# Efficacy of acupuncture as an adjunctive therapy for perimenopausal insomnia: A systematic review and meta-analysis of randomized controlled trials

## TL;DR

Acupuncture helps improve sleep and quality of life in perimenopausal women when used alongside other treatments, and it is safer than medication.

## Contribution

This study provides the first systematic review and meta-analysis on acupuncture as an adjunctive therapy for perimenopausal insomnia.

## Key findings

- Acupuncture improved sleep quality and insomnia symptoms significantly compared to non-acupuncture treatments.
- Acupuncture had fewer adverse effects than medication and improved overall quality of life in perimenopausal women.
- The GV20 acupoint was most commonly used and individualized acupuncture schemes were effective.

## Abstract

•Acupuncture can enhance the clinical efficacy of PMI as an adjunctive therapy.•The GV20 acupoint is the most widely used in PMI treatment.•Acupuncture adjuvant treatment of PMI is safe and superior to medication.•Individualized scheme design is flexible and effective.

Acupuncture can enhance the clinical efficacy of PMI as an adjunctive therapy.

The GV20 acupoint is the most widely used in PMI treatment.

Acupuncture adjuvant treatment of PMI is safe and superior to medication.

Individualized scheme design is flexible and effective.

This investigation evaluates the efficacy of acupuncture used alongside conventional interventions for Perimenopausal Insomnia (PMI). The research aims to provide clinically relevant evidence, support individualized treatment planning, and improve sleep quality and overall well-being in perimenopausal women.

A systematic search was conducted up to December 2024, encompassing six major databases, including international (PubMed, Web of Science, Cochrane Library, Embase) and Chinese-language sources (CNKI, Wanfang). The search focused exclusively on Randomized Controlled Trials (RCTs) investigating acupuncture as an adjunctive treatment for PMI. To evaluate result stability and identify potential heterogeneity sources, the authors performed sensitivity and subgroup analyses utilizing Review Manager (v5.4) and Stata (v15.0).

The study included 32 RCTs involving 2,673 participants. Compared with control interventions, the use of adjunctive acupuncture was associated with significantly improved therapeutic effects (RR = 1.25, 95 % CI [1.20, 1.30]). The observation group receiving adjunctive acupuncture therapy demonstrated significant advantages over the non-acupuncture group in improving: Pittsburgh Sleep Quality Index (PSQI) (SMD = -1.00, 95 % CI [-1.21, -0.79]), Menopause-Specific Quality of Life (MENQOL) (SMD = -0.56, 95 % CI [-0.88, -0.23]), Traditional Chinese Medicine Syndrome Score Scale (TCMSSS) (SMD = -1.40, 95 % CI [-2.55, -0.24]), Adverse Drug Reactions (ADR) (RR = 0.35, 95 % CI [0.17, 0.71]), Epworth Sleepiness Scale (ESS) (SMD = -0.57, 95 % CI [-0.83, -0.31]), and Insomnia Severity Index (ISI) (SMD = -0.94, 95 % CI [-1.43, -0.46]).

Acupuncture as an adjunctive therapy enhances treatment outcomes for PMI, offering superior efficacy with minimal risks. Given the intrinsic limitations of the present study, additional investigations are necessary to substantiate these outcomes.

PROSPERO database (ID: CRD420251020144).