Efficacy and Safety of Electroacupuncture Combined with Agomelatine Tablets Therapy in Treating Insomnia After Stroke

Insomnia, a common complication following stroke, significantly impairs patients’ clinical outcomes. Electroacupuncture (EA), an advanced acupuncture technique, has demonstrated efficacy in alleviating insomnia symptoms. Agomelatine (AT), a melatonin receptor agonist, is widely utilized for depression management. This study aimed to evaluate the therapeutic effects of combined EA + AT therapy for post-stroke insomnia. A total of 120 stroke-related insomnia patients were randomly assigned to three intervention groups (n = 40 each): EA therapy, AT treatment, and EA + AT combination therapy. Sleep efficiency and cognitive function were comprehensively assessed using the Cardiopulmonary Coupling-based sleep quality evaluation system, Montreal Cognitive Assessment (MoCA), and National Institutes of Health Stroke Scale (NIHSS). The results revealed that all three interventions significantly enhanced sleep efficiency (EA: 78.23 ± 4.19; AT: 75, 5; EA + AT: 80.97 ± 4.21) and MoCA scores (EA: 24, 2; AT: 24, 2; EA + AT: 27, 2), with the combination therapy showing superior effectiveness. Similarly, NIHSS scores exhibited marked reduction across all treatment groups (EA: 6, 2; AT: 7, 2), particularly in the EA + AT combination cohort (EA + AT: 4, 3). Notably, post-treatment analysis revealed significant positive correlations between sleep efficiency and MoCA scores in all groups, with the strongest correlation observed in the AT group (r = 0.87). These findings demonstrate that EA + AT combination therapy outperforms monotherapies in treating post-stroke insomnia. In conclusion, this study establishes EA + AT as an effective intervention for improving both sleep quality and cognitive function in stroke-related insomnia patients, offering a promising therapeutic strategy for this clinical condition.