Is Sham Acupuncture Equally Effective for Primary Insomnia? A Bayesian Network Meta-Analysis.

IF 3.4 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2025-08-29 eCollection Date: 2025-01-01 DOI:10.2147/NSS.S541797

Yuting Wang, Minmin Wu, Jiongliang Zhang, Xinyue Li, Donghui Yu, Yumeng Su, Xiangyu Wei, Luwen Zhu

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Abstract

Purpose: To compare the efficacy differences between acupuncture and sham acupuncture in adult primary insomnia through Bayesian network meta-analysis, analyze the impact of different types of sham acupuncture on efficacy, and explore the basis for the control setting.

Methods: A literature search of seven databases, including PubMed and Embase, until April 23, 2025, included randomized controlled trials (RCTs) comparing AT with noninvasive sham acupuncture (NISA), superficial acupuncture (SA), and non-acupuncture therapy (NAT) for treating PI in adults. The statistical analyses were conducted using R (version 4.4.1) and Stata (version 15.1). The protocol was registered with the International Prospective Register of Systematic Reviews (CRD420251012912).

Results: This meta-analysis incorporated 33 RCTs encompassing 3004 participants, with most studies originating from China. The results showed that at the treatment endpoint and after 4 weeks, AT significantly improved subjective sleep quality (Pittsburgh Sleep Quality Index, PSQI) compared to SA and NISA, exceeding the minimum clinically important difference (MCID: 2.5 points). Specifically, at the endpoint, AT vs SA (MD: -3.66; 95% CI: -4.48 to -2.84) and AT vs NISA (MD: -4.35; 95% CI: -5.67 to -3) were significant, while differences among SA, NISA, and NAT were not. Based on the surface under the cumulative rank curve (SUCRA), AT ranked first (99.9%), followed by SA (47.8%), NAT (31.9%), and NISA (20.4%). No significant differences were found between AT, NISA, and SA regarding objective sleep parameters.

Conclusion: AT significantly improved subjective sleep quality in patients with PI, though its impact on objective sleep measures was limited. When designing RCTs of acupuncture for PI, NISA is recommended as the sham acupuncture control. However, due to geographical limitations, the study results may be difficult to generalize. Future research should focus on monitoring objective sleep parameters and conducting international, multicenter RCTs involving diverse cultural populations.

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假针灸对原发性失眠同样有效吗？贝叶斯网络元分析。

目的：通过贝叶斯网络meta分析比较针刺与假针治疗成人原发性失眠症的疗效差异，分析不同类型假针对疗效的影响，探讨对照设置的依据。方法：文献检索包括PubMed和Embase在内的7个数据库，截至2025年4月23日，包括随机对照试验（rct），比较AT与无创伤假针灸（NISA）、浅表针灸（SA）和非针灸疗法（NAT）治疗成人PI的疗效。使用R（版本4.4.1）和Stata（版本15.1）进行统计分析。该方案已在国际前瞻性系统评价注册（CRD420251012912）注册。结果：本荟萃分析纳入33项随机对照试验，包括3004名受试者，其中大多数研究来自中国。结果显示，在治疗终点和4周后，与SA和NISA相比，at显著改善了主观睡眠质量（匹兹堡睡眠质量指数，PSQI），超过了最小临床重要差异（MCID: 2.5分）。具体来说，在终点，at vs SA （MD: -3.66; 95% CI: -4.48至-2.84）和at vs NISA （MD: -4.35; 95% CI: -5.67至-3）具有显著性，而SA、NISA和NAT之间的差异无统计学意义。从累积等级曲线下曲面（SUCRA）来看，AT排名第一（99.9%），其次是SA（47.8%）、NAT（31.9%）和NISA（20.4%）。在客观睡眠参数方面，AT、NISA和SA无显著差异。结论：AT可显著改善PI患者的主观睡眠质量，但对客观睡眠测量的影响有限。在设计针刺治疗PI的随机对照试验时，推荐采用NISA作为假针刺对照。然而，由于地理位置的限制，研究结果可能难以推广。未来的研究应侧重于监测客观睡眠参数，并开展涉及不同文化人群的国际多中心随机对照试验。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.