Acupuncture and related therapies improve Pittsburgh Sleep Quality Index scores in post-stroke insomniaAcupuncture therapies show promise for insomnia after a stroke

This systematic review and network meta-analysis evaluated the efficacy of various acupuncture modalities in treating post-stroke insomnia. The study included a large population of 8062 patients to compare acupuncture (Acu) and related therapies, such as auriculotherapy, electroacupuncture, point embedding, and warm acupuncture, against standard western medicine and conventional rehabilitation therapy. The primary outcome measured was the Pittsburgh Sleep Quality Index total score.

In terms of the primary outcome, results indicated that Acu related therapies were superior to both western medicine and conventional rehabilitation therapy. Specifically, a combined therapy approach involving Acu, auriculotherapy, and electroacupuncture yielded the best outcomes for the Pittsburgh Sleep Quality Index total score. While specific p-values or confidence intervals were not reported in the synthesis, the direction of effect was clearly favorable for acupuncture interventions.

Secondary outcomes provided more granular insights into specific sleep parameters. For the goals of prolonging sleep duration and shortening sleep latency, three regimens showed better effects: Acu alone, a combination of Acu plus auriculotherapy and point embedding, and a combination of Acu with western medicine. Regarding subjective sleep quality, point embedding was identified as achieving the best outcomes among the studied interventions.

Other specific clinical manifestations were addressed by different modalities. Warm acupuncture demonstrated the best results for improving daily functional dysfunction. Furthermore, Acu alone was ranked as the best intervention for reducing the overall degree of sleep disorder. These findings suggest that while various acupuncture techniques are effective, specific types may be more suitable depending on whether the primary goal is general sleep quality, duration, or functional improvement.

Safety and tolerability data were not reported in the included studies, meaning the rate of adverse events or discontinuations for these acupuncture modalities remains unknown from this analysis. The study notes that while an association was established via network meta-analysis of randomized controlled trials, the evidence is currently limited by a lack of standardized clinical trials to determine the optimal treatment regimen.

These results suggest that acupuncture and related therapies have a positive effect in ameliorating poststroke insomnia. Clinicians may consider different Acu regimens based on specific patient manifestations, such as using warm acupuncture for functional dysfunction or point embedding for subjective sleep quality. However, because this is a systematic review and not a primary trial, the findings should be interpreted with caution regarding the exact magnitude of effect. Several questions remain unanswered due to the current evidence base. Specifically, more standardized clinical trials are needed to provide higher quality evidence and establish an optimal treatment regimen for post-stroke patients. The lack of reported safety data also necessitates cautious integration into standard care protocols until further primary research is conducted.