Health & Fitness

Acupuncture for primary insomnia: Effectiveness, safety, mechanisms and recommendations for clinical practice.

Kristen Sparrow • May 04, 2024

primary insomnia
Good sleep for long life

Primary insomnia (PI) is a growing concern, with cognitive-behavioral therapy as the first-line treatment, though accessibility and cost are issues. Hypnotics have risks and limited long-term effectiveness. Acupuncture is a potential treatment, showing improvements in subjective sleep quality, cognitive function, and emotional symptoms in clinical trials. It also enhances objective sleep measures and may restore circadian rhythms, possibly through neurotransmitters, neurotrophic factors, inflammatory cytokines, and gut microbiota. More trials are required to confirm its benefits.

We’ve looked at acupuncture and sleep here and here and here.

FOR ACUPUNCTURE PRACTITIONERS: A related study is here  
Points used were Baihui (GV 20), Shenmen (HT 7), Sanyinjiao (SP 6), Zhaohai (KI 6) and Shenmai (BL 62)
Zhao FY, Spencer SJ, Kennedy GA, Zheng Z, Conduit R, Zhang WJ, Xu P, Yue LP, Wang YM, Xu Y, Fu QQ, Ho YS. Acupuncture for primary insomnia: Effectiveness, safety, mechanisms and recommendations for clinical practice. Sleep Med Rev. 2024 Apr;74:101892. doi: 10.1016/j.smrv.2023.101892. Epub 2023 Dec 11. PMID: 38232645.

Acupuncture for primary insomnia: Effectiveness, safety, mechanisms and recommendations for clinical practice

Affiliations
  • Abstract

Primary insomnia (PI) is an increasing concern in modern society. Cognitive-behavioral therapy for insomnia is the first-line recommendation, yet limited availability and cost impede its widespread use. While hypnotics are frequently used, balancing their benefits against the risk of adverse events poses challenges. This review summarizes the clinical and preclinical evidence of acupuncture as a treatment for PI, discussing its potential mechanisms and role in reliving insomnia. Clinical trials show that acupuncture improves subjective sleep quality, fatigue, cognitive impairments, and emotional symptoms with minimal adverse events. It also positively impacts objective sleep processes, including prolonging total sleep time, improving sleep efficiency, reducing sleep onset latency and wake after sleep onset, and enhancing sleep architecture/structure, including increasing N3% and REM%, and decreasing N1%. However, methodological shortcomings in some trials diminish the overall quality of evidence. Animal studies suggest that acupuncture restores circadian rhythms in sleep-deprived rodents and improves their performance in behavioral tests, possibly mediated by various clinical variables and pathways. These may involve neurotransmitters, brain-derived neurotrophic factors, inflammatory cytokines, the hypothalamic-pituitary-adrenal axis, gut microbiota, and other cellular events. While the existing findings support acupuncture as a promising therapeutic strategy for PI, additional high-quality trials are required to validate its benefits.

Keywords: Acupuncture; Complementary and alternative medicine; Inflammation; Insomnia; Mechanisms; Melatonin; Microbiota; Sleep.