Acupuncture treatment for post-stroke insomnia: A systematic review and meta-analysis of randomized controlled trials

Objectives: The meta-analysis aimed to assess the effectiveness and safety of acupuncture for the treatment of post-stroke insomnia. Methods: Randomized controlled trials were identified from five databases before April 2020. The primary outcomes were the rate of improvement and the Pittsburgh sleep quality index (PSQI) scores; the secondary outcomes included the follow-up PSQI scores and safety. Results: Forty-one trials were included. Compared to drugs, the pooled results revealed that acupuncture had a higher rate of improvement in sleep (risk ratio: 1.21, 95% confidence interval [CI]: 1.17, 1.24) and a better PSQI score immediately and three months after treatment (weighted mean differences [WMD]: 3.23, 95%CI: 3.92, -2.54; and -6.18, 95%CI: 8.28, -4.07, respectively). Side effects were minor and rarely reported on acupuncture. Conclusion: The existing evidence suggests acupuncture may be more effective in treating post-stroke insomnia than drugs. It also appears to have a good safety profile and more long-term benefits.