.63],I2 = 53%), Auricular acupressure was superior to placebo acupuncture (1RCT,MD = -4.16,95% [-6.57, -1.75]), minimal acupuncture was superior to electroacupuncture (2RCTs, MD = 0.70,95%CI [0.52, 0.87],I2 = 0%), while there was no significant difference between auricular acupressure and minimal acupuncture, between electroacupuncture and placebo acupuncture. trials). (2) for secondary outcome (ISI,TST,WASO,SE,SOL).ISI, the ISI score of minimal acupuncture was lower than that of electroacupuncture (2RCTs,MD = 0.80,95%CI [0.55, 1.04],I2 = 0), acupuncture was lower placebo acupuncture (1RCT, MD = -7.89,95%CI [-10.15, -5.63]), There was no significant difference between electroacupuncture and minimal acupuncture. Conclusion: Based on the outcomes included in this study, the efficacy of acupuncture was superior to that of placebo acupuncture in treating insomnia. Types of acupuncture therapy and placebo may underestimate the efficacy of acupuncture in different ways.

Zhang J ，He Y ，Huang X ，Liu Y ，Yu H ... -  《-》

Acupuncture for insomnia.

Cheuk DK ，Yeung WF ，Chung KF ，Wong V ... -  《Cochrane Database of Systematic Reviews》

Electroacupuncture Plus Auricular Acupressure on Chemotherapy-Related Insomnia in Patients With Breast Cancer (EACRI): Study Protocol for a Randomized, Sham-Controlled Trial.

Zhang J ，Yang M ，So TH ，Chang TY ，Qin Z ，Chen H ，Lam WL ，Yeung WF ，Chung KF ，Jiang F ，Lao L ，Zhang ZJ ... -  《-》

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 ... -  《-》

Efficacy and safety of acupuncture for the treatment of insomnia in breast cancer patients: A systematic review and meta-analysis.

Breast cancer-related insomnia is one of the most common symptoms in patients with breast cancer, and acupuncture has been increasingly used in the treatment. However, there has been no meta-analysis that specifically explores the efficacy and safety of acupuncture in treating insomnia related to breast cancer. The aim of this review was to systematically analyze the existing literature through a meta-analysis to evaluate the effectiveness and safety of acupuncture for breast cancer-related insomnia. Six medical databases were comprehensively searched for previous randomized controlled trials (RCTs) up to April 2024. The Pittsburgh Sleep Quality Index (PSQI) score was the primary outcome. The secondary outcomes include the Insomnia Severity Index (ISI), Sleep Onset Latency (SOL), Wake After Sleep Onset (WASO), Total Sleep Time (TST), and Sleep Efficiency (SE), and the later four outcomes were measured by Actiwatch and sleep diary, respectively. A total of seven articles with 434 participants were included. The meta-analysis revealed that acupuncture produced a significant improvement in the total PSQI score (MD 95 %CI = -2.16[-2.88, - 1.45], P < 0.001), but had no statistical significance on ISI scores compared with controls (MD 95 %CI = -1.53[-3.97, 0.91], P = 0.22). From the Actiwatch, there was no substantial disparity observed in the enhancement of Sleep Onset Latency (SOL) (MD 95 %CI = -6.40[-13.19, 0.39], P = 0.06), Wake After Sleep Onset (WASO) (MD 95 %CI = -1.45[-7.09, 4.20], P = 0.62), or Total Sleep Time (TST) (MD 95 %CI = 3.54 [-4.71, 11.79], P = 0.40) between the experimental group and the control group. However, a significant distinction was observed in Sleep Efficiency (SE) improvement (MD 95 %CI = 2.43 [0.14, 4.72], P = 0.04). From the sleep diary, there was a significant difference in the amelioration of SOL (MD 95 %CI = -9.15[-16.48, - 1.81], P = 0.01), TST (MD 95 %CI = 29.92 [16.74, 43.10], P < 0.001), and SE (MD 95 %CI = 4.57 [1.92, 7.23], P = 0.0007) between the experimental group and the control group. However, no significant divergence was observed in the improvement of WASO (MD 95 %CI = 4.53[-4.81, 13.87], P = 0.34). All reported acupuncture-related adverse events were mild in severity. Acupuncture can partially alleviate insomnia symptoms in breast cancer patients. Moreover, acupuncture is safe and may serve as a dependable alternative therapy in clinical settings. Owing to the limited number of studies included, potential biases of heterogeneous interventions, and methodological weaknesses of long-term follow-up, more high-quality RCTs with large sample sizes should be conducted to evaluate acupuncture treatment.

Weng Y ，Ren X ，Zu Z ，Xiao L ，Chen M ... -  《-》