Efficacy and Safety of Acupuncture in the Treatment of Poststroke Insomnia: A Systematic Review and Meta-Analysis of Twenty-Six Randomized Controlled Trials

Abstract

Objective. To evaluate the efficacy and safety of acupuncture in the treatment of poststroke insomnia. Methods. PubMed, the Cochrane Library, Embase, Web of Science, China Biology Medicine (CBM), CNKI, VIP, and Wanfang databases were searched by computer from their inception to April 29, 2021, for collecting all randomized controlled trials of acupuncture in the treatment of poststroke insomnia. After two reviewers independently screened the literature, extracted the data, and evaluated the risk of bias in the included studies, the data were analyzed by RevMan 5.3 and STATA 16.0. The quality of outcomes was evaluated by the Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results. A total of 26 studies with 1874 cases were included, which had 942 cases in the treatment group and 932 cases in the control group. Meta-analysis results showed that, compared with oral medications alone, acupuncture alone or acupuncture combined with oral medications could improve the clinical effective rate and the sleep quality of patients, and the combined effects were RR = 1.21; 95% CI: 1.15, 1.27; P < 0.00001 and MD = 3.41; 95% CI: 2.40, 4.41; P < 0.00001 , respectively. As for adverse reactions, the incidence of acupuncture alone or acupuncture combined with oral drugs was lower than that of oral drugs alone, which was safer and the combined effect was RR = 0.21; 95% CI: 0.09, 0.48; P = 0.0002 . Sensitivity analysis showed that the results were stable. We evaluated the quality of evidence with the GRADE system; the clinical effective rate was rated as “LOW,” the evidence grade of PSQI score was “LOW,” and the evidence grade of adverse reactions was “Very LOW.” Conclusion. Acupuncture alone or acupuncture combined with oral drugs is more effective and safer than oral drugs alone in the treatment of poststroke insomnia, which is suitable to promote in clinical practice.

A Systematic Review and Meta-Analysis Protocol to Establish How Common Clinical Acupoint Stimulation-Related Therapies Should Be Used for Managing Insomnia

“…In addition to acupuncture and acupressure, ASRTs have now evolved into numerous treatment techniques driven by clinical need, with acupoint selection varying from practitioner to practitioner. While several clinical common ASRTs for insomnia have been evaluated in previous systematic reviews, [45][46][47][48][49][50][51][52][53] in the face of such a wide range of ASRTs, there is no conclusion on how ASRT clinicians should manage insomnia in clinical practice. To develop guidelines and further drive future clinical practice and research, a more thorough and comprehensive evaluation of all the existing literature is required.…”

“…43,44 Numerous systematic reviews have also reported that the efficacies of these common clinical ASRTs for primary insomnia and comorbid insomnia were higher than that of routine care, placebo acupuncture, or waiting list controls. [45][46][47][48][49][50][51][52][53] However, the generalizability of these findings was constrained by the fact that the quality of the available literature is generally poor and these meta-analyses concentrated on a particular form of insomnia and/or a single therapy approach.…”

Interventional psychiatry (Part 2)

“…70 Nonetheless, active acupuncture was shown to be minimally superior to placebo acupuncture. 70 A meta-analysis of acupuncture for preoperative anxiety 71,72 and poststroke insomnia 73 reported a similar low study quality. A study of 72 patients with primary insomnia revealed that acupuncture was more effective than sham acupuncture for most sleep measures.…”

Deciphering Post-Stroke Sleep Disorders: Unveiling Neurological Mechanisms in the Realm of Brain Science

“…Multiple randomized controlled trials have shown that acupuncture serves as a useful tool for patients with post-stroke sleep disorders [225][226][227]. Recently, acupuncture therapy, as a traditional Chinese medicine therapy, has been widely used in the treatment of post-stroke sleep disorders for its convenient operation and low adverse effect characteristics [228][229][230][231].…”