Acupuncture for Chronic Pain-Related Insomnia: A Systematic Review and Meta-Analysis

Abstract

Objectives. Acupuncture has been widely used to relieve chronic pain-related insomnia (CPRI). However, the efficacy of acupuncture for CPRI is uncertain. The purpose of this study was to evaluate the efficacy of acupuncture for CPRI. Methods. Seven electronic databases were searched from inception to December 2018. Randomized controlled trials (RCTs) were included if acupuncture was compared to sham acupuncture or conventional drug therapies for treating CPRI. Two reviewers screened each study and extracted data independently. Statistical analyses were conducted by RevMan 5.3 software. Results. A total of nine studies involving 944 patients were enrolled. The pooled analysis indicated that acupuncture treatment was significantly better than control group in improving effective rate (OR = 8.09, 95%CI = [4.75, 13.79], P < 0.00001) and cure rate (OR = 3.17, 95%CI = [2.35, 4.29], P < 0.00001), but subgroup analysis showed that there was no statistically significant difference between acupuncture and sham acupuncture in improving cure rate (OR =10.36, 95% CI [0.53, 201.45], P=0.12) based on one included study. In addition, meta-analysis demonstrated that acupuncture group was superior to control group in debasing PSQI score (MD = -2.65, 95%CI = [-4.00, -1.30], P = 0.0001) and VAS score (MD = -1.44, 95%CI = [-1.58, -1.29], P < 0.00001). And there was no significant difference in adverse events (OR =1.73, 95%CI = [0.92, 3.25], P =0.09) between the two groups. Conclusions. Acupuncture therapy is an effective and safe treatment for CPRI, and this treatment can be recommended for the management of patients with CPRI. Due to the low quality and small sample size of the included studies, more rigorously designed RCTs with high quality and large sample size are recommended in future.

The efficacy of acupuncture on the sleep structure of patients with insomnia: A systematic review and meta‐analysis

“…The χ 2 test was used to analyze the statistical heterogeneity of the test results, assuming that the significance level of I 2 was 50%. If I 2 ≤ 50%, low heterogeneity of the research results was suggested, and the fixed effects model would be used for analysis; on the contrary, if I 2 > 50%, high heterogeneity was suggested, and the random effects model would be chosen (Liu et al, 2019). When p < 0.05, the comparison between the two was considered statistically significant.…”

Effect of Acupuncture on Cognitive Function of Insomnia Patients Compared with Drugs: A Protocol for Meta-analysis and Systematic Review

“…Therefore, we urgently need a relevant meta-analysis to provide reliable evidence for medical decision-making. There have been meta-analyses on acupuncture for insomnia, but they only focused on the effects of acupuncture on sleep and did not study from the perspective of acupuncture improving cognitive function in patients with insomnia [41][42][43][44][45]. Different from some studies only included in patients with comorbid insomnia [41][42][43]; this study as long as patients meet the diagnostic criteria of insomnia, whether simple insomnia or comorbid insomnia, can be included.…”

“…There have been meta-analyses on acupuncture for insomnia, but they only focused on the effects of acupuncture on sleep and did not study from the perspective of acupuncture improving cognitive function in patients with insomnia [41][42][43][44][45]. Different from some studies only included in patients with comorbid insomnia [41][42][43]; this study as long as patients meet the diagnostic criteria of insomnia, whether simple insomnia or comorbid insomnia, can be included. Although it may increase the heterogeneity of the study, we can analyze whether acupuncture is effective for any type of insomnia.…”

Non-pharmacological Treatment for Elderly Individuals With Insomnia: A Systematic Review and Network Meta-Analysis

“…However, some previously published studies suggest that CBT-I, known as the first-line treatment for insomnia, and acupuncture may have different therapeutic characteristics. These studies have found that acupuncture showed weaker effects of improving insomnia itself compared to CBT-I, but showed an excellent effect in improving accompanying conditions, especially pain and painrelated insomnia (73)(74)(75)(76). Although acupuncture may still need more solid evidence to be recommended for routine treatment of elderly individuals with insomnia (77), the treatment seems to be useful as an adjuvant strategy to complement conventional treatments.…”