Abstract
BACKGROUND: We aimed to conduct a systematic evaluation of the efficacy and safety of acupuncture and moxibustion in treating insomnia, and to provide evidence-based guidance for clinical practice. METHODS: A comprehensive literature search was performed using PubMed, CNKI, and other databases to identify randomized controlled trials (RCTs) and clinical controlled trials of acupuncture or moxibustion for the treatment of insomnia. The search was conducted up to May 2025. The articles were screened based on the inclusion and exclusion criteria and the quality of the literature was assessed using the Cochrane 5.1.0 bias risk assessment tool. Meta-analysis was conducted using Review Manager 5.4 software. RESULTS: A total of 1215 subjects were included in 25 relevant articles. Meta-analysis demonstrated that acupuncture or moxibustion significantly increased treatment effectiveness (odds ratio [OR] =4.94, 95% CI: 3.52-6.92, P<0.00001) while substantially reducing symptom scores: Pittsburgh Sleep Quality Index (weighted mean difference [WMD] =3.81, 95% CI: 2.95-4.66, P<0.00001), Self-rating Depression Scale (WMD=10.77, 95% CI: 5.43-16.11, P<0.00001), and Self-rating Anxiety Scale (WMD=8.25, 95% CI: 4.21-12.28, P<0.00001). The incidence of adverse reactions was relatively low. CONCLUSION: Acupuncture or moxibustion therapy demonstrates potential advantages in the treatment of insomnia and warrants further investigation in a clinical setting.