Zhao, Fei-Yi; Spencer, Sarah J; Kennedy, Gerard A; Zheng, Zhen; Conduit, Russell; Zhang, Wen-Jing; Xu, Peijie; Yue, Li-Ping; Wang, Yan-Mei; Xu, Yan; Fu, Qiang-Qiang; Ho, Yuen-Shan

doi:10.1016/j.smrv.2023.101892

Author(s)

Zhao, Fei-Yi

Spencer, Sarah J

Kennedy, Gerard A

Zheng, Zhen

Conduit, Russell

Zhang, Wen-Jing

Xu, Peijie

Yue, Li-Ping

Wang, Yan-Mei

Xu, Yan

Fu, Qiang-Qiang

Ho, Yuen-Shan

Publication Date

2023-12-11

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.

Citation

Sleep Medicine Reviews 2023-12-11; 74

ISSN

1532-2955

Jornal Title

Sleep Medicine Reviews

OrcId

#PLACEHOLDER_PARENT_METADATA_VALUE#

Link

https://ahro.austin.org.au/austinjspui/handle/1/34969

Subject

Acupuncture

Complementary and alternative medicine

Inflammation

Insomnia

Mechanisms

Melatonin

Microbiota

Sleep

Title

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

Type of document

Journal Article

Austin Health

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

Files:

Author(s)	Zhao, Fei-Yi Spencer, Sarah J Kennedy, Gerard A Zheng, Zhen Conduit, Russell Zhang, Wen-Jing Xu, Peijie Yue, Li-Ping Wang, Yan-Mei Xu, Yan Fu, Qiang-Qiang Ho, Yuen-Shan
Publication Date	2023-12-11
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.
Citation	Sleep Medicine Reviews 2023-12-11; 74
ISSN	1532-2955
Jornal Title	Sleep Medicine Reviews
OrcId	#PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE# #PLACEHOLDER_PARENT_METADATA_VALUE#
Link	https://ahro.austin.org.au/austinjspui/handle/1/34969
Subject	Acupuncture Complementary and alternative medicine Inflammation Insomnia Mechanisms Melatonin Microbiota Sleep
Title	Acupuncture for primary insomnia: Effectiveness, safety, mechanisms and recommendations for clinical practice.
Type of document	Journal Article