Network meta-analysis ranks TCM nursing techniques for post-stroke insomnia efficacy

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Topics in stroke rehabilitation Published April 2, 2026 Medically reviewed April 26, 2026 Study authors: Zhang Ling, Huang Shuangying, Mei Huiting, Wang Fangying PubMed ↗ DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Consider TCM nursing technique rankings for post-stroke insomnia with caution due to study heterogeneity and bias risk.

A network meta-analysis synthesized evidence from 46 studies evaluating 20 different Traditional Chinese Medicine (TCM) nursing techniques for treating post-stroke insomnia. The analysis compared the relative efficacy of these interventions, though specific comparators and study settings were not reported. The patient population was defined as individuals with post-stroke insomnia.

For the primary outcome of clinical effectiveness rate, auricular acupressure combined with gua sha was ranked as the best intervention, with a surface under the cumulative ranking curve (SUCRA) value of 74.3%. For improvement in Pittsburgh Sleep Quality Index (PSQI) scores, acupoint application was ranked highest, with a SUCRA value of 84.4%. The analysis did not report absolute numbers, p-values, or confidence intervals for these rankings.

Safety and tolerability data, including adverse events and discontinuation rates, were not reported in the analysis. Key limitations identified include significant heterogeneity among the included studies, a risk of bias, and limited sample sizes in some of the constituent trials. The funding sources and potential conflicts of interest were also not reported.

While the analysis suggests certain TCM nursing techniques may be associated with improved sleep outcomes in post-stroke insomnia, the practice relevance is restrained. The findings indicate relative rankings, not absolute efficacy. Clinicians should interpret these results with caution due to the methodological limitations and the lack of safety data. More large-sample, high-quality randomized controlled trials are needed to confirm these associations and establish safety profiles.

Study Details

Study typeMeta analysis

EvidenceLevel 1

PublishedApr 2026

PMID40874827

View Original Abstract ↓

BACKGROUND: Insomnia is a common problem after a stroke, affecting daily life and the recovery process. Among the many Traditional Chinese Medicine(TCM) nursing techniques, it is still unknown which measures are most effective. OBJECTIVE: To evaluate the efficacy of different TCM nursing techniques on post-stroke insomnia(PSI) by network meta-analysis(NMA). METHODS: A search was conducted across ten databases to identify randomized controlled trials (RCTs) investigating TCM nursing techniques for patients with PSI, up to April 25, 2024. The quality of the literature was assessed using the bias risk assessment tool recommended in Cochrane Handbook 5.1.0.The NMA was performed using Stata software. Intervention efficacy was ranked using Surface Under the Cumulative Ranking Curve (SUCRA) values. RESULTS: A total of 4, 334 articles were identified, and 46 studies were finally included. A total of 20 TCM nursing techniques were included. In terms of clinical effectiveness rate, auricular acupressure combined with gua sha performed best (SUCRA = 74.3%), while acupoint application was the best intervention for improving PSQI score (SUCRA = 84.4%). CONCLUSIONS: TCM nursing techniques can effectively improve sleep in patients with PSI. However, caution is warranted due to the heterogeneity of the included studies, risk of bias, and limited sample sizes in some studies. In the future, more large-sample, high-quality randomized controlled studies are needed to provide more evidence-based evidence for clinical healthcare professionals. TRIAL REGISTRATION: The core protocol of this study was registered at PROSPERO database (CRD42024585602) on September 2024.

Network meta-analysis ranks TCM nursing techniques for post-stroke insomnia efficacy

Study Details

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Network meta-analysis ranks TCM nursing techniques for post-stroke insomnia efficacy

Study Details

Intravenous tenecteplase improves functional outcomes but increases hemorrhage risk in non-large vessel occlusion acute ischemic stroke.

Tenecteplase improves stroke recovery but increases bleeding risk in late treatment window

Clinical research that matters. Delivered to your inbox.

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